"Autistic people don't have empathy." It's one of the most widely repeated claims about autism — and one of the most consistently misrepresented by the research that has accumulated since it was first proposed.

The direct answer: Autism and empathy have a genuinely complex relationship that the current research does not reduce to "deficit." Studies published in 2024 show that autistic individuals demonstrate significant heterogeneity in empathy — some show reduced cognitive empathy (understanding others' mental states) but intact or even elevated affective empathy (sharing others' emotional experiences). A growing body of work on the "double empathy problem" documents that the empathy gap runs in both directions: non-autistic people also struggle to accurately read and understand autistic emotional experiences. The picture is not "autistic people lack empathy." It's "empathy between autistic and non-autistic people is a two-sided challenge."

This matters for parents because it changes what support looks like — and because framing an autistic child as "lacking empathy" can damage self-concept and relationships in ways that accurate framing doesn't.

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What Empathy Actually Is — Two Components Worth Separating

Empathy is not a single thing. Research consistently distinguishes two components:

Cognitive empathy — the ability to understand and reason about another person's mental state: what they're thinking, what they know, what they're likely to feel. This is closely related to what researchers call Theory of Mind (ToM). It's largely intellectual — inferring mental states from available information.

Affective empathy — the capacity to feel or share another person's emotional experience. This is more automatic and less cognitively mediated — feeling distressed when someone else is in distress, or experiencing joy alongside someone who is celebrating.

Most early research on autism and empathy focused heavily on cognitive empathy, particularly Theory of Mind tasks. That research showed consistent differences. But the picture for affective empathy is more complicated — and the most recent studies suggest the relationship between autism and empathy depends substantially on which component you're measuring.

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What the 2024 Research Actually Shows

The last two years have produced several important studies that update the older, deficit-dominated picture.

Cognitive and Affective Empathy Are Not the Same in Autism

A 2024 study by Kimmig and colleagues, published in Scientific Reports, examined empathy in 34 autistic adults versus 33 matched controls using a validated measure designed to assess both cognitive and affective empathy. The study found that autistic participants showed lower cognitive and affective empathy compared to controls — but importantly, the differences in affective empathy were mediated by alterations in emotional reactivity rather than a direct inability to feel empathy. In other words, how strongly someone is emotionally activated by a situation affects how much they share in it — and that mechanism, not a simple empathy "absence," explains much of what researchers observe. 

Empathy in Autism Is Highly Heterogeneous

A 2024 study by Brett and colleagues in the Journal of Autism and Developmental Disorders, using a newly validated empathy scale applied to both autistic and non-autistic adults, found that while autistic individuals on average reported lower cognitive and affective empathy, there was significantly greater heterogeneity within the autistic sample than within the non-autistic sample. The authors proposed an "empathy heterogeneity hypothesis of autism" — the idea that autism is associated with a wider range of empathy profiles, not a uniform deficit. Some autistic individuals showed fully typical or above-typical empathy; others showed reduced empathy; many fell somewhere in between. The mean difference does not describe the individual well. 

Some Autistic Children Show Emotional Overarousal, Not Absence of Empathy

A 2024 study by Li and colleagues, published in Autism, examined empathic responses in 25 autistic children aged 5 to 8, specifically in response to others' physical pain. Rather than finding reduced emotional response, the study found evidence of emotional overarousal in response to others' distress — the autistic children showed heightened physiological and affective responses, not reduced ones. The challenge appeared not in feeling empathy but in regulating the emotional activation that resulted.

This finding aligns with accounts from autistic adults, many of whom describe themselves as highly empathic — sometimes overwhelmingly so — while struggling to express that empathy in ways others can recognize.

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The Double Empathy Problem: A Different Way of Understanding the Gap

The most significant shift in current autism empathy research is the widespread uptake of the double empathy problem, originally proposed by autistic researcher Damian Milton. The theory holds that the social communication difficulties observed in autism are not simply a deficit within the autistic person — they reflect a mutual misunderstanding between autistic and non-autistic people.

