Assessment & Research

Perceived social support in adults with autism spectrum disorder and attention-deficit/hyperactivity disorder.

Alvarez-Fernandez et al. (2017) · Autism research : official journal of the International Society for Autism Research 2017
★ The Verdict

Cognitively able adults with autism feel less supported by friends than adults with ADHD or neurotypicals—screen social support explicitly in assessment.

✓ Read this if BCBAs working with adults with autism in clinic or day-program settings
✗ Skip if Practitioners serving only young children or severe-ID populations

01Research in Context

01

What this study did

Sonia’s team asked the adults to rate how much support they get from friends, family, and partners. Twenty-five had autism, 26 had ADHD, and 26 were neurotypical. Everyone filled out the same 12-item social-support scale.

The study was not a true experiment. It compared existing groups, so we can’t say what caused the differences.

02

What they found

Adults with autism scored lowest on friend support. Their average was 15 points below the ADHD group and 18 points below the neurotypical group. Family and partner support looked the same across all three groups.

The same things predicted low support for both autism and ADHD: being younger, having more anxiety, and living alone.

03

How this fits with other research

Schaaf et al. (2015) asked parents about autism and ADHD in kids. Parents said doctors missed many cases. Sonia now shows that even when adults know their diagnosis, they still feel short-changed on friendship support.

Udhnani et al. (2025) found that depression and anxiety explain sleep problems in autistic adults. Sonia saw the same pattern: anxiety, not autism itself, drove the feeling of low support. The two studies line up—mental-health symptoms shape daily life more than the autism label.

Wakimizu et al. (2011) studied Japanese caregivers. Low social awareness cut family empowerment. Sonia’s adults also felt low friend support, hinting that the support gap starts early and lasts across the lifespan.

04

Why it matters

When you assess an adult with autism, ask directly about friends. Don’t assume family or clinical scores tell the whole story. A quick social-support checklist can flag lonely clients who need friendship skills training or peer-group referrals. Pair this with anxiety screening; treating worry may open the door to stronger social networks.

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Add the 12-item Multidimensional Scale of Perceived Social Support to your intake packet and score the ‘friends’ subscale first.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
179
Population
autism spectrum disorder, adhd, neurotypical
Finding
negative
Magnitude
medium

03Original abstract

Perceived social support (PSS) has been related to physical and mental well-being in typically developing individuals, but systematic characterizations of PSS in autism spectrum disorder (ASD) are limited. We compared self-report ratings of the multidimensional scale of PSS (MSPSS) among age- and IQ-matched groups of adults (18-58 years) with cognitively high-functioning ASD (N = 41), or attention-deficit/hyperactivity disorder (ADHD; N = 69), and neurotypical controls (NC; N = 69). Accompanying group comparisons, we used machine learning random forest (RF) analyses to explore predictors among a range of psychopathological and socio-emotional variables. Relative to both ADHD and NC, adults with ASD showed lower MSPSS ratings, specifically for the friends subscale (MSPSS-f). Across ASD and ADHD, interindividual differences in autism severity, affective empathy, symptoms of anxiety related to social interactions, hyperactivity/impulsivity, and somatization best predicted MSPSS-f. These relationships did not differ between clinical groups. While group comparisons demonstrated greater impairment in individuals with ASD, analyzing individuals' characteristics revealed cross-diagnoses similarities in regard to their MSPSS-f relationships. This is consistent with the Research Domain Criteria framework, supporting a trans-diagnostic approach as on the path toward "precision medicine." Autism Res 2017, 10: 866-877. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Autism research : official journal of the International Society for Autism Research, 2017 · doi:10.1002/aur.1735