Impaired Theory of Mind & the Double Empathy Problem

in

“Impaired Theory of Mind” is a cognitive model which aims to explain the various social and communication challenges associated with ASD. According to this theory, individuals on the autism spectrum demonstrate a general deficit in comprehending and interpreting the mental and emotional experiences of others, and difficulty seeing things from others’ perspectives. Building on this theory, the “Double Empathy Problem” emphasises the mutual difficulties neurotypical and ASD individuals have in deciphering each other’s social cues, and empathising effectively with each other. The points below provide a synopsis of the “Impaired Theory of Mind” and “Double Empathy Problem” theories.

 

Important Note: Cognitive vs. Emotional Empathy. Cognitive empathy involves reading and interpreting the emotions, thoughts, and intentions of other people, while emotional empathy refers to the capacity to share in the emotions and feelings of others. A large body of research shows that individuals with ASD have reduced cognitive empathy alongside intact emotional (affective) empathy1.

 

Impaired Theory of Mind (ToM)

  1. Difficulties with Cognitive Empathy: Extensive research1shows that individuals with ASD have difficulty accurately reading and interpreting the emotions, thoughts, and intentions of others; a phenomenon referred to as ‘Impaired Theory of Mind’. This problem manifests in poor performance on tasks examining cognitive empathy (such as the “Sally–Anne test”), the misinterpretation of various social cues, difficulty seeing things from others’ perspectives, limited insight into cause and effect in social interactions, as well as difficulty understanding the pragmatic aspects of language. As noted in a recent research paper, the “literature showing that individuals with ASD display deficits in ToM is extensive and robust”2
  2. Neurological Underpinnings: Although some individuals with ASD can accurately interpret social information, neuroimaging studies reveal atypical brain functioning during this processing. Due to neurodevelopmental atypicalities in the regions of the brain involved in social cognition, individuals with ASD tend to utilise compensatory neurocognitive strategies to help them process social/empathetic information3,4. This goes some way towards explaining why those on the autism spectrum experience considerable mental exhaustion after social interactions, as they need to put much more conscious effort into interpreting social information than most people do.

Double Empathy Problem (DEP)

The “Double Empathy Problem”(DEP)5 is a theory put forward by sociologist Damian Milton. It proposes that people with ASD and neurotypical individuals experience mutual challenges empathising with and reading each other.

  1. Bi-Directional Communication Challenges: Research shows that while neurotypical individuals are generally proficient at interpreting each others social cues (facial expressions, vocal tones, gestures, body postures, reciprocal behaviours, pragmatic language etc), they often struggle to decipher the atypical social behaviours demonstrated by individuals with ASD. Similarly, people with ASD frequently experience difficulty interpreting the social cues of neurotypical individuals6.
  2. Heterogeneity of ASD: It is important to note that individuals with ASD also have difficulty interpreting each other’s atypical behaviours/nonverbal cues6. This is mainly due to ASD being a heterogeneous neurodevelopmental condition, resulting in considerable variation in atypical behaviours among individuals on the spectrum. Unlike neurotypical social-communicative behaviours, which consist of combinations of universally and intra-culturally recognisable cues, the atypical behaviours in ASD are largely idiosyncratic to each individual and do not form a distinct, coherent social-communication system in their own right. (However, an individual with ASD will often demonstrate certain atypical behaviours that can be interpreted by those who know them well, such as their family members or friends etc). The idiosyncratic nature of autistic atypical behaviours makes them confusing and challenging for other people to decipher, potentially diminishing their desire to engage with individuals with ASD.7
  3. Empathy Within the Autism Spectrum: Other studies have looked at the capacity of ASD individuals to identify with others who are similar to themselves.8 This was achieved by having ASD and neurotypical participants read short texts that described characters demonstrating various behaviours or traits, or having certain experiences. It was found that the ASD participants were more likely to identify/empathise with characters displaying characteristics typically associated with autism, while the neurotypical participants primarily empathised with characters exhibiting behaviours considered more neurotypical. This finding aligns with an established principle in social psychology, according to which people generally demonstrate greater empathy towards others who are similar to themselves (or who have had similar life experiences)9 than towards those who are quite different. Thus, the “Double Empathy Problem” theory suggests that this principle applies to individuals on the autism spectrum as well.