In a landmark 2021 study by Crompton and colleagues (published in Autism), autistic and non-autistic participants were paired in conversations and rated by independent observers. Conversations between two autistic people were rated as equally smooth and enjoyable as conversations between two non-autistic people. Conversations between an autistic person and a non-autistic person were rated as significantly more awkward — by both parties. The awkwardness was not located in the autistic participant alone.

A 2024 study by Cheang and colleagues specifically tested whether non-autistic people could accurately imagine and share autistic emotional experiences. The study found that non-autistic individuals showed limited empathic accuracy toward autistic participants — mirroring what is typically described as an autistic deficit in the reverse direction. 

What this means practically: When an autistic child struggles to understand how a classmate is feeling, and when that classmate struggles equally to understand the autistic child, framing only the autistic child as the one with the empathy problem is inaccurate. Both parties face a cross-neurotype understanding gap. This reframe doesn't eliminate the challenges — it correctly places them.

📌 Seeing social communication challenges in your child? Understanding the current research on autism and empathy is one thing. Building the specific social communication skills that help your child connect with peers in their daily environment is another. Apex ABA's BCBAs develop individualized programs targeting social communication, perspective-taking practice, and emotion identification — for children ages 2–12 in North Carolina, Georgia, and Maryland. Talk to an Apex BCBA about social communication support →

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Alexithymia: The Confound That Changes Everything

One of the most important variables in the autism-empathy research is alexithymia — difficulty identifying and describing one's own emotional states. It's less discussed than Theory of Mind but arguably more important for understanding what families actually observe.

Alexithymia occurs in roughly 50% of autistic individuals compared to approximately 10% in the general population. This high co-occurrence rate is documented in a systematic review by Kinnaird and colleagues, published in Molecular Autism (2019), which synthesized prevalence data across multiple studies.

The critical question is whether the empathy differences observed in autism are caused by autism itself or by co-occurring alexithymia. A landmark study by Bird and Cook, published in Translational Psychiatry (2013), proposed the "alexithymia hypothesis" — that many of the emotional and empathic difficulties attributed to autism are actually driven by alexithymia. When controlling for alexithymia, the study found that autism alone did not predict reduced empathic brain responses to others' pain; alexithymia did.

Research since then has been more nuanced. Shah et al. (2019) in JADD found that autistic traits were a stronger predictor of empathy than alexithymia alone — suggesting both are relevant, with autism independently contributing beyond the alexithymia overlap. But the core implication holds: a significant portion of what parents observe as "reduced empathy" may be attributable to the child's difficulty identifying their own emotional states, not to an absence of caring about others.

This matters practically. A child who struggles with empathy primarily because they can't identify what they're feeling — and therefore can't recognize similar feelings in others — responds very differently to intervention than a child who genuinely doesn't engage with others' emotional states. Explicit emotion vocabulary building, interoception work, and body-signal awareness are the specific tools that address the alexithymia piece.

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What Actually Challenges Autistic Children Around Empathy

Grounding the discussion in specific documented challenges — rather than a sweeping "empathy deficit" — helps identify what support looks like.

Reading nonverbal emotional cues. Autistic children consistently show greater difficulty inferring emotional states from facial expressions, tone of voice, and body language. This isn't absence of caring; it's a difference in how emotional information is processed. Many autistic individuals compensate consciously — systematically analyzing cues that others process automatically. This works, but it's effortful and sometimes slow.

Theory of Mind. Understanding that other people hold different knowledge, beliefs, and perspectives than oneself develops later in many autistic children and may require more explicit scaffolding. This is specifically cognitive empathy — it doesn't automatically reflect on affective capacity.

Emotion regulation interfering with empathic response. When a child is already overwhelmed — by sensory input, an unexpected change, accumulated anxiety — their capacity to attend to and respond to others' emotional states is diminished. This looks like reduced empathy in the moment but reflects regulatory capacity, not empathic ability.

Expressing empathy in recognizable ways. Many autistic people report feeling genuine empathy but expressing it in ways that neurotypical people don't recognize as empathic — providing practical help rather than verbal comfort, for example, or going silent rather than offering reassurance. The empathy is present; the expression doesn't match expectations.

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How ABA-Based Social Communication Programs Help

Modern ABA approaches to social communication and perspective-taking work from the current evidence base — not the deficit narrative. The goal is to build skills and expand the child's available repertoire, not to make the child perform emotions they don't feel.

