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Understanding the Double Empathy Theory of Autism

Updated: Jul 28, 2021

A recent study by the University of Texas looked at the role of non-autistic people in the social difficulties experienced by autistic people. They sought to alleviate some of these difficulties by educating the non-autistic people about autism with some success. This study added more evidence for the popular double empathy theory of autism, so what is the double empathy theory and where did it come from?

One of the earliest theories that attempts to pinpoint the unique difference seen in autism is the theory of mind. This theory was proposed by Baron-Cohen, Leslie and Firth in 1985. The gist of this theory is that autistic people struggle with social situations as they find it difficult to see things from somebody else’s perspective. They tested this theory using the ‘Sally Anne’ test. The Sally Anne test is used to find out whether an individual can predict the false beliefs of another person. In the scenario put to the children tested there were 2 dolls, one called Sally and one called Ann. Sally puts a marble in a basket and then goes for a walk. Whilst Sally is out of the room Anne moves the marble and puts it in a box. Sally then returns and wants to play with her marble, where will she look? The ‘correct’ answer that is expected is that Sally will look in the basket as she has the false belief that this is where the marble is as she did not see Anne move the marble to the box. When posed with this scenario 80% of autistic children predicted that Sally would look for the marble in the box. It was suggested that his demonstrated that the autistic children who failed this test did not have theory of mind as they were unable to see the scenario from Sally’s perspective and based their answer on what they knew about the location of the marble. As we can see 20% of autistic children did give the ‘correct’ response to this scenario and as such this theory was later adapted to propose that rather than lacking theory of mind autistic children are delayed in developing theory of mind. There are many critics to this theory and indeed many autistic people are deeply empathetic and feel the emotions of others more strongly than a typical person would. It could however be difficult to empathize and understand others when your experience of the world and your interests are different from others. In childhood when the understanding of emotions are in the early stages it will be challenging to empathize with other children whose experiences of the world are very different from your own. For example, a child who finds touch difficult to process may shy away from physical play with others and find it difficult to understand why other children may find this type of play enjoyable.

A more recent study looking at theory of mind and autism across different age groups suggested that there were difference in theory of mind within the autistic population but that autistic people were also more likely than the general population to experience alexithymia which is a difficultly in recognizing one’s own emotions. Approximately 50% of autistic people have alexithymia and it can be linked with sensory differences of interoception (our ability to interpret signals from our body organs including emotions) if we are unable to identify our own emotions it will be practically impossible to interpret the emotions of others and therefore demonstrate empathy. What this tells us is that autistic people with alexithymia might find it difficult to empathize with others but that autistic people without this difficulty can empathize just as well (and sometimes better) than non-autistic people. As with other sensory differences related to autism there will be some autistic people who present as under sensitive to emotions and yet others who present as overly sensitive to emotions. Those who present as overly sensitive to emotions will likely be highly empathetic but may also find it difficult to regulate their own emotions as they are felt so strongly.

In 2012 Dr Damian Milton put forward the double empathy theory which proposes that empathy difficulties between the autistic and non autistic populations is a two way street. This theory suggests that it is not just autistic people who can find it difficult to understand and relate to non-autistic people but also non-autistic people find it difficult to understand and relate to autistic people. This theory proposes that autistic people do not lack empathy or theory of mind but that they find it harder to empathize with non-autistic people who view the world differently to them. Just as importantly non autistic people also find it difficult to empathizes with autistic people due to these differing perspectives. We might consider that autistic people sometimes show much more empathy towards the non-autistic population than vice versa due to the effort they make to fit in and understand the non-autistic mindset. Catherine Crompton devised an experiment to test this theory using the telephone game. This popular childhood game involves passing a message down a line of people by whispering the message in the ear of your neighbor with the aim being for the last person in the line to be able to recall the message as closely to the original message as possible. Crompton set up 3 groups to play this game, one autistic, one non autistic and a mixed group consisting of autistic and non autistic people. She found that the message was passed with near equal clarity between the autistic and the non-autistic groups with the mixed group being the least successful at recalling the original message. She concluded that this demonstrates that both autistic and non autistic people find it easier to communicate with someone with the same status.

Many autistic people attempt to mask their autism to fit in a non-autistic world. This masking may contribute to the greater incident of depression and anxiety seen within the autistic population as they battle to hide their true self from others. It does seem it is time for the non-autistic population to step up and demonstrate greater empathy, understanding and respect for the autistic community without trying to change them, the benefits will be felt on both sides of the autism fence.

''Autists are the ultimate square pegs, and the problem with pounding a square peg into a round hole is not that the hammering is hard work. It's that you are destroying the peg.'' – Paul Collins

Study: Reducing Biases About Autism May Increase Social Inclusion - News Center - The University of Texas at Dallas (

Double empathy problem.pdf (

For people with alexithymia, emotions are a mystery | Spectrum | Autism Research News (

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