A recent research paper10 has noted that the Double Empathy Problem (DEP) is poorly conceptualised, often being conflated with a number of other social-cognitive constructs including Theory of Mind, emotion recognition, perspective taking, and social perception. The authors of the paper also note that many of the studies which are posited to examine the DEP suffer from various methodological and design issues, meaning that their findings are difficult to interpret. They suggest that “carelessly translating the DEP theory into real-world applications may have unintended and potentially harmful consequences for autistic people and those with similar conditions. It might promote intergroup conflict where there is none or lead to distress for some people if within-group interactions are not as successful as the DEP theory predicts they should be”.

 

The paper’s authors conclude by cautioning against the translation of Double Empathy Problem theory into practical applications (e.g., clinical practice, education, policy-making) until such time that there is empirical justification for doing so.

 

In summary, the “Impaired Theory of Mind” hypothesis relates to the challenges individuals with ASD face in comprehending and interpreting others’ emotions, thoughts and intentions. Building on this theory, Sociologist Damian Milton’s ‘Double Empathy Problem’ (DEP) suggests that people with ASD and neurotypical individuals face mutual difficulties in empathising with and reading each other. The heterogeneous nature of ASD further complicates social interactions for those on the autism spectrum, as the atypical behaviours that characterise the condition vary greatly among individuals, making them particularly difficult to interpret. Nevertheless, mirroring a broader principle in social psychology, it has been found that individuals with ASD generally find it easier to identify or empathise with other autistic individuals (who are similar to themselves), than with neurotypical individuals (who are quite different).

– The Autism Hub Team, 03/08/2024

 

References

  1. Shalev, I., Warrier, V., Greenberg, D. M., Smith, P., Allison, C., Baron-Cohen, S., Eran, A., & Uzefovsky, F. (2022). Reexamining empathy in autism: Empathic disequilibrium as a novel predictor of autism diagnosis and autistic traits. Autism Research, 15(10), 1917-1928. doi: 10.1002/aur.2794.
  2. Rosello, B., Berenguer, C., Baixauli, I., García, R. & Miranda, A. (2020). Theory of mind profiles in children with autism spectrum disorder: Adaptive/social skills and pragmatic competence. Frontiers in Psychology, 11, 567401. doi: 10.3389/fpsyg.2020.567401
  3. Harms, M. B., Martin, A. & Wallace, G. L. (2010). Facial emotion recognition in autism spectrum disorders: A review of behavioral and neuroimaging studies. Neuropsychology Review, 20, 290–322. doi:10.1007/s11065-010-9138-6
  4. Livingston, L. A., Shah, P., Milner, V. & Happé, F. (2020). Quantifying compensatory strategies in adults with and without diagnosed autism. Molecular Autism, 11, 15. doi.org/10.1186/s13229-019-0308-y
  5. Milton, D. E. M. (2012). On the ontological status of autism: The ‘double empathy problem’. Disability & Society, 27(6), 883–887. doi.org/10.1080/09687599.2012.710008
  6. Brewer, R., Biotti, F., Catmur, C., Press, C., Happé, F., Cook, R., & Bird, G. (2016). Can neurotypical individuals read autistic facial expressions? Atypical production of emotional facial expressions in autism spectrum disorders. Autism Research, 9(2), 262-271. doi: 10.1002/aur.1508.
  7. Sasson, N. J., Faso, D. J., Nugent, J., Lovell, S., Kennedy, D. P., & Grossman, R. B. (2017). Neurotypical peers are less willing to interact with those with autism based on thin slice judgments. Scientific Reports, 7:40700. doi: 10.1038/srep40700.
  8. Komeda, H., Kosaka, H., Saito, D. N., Mano, Y., Jung, M., Fujii, T., Yanaka, H. T., et al. (2015). Autistic empathy toward autistic others. Social Cognitive and Affective Neuroscience, 10(2), 145–152. doi.org/10.1093/scan/nsu126
  9. Gerace, A., Day, A., Casey, S., & Mohr, P. (2015). Perspective taking and empathy: Does having similar past experience to another person make it easier to take their perspective? Journal of Relationships Research, 6, Article e10. doi.org/10.1017/jrr.2015.6
  10. Livingston, L. A., Hargitai, L. D., & Shah, P. (2025). The double empathy problem: A derivation chain analysis and cautionary note. Psychological Review, 132(3), 744–757. doi.org/10.1037/rev0000468
autismhub
Author: autismhub

© Copyright - Autism Hub 2026
Broader Autism Phenotype (BAP) & Autism Spectrum Disorder (ASD)The Nature of Social Difficulties in Autism Spectrum Disorder (ASD)