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Matthew rarely was invited to birthday parties or play groups as a young child. On the few occasions he was included, his mother said a prayer and "hoped nothing bad would happen," she recalls.

"Crowds overwhelmed him. The noise, the games and toys were too much, and sometimes he'd run to another room and hide. What made social situations even harder was that he struggled with impulse control. And he gets locked on ideas. He was perceived as the different one," says Cat of her now 14-year-old son, who has autism. (Cat and Matthew are identified by their first names only, to protect their privacy.)

Though he desperately wanted to make friends, it was difficult for Matthew, just as it is for many kids with communication barriers and other challenges that make bonding hard.

Many of these kids don't know how to begin to make friends. Some can reach out initially, but the friendship quickly fades because they lack the social and communication skills required to navigate and maintain relationships, says Lessie Kauzlarich, program coordinator for the Oakmont secondary program at Frost School in Rockville, Maryland, a day school for students with autism.

"They don't understand why the car went off the road," she says. "They keep trying the same things that haven't worked and, without help, they often eventually give up," she says. Kauzlarich has seen students with autism grow and form healthy bonds, but it takes a lot of practice, especially in expressing themselves and learning what is considered appropriate behavior.

To be successful, they need to begin exercising their social and emotional muscles early, and in different settings, with children who have similar issues, and with those who do not. There are plenty of opportunities to gain experience in special programs designed for them, such as autism group meetups where they may engage with people their age who have similar needs. But finding the right social circles with "typically developing" kids can be hard. Cat and Matthew have worked at it for years, trying to find the best fit.

Children who do well get a lot of practice in generalizing skills in different scenarios, which they can then apply to other situations.

"We've done video modeling where we record students and then they watch themselves engaging in positive social interaction, which is powerful and reinforcing," Kauzlarich says.

They are also guided by therapists in resolving problems they may have in their social interactions. This is done in a comfortable and confidential setting.

"For instance, we had two students who wanted to be friends but were driving each other crazy. Their joking can sound mean. When it came to a head, our therapist sat them down and had both say what they felt about the other person. So they get perspective, learn conversation skills and conflict resolution. And they do it in a safe environment where they can say what they feel," Kauzlarich says.

Another key to establishing successful relationships is to find the right match. Parent and child should talk about activities of interest and cast a wide net, trying many opportunities with kids with similar interests, says Kristen Kalymon, a psychologist at Kennedy Krieger Institute's Pediatric Developmental Disorders Clinic.

"I had a kid who, after trying a lot of activities, got involved in adaptive ball with kids with physical disabilities, though he did not have a physical disability himself. He ended up loving it . there was not as much pressure ⅛to perform⅜, and he found common ground," Kalymon says.

Programs that include typically developing kids alongside those with special needs can have benefits. For instance, they can help children with disabilities learn to interact with people in situations outside a closed community.

But finding good opportunities for friendship can take persistence. Matthew went to an open gym in sixth grade where he gravitated to younger kids.

"He didn't see them just as little kids, but someone to play with, and he loves being helpful. He would jump in to help them, say walk on the balance beam. But you could see in the faces of some parents that they were thinking, what is this 11-year-old's deal? Some of them would call their kids away," remembers Cat.

She tried something new that would still allow Matthew to engage with his neurotypical peers. She enrolled him in a class with youth his age. But, first, she got to know the instructor. He had to be someone positive and gentle when correcting. And she made sure he understood Matthew's triggers.

Cat gets to know the parents of her son's friends too.

"You want a parent that is attentive and willing to monitor. You don't let kids totally disappear without listening for something they may not be able to negotiate themselves. In a stalemate a parent has to step in," she says.

Using something they are interested in to build a relationship around can help kids with autism form connections, as well. If your child is passionate about space travel you might help him learn to talk about rockets and explain what he knows to someone else, suggests Elizabeth Crais, a professor in the division of speech and hearing sciences at the University of North Carolina, Chapel Hill. In time, they may be comfortable talking about it in a group during circle time.

She encourages parents to help with whatever does not come natural. For younger kids, especially, it could be showing them which words to use, how to combine them and when to use them. For teens, Crais suggests helping them ask questions, but not too many.

"If they ask a flood of questions and don't get a response, teach them to stop," she says. "They may not always understand why this is appropriate, but through practice and reward they learn new, positive behaviors."

Cat's son has come out of his shell, but it's an ongoing process. He has made a close friend, someone he Skypes with and plays laser tag with on weekends. And she has found Teens Like Us, a program that pairs atypical adolescents with typically developing peer volunteers. Matthew is not judged as he engages with kids like himself and with teen role models at the community pool or a matinee.

His weekends are full, between this special club, Friday nights at a trampoline park and volunteering at Sunday school.

"The younger kids at church really like him," Cat says. "They high-five him and compete for his attention at playtime. And at the park, he's like the man on campus. He's a regular there. He knows the rules by now and speaks up if someone does something that bothers him. He can be more like a 14-year-old."

Her advice to parents of kids with similar issues: "Find what they can do that makes them happy.