Autism & Double Empathy Problem

The double empathy problem is a theory that describes mutual misunderstandings between autistic people and non-autistic (neurotypical) people.

Unlike older views that saw communication issues in autism as a one-sided deficit, this concept emphasizes that both parties struggle to fully empathize with and understand each other.

The term was first coined in 2012 by Damian Milton, an autistic researcher, as a way to reframe how we think about autism and social interaction.

Picture an autistic person and a non-autistic person talking. Milton observed that people with very different experiences of the world can struggle to read each other’s intentions, emotions, and communication style.

It’s called a “double” empathy problem because the difficulty runs both ways. Autistic individuals may find it hard to read non-autistic people, and non-autistic individuals have just as much trouble reading autistic people. Neither side is uniquely at fault.

This idea emerged from the autism community and the neurodiversity movement, which argue that autism is a difference in communication and thinking style rather than a simple deficit.

How It Challenges Traditional Theories (Theory of Mind Deficit)

The double empathy problem challenges Simon Baron-Cohen’s “mind-blindness” theory — his proposal that autistic people have a severe, one-sided impairment in understanding other people’s mental states. This theory suggests autistic individuals lack “theory of mind“, the ability to understand others’ perspectives.

This theory attributes social difficulties to an autistic deficit. However, the double empathy problem highlights a reciprocal misunderstanding.

Autistic individuals may struggle with neurotypical cues, but neurotypical people also struggle with autistic communication.

This refutes the misconception that autistic people inherently lack empathy. Instead, it proposes a mismatch in social “languages.”

Everyday Examples

For instance, neurotypical individuals might misinterpret autistic communication as disinterest, while autistic individuals may miss subtle neurotypical cues.

The issue is not a lack of empathy, but differing expressions and interpretations.

This shifts the focus from individual deficits to mutual understanding, aligning with neurodiversity and emphasizing the need for reciprocal social insight.

Understanding the Double Empathy Dynamic

Shared Understanding: Autistic-to-Autistic Communication

The double empathy problem highlights a crucial aspect of social interaction: communication flows most smoothly between those who share similar ways of understanding the world.

It’s observed that autistic individuals often communicate effectively with each other, experiencing a sense of natural understanding and rapport.

This suggests that autistic social skills are not inherently deficient, but rather thrive within compatible communication styles.

The Reciprocal Gap: Autistic-Neurotypical Interactions

Conversely, interactions between autistic and non-autistic individuals frequently lead to miscommunication and a lack of mutual understanding.

This isn’t a one-sided issue; both groups may struggle to interpret each other’s social cues and emotional expressions.

This reciprocal gap in understanding underscores the core idea of the double empathy problem: both autistic and non-autistic individuals can experience difficulty understanding those with different social styles.

In Their Own Words

Firsthand accounts echo this research. In a 2026 study of young autistic adults, one participant explained: “Yes, I misunderstand people. And people misunderstand me too” (Øverland et al., 2026).

Another participant, asked why these mix-ups happen, said it was “because I express myself in other ways, I guess” (Øverland et al., 2026). That points to a difference in expression, not a one-sided failure to understand.

The Benefits of Neurotype Matching

The benefits of neurotype matching are evident. Autistic individuals often report feeling more comfortable and less stressed when interacting with other autistic people, leading to improved well-being.

This highlights how social difficulties are often context-dependent, arising from the constant need to navigate non-autistic social norms.

The pattern shows up in research, too. A 2025 study of 143 adults found autistic participants rated their group interactions as more enjoyable and friendly when everyone in the group was autistic. Their comfort dropped as more non-autistic people joined the group (Foster et al., 2025).

Ongoing Exploration and Nuances

While the double empathy problem offers a valuable perspective, it’s acknowledged that social interaction is complex.

Further exploration is needed to understand how this dynamic plays out across diverse autistic populations, including children and those with language or intellectual disabilities.

The concept is gaining traction, but it’s important to recognize that it is a relatively new area of study and requires ongoing research to fully understand its nuances and applications.

Implications for Communication Between Autistic and Non-Autistic People

The double empathy problem shifts the focus from fixing autistic communication to bridging a two-way gap. This requires mutual effort and understanding and involves the following:

Mutual Adaptation

Both autistic and non-autistic individuals should adapt their communication styles. Non-autistic people can be more direct, while autistic individuals can request clarification.

Neither style is inherently wrong, but meeting in the middle fosters understanding.

Clarity and Patience

Prioritize clear communication and patience. Misunderstandings are inevitable.

Checking for understanding and allowing time for responses is crucial. Give each other the benefit of the doubt and seek clarification when confused.

Reducing Assumptions

Avoid interpreting behaviors through a single lens. Non-autistic individuals should avoid judging autistic behaviors based on neurotypical norms.

Autistic individuals should recognize that neurotypical social cues are often intended to build rapport. Open dialogue about communication preferences can greatly improve interactions.

Practical Applications in Education, Therapy, and Social Settings

Understanding the double empathy problem fosters inclusive environments in education, therapy, and social settings.

Education: Inclusive Classrooms

Educators can create inclusive environments by teaching non-autistic students about autism and diverse communication styles.

