Impact of Choice on Social Outcomes of Adults with ASD.

The team asked the adults with autism and the adults with other developmental delays to fill out two short surveys. One survey measured Social Determination—how much they feel they can pick their own friends and leisure. The other counted current friendships.

All participants lived in group homes or supported apartments in the same state. The researchers then used statistics to see if low scores on the surveys predicted less real-world social participation.

Adults with autism scored 18 points lower on Social Determination and had half as many friendships as adults with other delays. The math model showed these two gaps explained most of their lower social participation.

In plain words, feeling you have no choice in friends plus having no friends equals staying home.

Siklos et al. (2006) saw the warning sign early: parents of autistic children already asked for more respite and peer info. Their needs survey is the parent view; Doughty et al. (2015) is the same child, now grown, still lacking friends.

Titlestad et al. (2019) asked college students with autism what helps. The students wanted one-to-one mentors and social coaches—exactly the supports the adults in H et al. never got.

Zakai-Mashiach (2023) lets autistic graduates describe special-ed rooms as "golden cages." The low friendship numbers in H et al. quantify the cage that Mati’s participants felt. Together the three papers trace a straight line: childhood isolation → adult loneliness.

If your client is an adult with autism, add Social Determination and friendship count to your intake. Ask, "Who do you hang out with by choice?" and "How did you pick them?" Low scores here signal you need to program for peer identification, not just social skills. Start small: one chosen leisure buddy, not a party.