What a social communication ABA program typically includes:

Explicit emotion identification teaching. Naming emotions in pictures, in stories, in direct interaction — building the vocabulary and recognition skills that allow a child to understand what others are experiencing. This directly addresses the emotion-reading challenge without requiring the child to feel differently.

Perspective-taking practice in structured contexts. Graduated practice understanding what another person knows, wants, or is likely to feel — starting with clear, unambiguous scenarios and moving toward more nuanced ones. This is scaffolded learning, not performance expectation.

Body-signal awareness for the child's own emotional states. Supporting the child in recognizing their own emotions before trying to extend that recognition outward. This is the alexithymia piece — and it's foundational. A child who can identify "I'm starting to feel upset" is much better positioned to extend that recognition to others.

Social story work. Short, personalized narratives that walk through social situations from multiple perspectives — what the other person might be feeling, why someone might act the way they did, what the child could do in response. These build the cognitive scaffolding that supports empathic interaction.

Natural environment practice. Skills practiced in structured sessions generalize when they're also practiced in the child's actual social environments — at home, at school, with siblings and peers. BCBAs work with families on how to support these skills in everyday interactions.

Modern ABA does not aim to make autistic children pretend to be neurotypical. It builds the specific skills — emotion identification, perspective-taking, communication — that allow autistic children to connect with others on their own terms, with their own genuine capacity for empathy recognized and built upon.

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A Real Example: What This Looks Like in Practice

An 8-year-old autistic child consistently responded to classmates' distress by walking away or changing the subject. Teachers and peers interpreted this as indifference. His parents knew he would cry watching a sad movie — but couldn't explain the disconnect.

An ABA assessment revealed two things: the child had significant alexithymia (difficulty identifying his own emotional states in real time), and he'd learned from experience that staying near an upset peer often escalated his own distress in ways he couldn't manage. He wasn't indifferent — he was overwhelmed and retreating.

The ABA program addressed this through three tracks: emotion vocabulary building (identifying his own feelings with words, at low intensity, during calm moments); body-signal awareness (learning to recognize early signs of empathic overwhelm before they became unmanageable); and explicit, rehearsed responses to peer distress (a small set of appropriate things to say or do, practiced until they were automatic and low-effort).

Within twelve weeks, the child was making consistent eye contact with distressed peers and using two or three reliable comfort responses. His empathic capacity hadn't changed — his ability to access and express it had.

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Conclusion: Empathy in Autism Is Real, Heterogeneous, and Buildable

Autism and empathy don't fit the "no empathy" narrative that many parents have encountered. The current research, including major 2024 studies, documents a more nuanced picture: some autistic individuals show reduced cognitive empathy, many show intact or elevated affective empathy, a significant proportion experience empathic overarousal rather than absence, and the empathy gap between autistic and non-autistic people runs in both directions.

What this means for your child: empathy differences in autism are real, specific, and addressable — but the address looks different from "fix the deficit." It looks like building emotion vocabulary, supporting self-awareness, scaffolding perspective-taking, and expanding the child's repertoire of ways to express the care they genuinely feel.

Apex ABA's BCBA team in North Carolina, Georgia, and Maryland builds individualized social communication programs grounded in current research — not outdated narratives. Most families start within 2–4 weeks of intake, and we verify insurance benefits upfront.

Social communication skills are teachable. Find out what an individualized program looks like for your child →

Sources

• https://www.verywellmind.com/cognitive-and-emotional-empathy-4582389 

• https://pmc.ncbi.nlm.nih.gov/articles/PMC3427869/ 
• https://pubmed.ncbi.nlm.nih.gov/39289415/ 
• https://pubmed.ncbi.nlm.nih.gov/39115741/ 
• https://pubmed.ncbi.nlm.nih.gov/39087850/ 
• https://pmc.ncbi.nlm.nih.gov/articles/PMC11966444/ 
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12332230/ 
• https://pubmed.ncbi.nlm.nih.gov/30627392/ 
• https://pmc.ncbi.nlm.nih.gov/articles/PMC3746736/ 

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