Friendship as a Key Outcome for People With Disabilities: The Critical Role of Communication

Friendship is one of the most enduring and meaningful parts of our lives. Think of the person you call in a moment of joy or when your world unravels—the one who knows your quirks, celebrates your victories, and sits with your pain. These relationships are not luxuries; they are essential. Decades of research confirm what we know intuitively: friendship is fundamental to human development and well-being. It shapes our cognitive, social, and emotional growth across the lifespan (Bagwell & Schmidt, 2011), and it acts as a buffer against loneliness, anxiety, depression, and even suicidal ideation (Asher et al., 1996; Hawkley & Cacioppo, 2010; Kwan et al., 2020; Vitaro et al., 2009). Yet for many disabled people especially those with communication-based needs, this essential aspect of life remains out of reach. Despite expressing a similar desire for meaningful friendships, people with disabilities face systemic and interpersonal barriers that increase their risk of social exclusion, peer rejection, and loneliness (Bossaert et al., 2012; Finke et al., 2019,2025). These difficulties often begin in childhood and persist into adulthood, with lasting impacts on self-esteem, emotional regulation, and life satisfaction (Hall-Lande et al., 2007; Heiman & Margalit, 1998; Rubin et al., 2011). A central reason for this disparity lies in the crucial role communication plays in forming and sustaining friendships. Communication is more than a set of skills—it is the conduit through which trust is built, connection is deepened, and relationships endure (Rossetti & Keenan, 2018). For individuals with communication disabilities, differences in pace, modality, and expression can present barriers to peer interaction, particularly in settings that are not designed with inclusivity in mind (Thirumanickam et al., 2011). Adult augmentative and alternative communication (AAC) users frequently name social exclusion as a significant concern and call for research that prioritizes their lived experiences and well-being (Rehabilitation Engineering Research Center on Augmentative and Alternative Communication [RERC on AAC], 2024). These challenges underscore a critical and often overlooked point, that effective communication is not an end in itself. It is a means to greater participation, connection, and belonging. Speech-language pathologists (SLPs), with their deep expertise in communication development and disorders, are uniquely positioned to support friendships as a clinical and ethical imperative. Clinically, supporting friendships enhances participation and quality of life. Ethically, it affirms the right to connection, dignity, and belonging, making friendship a core focus of neurodiversity-affirming clinical practice. Through direct intervention, consultation, and collaboration with families, teachers, and peers, SLPs have the capacity to reduce social barriers and create inclusive environments that foster authentic peer relationships (Kent-Walsh et al., 2015; McCormack et al., 2009; Therrien et al., 2023). Supporting friendship requires individualized, person-centered approaches that align with each person’s communication profile, social goals, and context. This might include selecting and customizing AAC systems, teaching interaction strategies to peers and caregivers, and embedding communication opportunities into natural settings (Light & McNaughton, 2013; O’Donoghue et al., 2021). When friendship becomes a core focus of communication support, we move closer to honoring the full humanity of those we serve. This special issue of Topics in Language Disorders responds to that call. It reimagines friendship not as a peripheral outcome, but as a central goal of speech and language intervention. Across the lifespan and communication modalities, the articles in this issue illuminate the complexity of friendships and urge us to build systems and practices that affirm reciprocity, joy, and belonging. The issue opens with an article presenting a framework for embedding friendship into AAC research and clinical practice (Finke et al., 2025). The authors critique models that undervalue emotional spontaneity and offer strategies rooted in the Participation Model to support deeper connection. This article articulates the reciprocal relationship between communication and friendship, emphasizing how communication enables the emotional disclosure, humor, and shared experiences that sustain friendships. It identifies how communication breakdowns—particularly those experienced by AAC users—impede relationship formation and maintenance across the lifespan. By exposing the mismatch between current AAC systems and the relational needs of friendship, this paper challenges clinicians to reassess traditional intervention goals. It encourages reflection on how well current practices support the depth, spontaneity, and co-construction required for genuine friendships and calls for greater intentionality in assessment and intervention planning. The next article (Kouvava et al., 2025) examines how cognitive flexibility, inhibition, and working memory shape peer relationships. This study highlights the invisible cognitive work of friendship and invites the field to consider integrated supports. The results of this study suggest that SLPs and educators may need to consider how executive function challenges contribute to social exclusion or reduced peer engagement. The article indirectly encourages practitioners to incorporate executive functioning support into friendship-focused interventions, especially for children with co-occurring communication and learning challenges and reinforces the broader message of this issue that friendship is both a developmental necessity and a clinical priority. In Werle et al. (2025), the authors highlight the lived experiences of children who stutter offering first-person advice about stuttering and friendship development. Participants shared both general and stuttering-specific strategies for initiating and sustaining peer relationships, shedding light on how communication identity, openness, and advocacy affect social belonging. Themes such as “stutter openly,” “authenticity,” and “confidence” exemplify how communication skills and self-perception shape friendship dynamics. The findings underscore both risks (e.g., teasing, exclusion) and protective factors (e.g., advocacy, kindness) relevant to friendship development. The study suggests SLPs can foster friendship opportunities by helping children increase self-perception as communicators and practice skills such as self-disclosure, resilience, and inclusive social behaviors. The next article (Edelman et al., 2025), provides a rich account of how communication shapes peer relationships in childhood. This paper demonstrates that peers who learned to interpret and engage with minimally speaking classmates through AAC experienced greater joint engagement and more reciprocal interactions. The findings reflect how early communication practices and inclusive attitudes lay the foundation for friendship development and invite clinicians to re-evaluate how their interventions may reinforce helper/helped dynamics. The study applies the Double Empathy Problem as a framework, emphasizing that interventions must not simply “teach” the autistic child to be social, but also support peers in becoming responsive, inclusive communication partners. We close the issue with the work of Strong and colleagues (2025), a poignant thematic analysis of adult friendships after aphasia. This study reflects on the enduring bonds that survive, and even deepen, amid communicative change, underscoring that the essence of friendship lies in shared meaning. It reveals how foundational communication skills, such as turn-taking, timing, and mutual understanding, are challenged post-aphasia, and how friends adapt by using new strategies to preserve the relational bond. The article identifies a critical barrier: friends often feel ill-equipped and uncertain about how to interact following the onset of aphasia, leading to distancing or loss of relationships. It also identifies clear opportunities for SLPs to intervene by providing education and training to friends, validating their emotional experiences, and designing interventions that involve the friend as a communication partner. Together, the articles in this special issue challenge us to ask what it would mean to prioritize friendship in every layer of our work. Across diverse populations and contexts, several crosscutting themes emerge: reciprocity as a core, though variably expressed, dimension of friendship; the essential role of multimodal communication, particularly in AAC, autism, and aphasia; and the transformative power of education and advocacy for peers, professionals, and broader systems. These themes compel us to reimagine the scope of speech-language pathology to include friendship as a meaningful, measurable, and attainable goal. This special issue offers the field of speech-language pathology a resource that invites reflection and lays the groundwork for new models of clinical practice, research, and collaboration. The papers included in this issue challenge clinicians, researchers, educators, and technology designers to treat friendship as a foundational outcome, and to work in partnership with disabled individuals to ensure all people, regardless of communication ability, have access to the friendships they desire. —Michelle Therrien, PhDSchool of Communication Science andDisorders, Florida State University,Tallahassee, Florida —Erinn H. Finke, PhD, CCC-SLPDepartment of Speech Pathology andAudiology, Calvin University, GrandRapids, Michigan