How does autism impact flexibility in friendship routines?

PostedDecember 22, 2025

UpdatedDecember 22, 2025

ByMy Patient Advice

Author: Beatrice Holloway, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Many autistic people prefer predictability, consistency, and familiar routines, not only in daily life, but also in friendships. These preferences can make sudden changes in social plans, communication patterns, or friendship rituals more stressful to manage. According to the National Autistic Society, this is linked to neurological differences in flexibility, sensory regulation, and tolerance for uncertainty.

Why predictability matters in friendships

Many autistic individuals rely on structure and repetition to reduce anxiety and maintain emotional balance. As Rainbow ABA Therapy explains, routines help create safety and predictability in social relationships. When these change unexpectedly, such as cancelled plans or shifts in communication, it can cause distress or confusion.

Cognitive flexibility differences can make it harder to adjust quickly to new situations or expectations. The NICE autism guidelines (CG142 and CG170) emphasise that change can be experienced as a loss of control, and autistic people may need extra time, information, and reassurance to adapt.

The role of sensory and emotional regulation

Sensory sensitivities often make social unpredictability like noise, last-minute gatherings, or unfamiliar environments overwhelming. This can contribute to social fatigue or avoidance. Emotional regulation differences can also make change more intense: the Riverside School’s 2024 guidance notes that strong feelings may surface when routines are disrupted, and recovery may take longer than expected.

Autistic adults and young people often use routines as anchors of stability: a way to manage both internal and external unpredictability.

Supporting flexibility in social life

The National Autistic Society’s SPELL framework and NICE guidelines recommend:

Clear communication and preparation for any social changes.

Visual schedules or countdowns to help process transitions gradually.

‘Plan B’ or ‘Plan C’ scenarios, so changes feel structured rather than sudden.

Collaborative decision-making, allowing the autistic person to feel in control of adjustments.

These approaches support emotional safety while gently building flexibility over time.

What research shows

A 2023 study in Frontiers in Psychology found that structured, predictable support, not enforced spontaneity, leads to better wellbeing and social participation for autistic people. Predictability helps preserve confidence and engagement, while respecting individual preferences.

Importantly, flexibility can develop gradually when autistic people feel secure, supported, and heard.

A reassuring takeaway

Autistic people often value deep, reliable friendships built on trust and understanding. Supporting predictability and offering time to adjust to change isn’t limiting; it’s empowering. As NHS and NICE guidance underlines, structure provides the foundation from which flexibility can grow.

Beatrice Holloway, MSc

Author

Beatrice Holloway is a clinical psychologist with a Master’s in Clinical Psychology and a BS in Applied Psychology. She specialises in CBT, psychological testing, and applied behaviour therapy, working with children with autism spectrum disorder (ASD), developmental delays, and learning disabilities, as well as adults with bipolar disorder, schizophrenia, anxiety, OCD, and substance use disorders. Holloway creates personalised treatment plans to support emotional regulation, social skills, and academic progress in children, and delivers evidence-based therapy to improve mental health and well-being across all ages.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.