Development of a Conceptual Model of Loneliness in Verbal Autistic Adults Using Qualitative Content Analyses.
Ask verbal autistic adults about social exhaustion and feeling different—these two items capture loneliness that standard scales miss.
01Research in Context
What this study did
Hillary et al. (2025) talked with verbal autistic adults about feeling lonely.
They read every interview line-by-line and grouped similar ideas.
The goal was to build a new picture of what loneliness really means for this group.
What they found
Two new themes popped out that old checklists miss.
Social exhaustion—feeling worn out from people—mattered as much as missing people.
Feeling different, not just isolated, also drove loneliness.
How this fits with other research
Kovačič et al. (2020) showed autistic adults can report their own mind skills just fine.
Hillary’s team used that same trust in self-report to find hidden parts of loneliness.
Adams et al. (2021) linked poor social skill to trouble naming emotions in autistic kids.
Hillary shifts the lens: for adults, the hurt comes from feeling unlike others, not only from skill gaps.
Why it matters
Next time you assess social health, add two quick questions. Ask, “Do people tire you out?” and “Do you feel different from peers?” These items capture adult autistic loneliness better than standard scales. You can add them to intake forms today—no extra training needed.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add two open questions to your intake: “Does socializing tire you?” and “Do you feel different from others?”
02At a glance
03Original abstract
PURPOSE: Loneliness has serious consequences for physical and mental health. Therefore, the high vulnerability of autistic adults to loneliness is concerning (Hymas et al., in: Rev J Autism Dev Disord., 2022. https://doi.org/10.1007/s40489-022-00330-w ). However, foundational questions regarding the operationalization and importance of loneliness to the autistic community remain largely unanswered, and thus were the aims of the current study. METHODS: Procedures followed initial steps of the PROMIS (Patient-Reported Outcomes Measurement Information System) guidelines. A preliminary conceptual model of loneliness was developed based on literature in the general population and presented to focus groups and individual interviews involving 13 autistic adults and 5 autism professionals. Transcripts were analyzed using qualitative content analysis. RESULTS: Participants indicated that research on loneliness in autistic adults was worthwhile because of the commonality, significant negative impact, need to challenge misconceptions, and identify prevention/intervention strategies. Revisions to an initially proposed conceptual model of loneliness in autism included clarifications (e.g., satisfaction with vs. presence of relationships), modifications (e.g., frequency vs. availability of contact), and additions (e.g., social exhaustion, feelings of difference, and animals). CONCLUSION: Our proposed conceptual model of loneliness in autism identifies key nuances and concepts overlooked by models and measures of loneliness developed for non-autistic populations. These findings underscore the need to improve methods for assessing loneliness among autistic adults.
Journal of autism and developmental disorders, 2025 · doi:10.1111/pere.12397