Empathy in autistic individuals is considered a complex topic studied within research on autism spectrum disorder (ASD).
In 1985, British researchers Simon Baron-Cohen and Uta Frith proposed the absence of theory of mind, defined as the inability of autistic individuals to understand the intentions and emotions of others, as a framework for understanding ASD symptoms. Later studies indicated that autistic people are not devoid of empathy, but that their empathy is often based on conscious cognitive processes and logical associations, with less emphasis on social acceptability, unlike the more automatic, socially driven processes observed in non-autistic individuals. Possible explanations have included the presence of alexithymia, differences in mirror neuron activity, variations in amygdala function, or an imbalance between heightened affective empathy and reduced cognitive empathy. In addition, recent studies have shown autistic people may empathize better with other autistic people.
Definition and description
According to , empathy is the "ability to see the world through someone else's eyes"As , notes, it is important to distinguish between empathy and sympathy, or compassion, because many people (including those with autism) who lack empathy can still show sympathy. and encompasses both cognitive and affective components. Cognitive empathy involves understanding another person's perspective, while affective empathy refers to experiencing an emotion in response to perceiving an emotional element. Three prerequisites are considered necessary for empathy: recognizing the expression of others' feelings, understanding their perspective (cognitive empathy or theory of mind), and reacting appropriately by sharing the same emotion (affective empathy). Researchers distinguish several forms of empathy based on the processes involved, including cognitive, emotional, and somatic empathy.
Autistic individuals often display emotional particularities that influence their social relationships. Qualitative differences in social interaction are a core feature of autism, as noted by British psychopathologist R. Peter Hobson (1993). Empathy is considered essential for effective social relationships, and several researchers have described autism as a "disorder of empathy" and social reciprocity, particularly in childhood autism. Autistic individuals are generally characterized as "having difficulty with empathy", facing challenges in both recognizing others' emotions and expressing their own, whether verbally or nonverbally. They may also struggle to identify their own emotions, particularly complex ones such as pride or embarrassment, and to interpret facial expressions. Empathy-related assessments in the Autism Spectrum Quotient (ASQ) are among the tools used in diagnosing autism.
Cognitive empathy overlaps with theory of mind, and the terms are often used interchangeably. However, due to the limited number of studies comparing different types of empathy in autistic individuals, it remains unclear whether they are equivalent.
The belief that autistic people entirely lack empathy is still common. British psychologist Tony Attwood has challenged this view, particularly in relation to Asperger's syndrome:
In Autism: Explaining the Enigma, British psychologist Uta Frith states that most autistic individuals have autonomous empathic reactions and "know not to appear indifferent to the pain experienced by others". Laboratory tests may not accurately measure their empathy, as performance in controlled settings is often better than in real-life situations. According to French psychoanalyst , the diversity within autism spectrum disorders (ASD)—which include individuals "profoundly deficient in intellectual capacities" as well as those "highly intelligent"—complicates assessment. Most research on empathy has been conducted with individuals "without associated intellectual disability".
The "lack of empathy" is also observed in individuals described as narcissistic or psychopathic (or "antisocial"), though its nature and causes appear to differ.
British psychiatrist Lorna Wing suggests that individuals with difficulties in empathy and social sensitivity form a group that is difficult to classify, with some regarded as disabled and others not.
Nature of autistic empathy Several specialists have reported examples of empathy in autistic individuals. Peter Vermeulen describes the case of a 12-year-old verbal autistic girl who, upon seeing a classmate crying, told her educator that the girl was making a "funny noise", indicating difficulty in understanding the meaning of sobbing and tears. He also notes that autistic people may display compassionate behavior when they can understand another person's feelings, often through personal experience. Uta Frith cites the example of an autistic individual who, after reading about a community suffering from hunger, felt empathy due to having personally experienced hunger.
Researchers have examined differences between the empathy of autistic and non-autistic individuals. The distinct form of empathy in autistic people is not considered a conscious choice to disregard others' emotions, but rather a set of particularities in automatic information processing. These include difficulty recognizing emotions and corresponding responses, different prioritization of information—often placing less emphasis on social cues—and slower processing of such information.
According to Vermeulen, behaviors in autistic children aimed at consoling or deliberately annoying others—sometimes observed as early as age two—indicate the early presence of a form of empathy. When placed in situations requiring empathy, autistic individuals often provide responses that are less socially oriented, relying on logic and concrete facts without considering potential discomfort. This may include discussing sensitive topics, such as death, or making candid remarks about another person's appearance, thereby breaking social politeness norms. Difficulties in empathy among autistic individuals appear to be linked to challenges in determining what is socially acceptable, with limited consideration of others' feelings, reactions, and perspectives. This also influences language use.
