A Systematic Review of Loneliness Prevalence and Risk Factors in Autistic Children and Adolescents

Emerging research suggests that autistic people frequently experience loneliness. Young autisticpeople may be particularly vulnerable due to the generally higher prevalence of loneliness inyouth. This systematic review assessed the prevalence of loneliness among autistic children andadolescents, and identified factors associated with heightened loneliness. PsycINFO, PubMed,and Web of Science were searched in November 2023, identifying 15 studies (N = 1661; 601autistic, 1060 non-autistic). The Mixed-Methods Appraisal Tool was used to assess study quality,and a narrative synthesis was employed to summarise the state of evidence regarding lonelinessprevalence, friendship quality, and social competence. Findings suggest autistic youth arelonelier, with adolescents being particularly aSected. Autistic children and adolescents reportedhaving fewer friends and experienced friendship quality as lower. Further, ratings from parentsand teachers indicated lower social competence among autistic children and adolescents,which may contribute to loneliness. Methodological heterogeneity, such as the measurementsused to assess autism diagnosis and loneliness, limits generalisability. Implications for practiceand future research are discussed.