Do People with Autism Lack Sympathy and Empathy?

How Autism May Affect Sympathy and Empathy

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Empathy is the ability to feel along with others. Sympathy is the ability to feel for others. People with autism spectrum disorder may appear to be both unempathetic and unsympathetic. They may laugh when someone is injured, or respond with little or no emotion to another person's grief or joy. Does this lack of appropriate response mean that people with autism feel neither empathy or sympathy?

What Research Says About Empathy, Sympathy, and Autism

Quite a bit of research has gone into the question of whether people with autism truly empathize with others.

As a result, we know quite a bit about what stands in the way of empathy; whether empathy can be taught; and whether apparent lack of empathy really reflects a lack emotional connectedness.

The skill of "mind-reading" -- understanding another's thoughts through careful observation of body language, vocal tone, facial expression, etc. -- is key to empathy. People with autism often have a very difficult time with "mind reading," though it's clear that the skills can be taught.

While Simon Baron-Cohen chalks up lack of mind reading skills to an "extreme male" brain which focuses on systems rather than on relationships, Dr. Uta Frith notes that "failure of bonding or attachment does not appear to be a distinguishing characteristic of autism in early childhood." A related study by Jones et al which compares psychopathic to autistic children finds "the affective/ information processing correlates of psychopathic tendencies and ASD are quite different.

Psychopathic tendencies are associated with difficulties in resonating with other people's distress, whereas ASD is characterised by difficulties in knowing what other people think."

While Frith, Jones, and others suggest that apparent lack of empathy in people with autism is the result of difficulties in verbal and non-verbal communication, though, other studies suggest physical differences in the brain might account for lack of empathy.

In addition, says one recent study, "Subjects with ASD may use an atypical cognitive strategy to gain access to their own emotional state in response to other people's emotions."

Why People with Autism May Seem Unsympathetic or Unempathetic

Most typically developing people learn appropriate body language and words to express sympathy and empathy by watching and imitating parents and other people. A typically developing four-year-old, for example, might recognize an expression of pain because she has seen it before, either in person or on TV. Similarly, she might "kiss a boo-boo" because she's seen someone else do the same thing.

People with autism, however, lack the social skills associated with observing and interpreting body language. They are also less likely to imitate others spontaneously. Thus, a lack of expressed sympathy or empathy may be the result of a lack of skills rather than a lack of feeling. That's because many of the skills required to understand and respond to others' emotions are precisely the skills that are most likely to be compromised in autism. For example:

  • To empathize with another person, one must recognize the other person's feelings. People with autism have difficulties with "reading" others' faces and body language, and may not fully understand their spoken words.
  • To empathize with another person, one must share the other person's hopes, dreams and/or expectations. People with autism may not, for example, share an intense desire for romantic involvement, ambition to rise up in an organization, or fear of embarrassment.
  • To empathize with another person, one must have the cognitive and emotional experience to relate personally to another's feelings. People with autism may have cognitive challenges -- or they may simply lack the experience necessary to empathize -- even if they are quite capable of sympathizing.
  • To empathize with another person, one must not only feel with that person but also have the tools to show or tell about one's empathic feelings. People with autism may not show or tell about their feelings in ways that are clearly understood by others.
  • To empathize with another person, one must share a cultural understanding that displays of empathy are expected and desired. People with autism may not pick up on cultural cues, and thus may not express empathic feelings even when they are felt.

The Bottom Line

Bottom line: While many people with autism may appear to lack empathy, the reasons may relate more to social communications deficits than to lack of underlying emotional response. On the other hand, there may, in fact, be physical differences that make it harder for people with autism to empathize - and show empathy - in a typical manner.

Sources:

Baron-Cohen, S.. "Sex differences in the brain: implications for explaining autism." Science. 2005 Nov 4;310(5749):819-23.

Frith, U. "Review: Mind Blindness and the Brain in Autism." Neuron, Vol. 32, 969–979, December 20, 2001, Copyright 2001 by Cell Press.

Jones, et al. "Feeling, caring, knowing: different types of empathy deficit in boys with psychopathic tendencies and autism spectrum disorder." J Child Psychol Psychiatry. 2010 Nov;51(11):1188-97.

Schrandt et al. "Teaching empathy skills to children with autism". J Appl Behav Anal. 2009 Spring;42(1):17-32.

 Schulte-Rüther et al. "Dysfunctions in brain networks supporting empathy: an fMRI study in adults with autism spectrum disorders." Soc Neurosci. 2011 Feb;6(1):1-21. Epub 2010 Oct 13.

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