Peter Vermeulen concludes that most visible displays of empathy in autistic individuals are based on egocentrism, requiring personal experience of the other person's emotional situation or knowledge of it through books or television. They may have difficulty spontaneously showing empathy toward unfamiliar situations. Behaviors considered non-empathetic or socially unacceptable— even when repeated—rarely stem from an intent to annoy, harm, or manipulate, but rather from a lack of anticipation of their impact on others.
In 2018, a study on socialization among autistic individuals during video game sessions, involving 30 participants, concluded that intersubjectivity plays an important role, with autistic people exhibiting their own forms of socialization and empathy that are not considered pathological. According to French psychologist Jérôme Lichté, observed empathy deficits in autistic individuals may result from a response bias that uses neurotypical empathy and socialization as the standard. This view was reinforced by a 2020 "double empathy" study, which found that autistic children could recognize acts of kindness among themselves, while non-autistic children were unable to identify such acts in autistic children.
A Japanese study published in October 2014, involving 15 autistic individuals and a control group, suggested that empathy between autistic individuals may be greater than empathy from autistic individuals toward neurotypical individuals.
Contribution of moral sense
Psychiatric context In forensic psychiatry, which addresses crimes and offenses, autism has sometimes been mistakenly associated in public opinion with psychopathy or antisocial personality disorder. Due to the presumed lack of empathy, autistic individuals have been suspected of lacking moral sense. Research has since shown that autistic people possess moral sense and are concerned about the suffering of others.
The association between autism and psychopathy is rejected by many researchers and autistic individuals. Citing several studies, Peter Vermeulen states that, unlike psychopaths, autistic people care about others' emotions, are sensitive to death, and respect moral rules. While both may appear to lack empathy, the underlying reasons differ: psychopaths are indifferent to others' emotions, whereas autistic individuals may be unaware of social rules and appear socially clumsy. Uta Frith, citing studies by James Blair comparing the reactions of psychopaths and autistic people, notes that psychopathic children perform above average for their age in attributing mental states to others, unlike autistic children. She concludes that autism and psychopathy are "two different disorders".
Simon Baron-Cohen emphasizes the distinction between the empathy characteristics of autism and those of psychopathy. In Zero Degrees of Empathy: A New Theory of Human Cruelty, he differentiates between negative zero, associated with psychopathic personalities lacking moral sense, and positive zero, associated with people with autism spectrum disorder (ASD). According to him, positive zero is characterized by reduced empathy alongside a greater ability to recognize recurring patterns and to systemize, which supports access to moral sense.
Differences in mobilization and expression
According to philosopher Sarah Arnaud, autistic people generally possess moral qualities: "these particularities [in the functioning of empathy] in no way prevent them from being part of the moral community. Autistic people can be rigorous moral agents, meaning they show a certain intransigence and moral inflexibility." She notes that these qualities are based on "an overuse of deliberate, rule-based cognitive reasoning rather than automatic processes". Temple Grandin is cited as an example of someone who "voluntarily and with interest built a morality applicable to life in society" through a system of conduct rules. Many autistic individuals exhibit a strong sense of justice and fairness, often grounded in rule-based reasoning rather than emotional cues, which can explain the inflexible social rules they may follow. Uta Frith mentions philanthropist John Howard, a prison reformer retrospectively diagnosed with Asperger's syndrome, who intervened when witnessing injustice and was severely punished. British psychiatrist Digby Tantam observes that autistic people are often idealists who care deeply about cruelty worldwide, sometimes becoming visibly upset by accounts of mistreated people or animals. However, their strict adherence to rules can occasionally lead them to act in ways perceived as cruel to avoid disobedience.
Theory of mind has a direct influence on self-awareness. According to Uta Frith and Francesca Happé, individuals diagnosed with Asperger's syndrome may have a form of self-awareness that differs from that of non-autistic individuals, relying more on intelligence and experience than on intuition. This type of self-awareness is described as being closer to that of a philosopher. Tony Attwood supports this perspective and cites autobiographies with qualities he characterizes as "almost philosophical". A study by Simon Baron-Cohen suggests that differences in empathy influence self-awareness, as the two domains are interconnected.
History