They can use clear, unambiguous instructions, checking for understanding rather than relying on implied social cues (e.g., asking “Did that make sense to you?”).

Facilitating positive discussions about differences, and implementing peer buddy programs that promote mutual perspective-taking are also key.

This shifts the focus from “correcting” autistic behavior to empowering all students to communicate effectively.

Therapy: Neurodiversity-Affirming Support

Therapy now incorporates two-way communication training. Therapists help autistic individuals express themselves effectively (e.g., teaching them to say, “I don’t understand, could you explain?”) and guide families to understand autistic communication, avoiding assumptions of disinterest.

Joint social practice and role-playing exercises offer safe spaces for learning, where both autistic and non-autistic participants can explain their interpretations of social scenarios.

This approach aims to build bridges, reduce anxiety, and improve relationships by validating autistic communication.

Social Settings: Everyday Inclusion

In workplaces, employers can provide clear, unambiguous instructions and offer neurodiversity training to staff.

Community events can offer multiple engagement options (speaking, writing) and prevent misunderstandings by being tolerant of diverse communication styles.

In personal relationships, open communication about needs and sensory sensitivities is vital (e.g., an autistic person explaining sensory overload at a party).

Universal design principles can make services and environments accessible to all neurotypes, such as healthcare providers giving autistic patients more time to respond.

Criticisms and Alternative Perspectives

While influential, the double empathy problem has limitations and alternative viewpoints.

Contemporary Research

Two lines of research since 2015 speak directly to these criticisms.

Does Autism Really Involve an Empathy Deficit?

Aim: Cusson, Meilleur, Bernhardt, Soulières, and Mottron (2025) tested whether the size of an “empathy deficit” in autism depends on the measure used.

Method: A meta-analysis of 226 studies. It pooled effect sizes separately for cognitive empathy, affective empathy, and combined measures.

Results: Autistic people showed a large gap in cognitive empathy, Hedges’ g = 0.85, rising to g = 1.70 when scored as one measure.

Their affective-empathy gap told a different story: small, and non-significant in the highest-quality studies.

Conclusion: Measurement matters here.

Autistic people struggle to read others’ thoughts, not to care about their feelings, and a single combined empathy score exaggerates the “deficit.”

Do Non-Autistic People Struggle to Read Autistic Cues Too?

Aim: Edey, Cook, Brewer, Johnson, Bird, and Press (2016) tested why typical adults seem to have a social edge over autistic adults.

Does this come from autistic people expressing mental states atypically, typical people reading that expression poorly, or both?

Method: Autistic and typical adults each controlled two on-screen triangles to act out a mental-state interaction, such as coaxing or surprising the other triangle.

Independent raters then judged what mental state each animation showed.

Results: Autistic-made animations moved more atypically than typical-made ones.

Typical raters read typical-made animations far more accurately than autistic-made ones, but autistic raters showed no such “same-group” advantage.

Conclusion: Part of the social gap blamed on autism is really typical people struggling to read autistic-generated cues.

That is direct experimental support for Milton’s (2012) double empathy problem.

Limited Scope and Further Research

Current research primarily focuses on articulate autistic adults. Critics emphasize the need for research on children, non-speaking individuals, and those with higher support needs to ensure generalizability.

Methodological Concerns

Studies often rely on qualitative reports and observations. Critics suggest incorporating objective measures like brain imaging to strengthen the theory and understand the mechanisms involved.

A large-scale meta-analysis already tested this. Brain-imaging studies mostly found little difference between autistic and non-autistic people (Cusson et al., 2025; see Contemporary Research, above).

Not Unique to Autism

Double empathy may occur between any groups with differing experiences. Critics argue that focusing solely on neurotype may overlook other factors like culture and gender.

An alternative view is to approach each interaction with individual understanding, regardless of neurotype.

Balancing with Traditional Views

Some acknowledge the double empathy problem but maintain that autistic individuals may have specific challenges in cognitive empathy.

They suggest that the theory complements, rather than replaces, traditional views.

This view has real support. The same 2025 meta-analysis found a genuinely large cognitive-empathy gap (Hedges’ g = 0.85), alongside almost no gap in emotional empathy (Cusson et al., 2025; see Contemporary Research, above).

Responsibility and Power Imbalance

Critics caution against misinterpreting the theory as implying equal responsibility for misunderstandings.

They emphasize the power imbalance and the greater burden on autistic individuals to adapt in a neurotypical world.

Expanded Frameworks

Some propose expanding the concept to a “triple empathy” framework, which includes additional factors like societal systems and communication mediums.

This highlights the complex interplay of factors influencing empathy and understanding.

References

Cusson, N. M., Meilleur, A. J., Bernhardt, B. C., Soulières, I., & Mottron, L. (2025). A systematic review and meta-analysis of empathy in autism: The influence of measures. Clinical Psychology Review, 120, Article 102623. https://doi.org/10.1016/j.cpr.2025.102623

Edey, R., Cook, J., Brewer, R., Johnson, M. H., Bird, G., & Press, C. (2016). Interaction takes two: Typical adults exhibit mind-blindness towards those with autism spectrum disorder. Journal of Abnormal Psychology, 125(7), 879–885. https://doi.org/10.1037/abn0000199

Foster, S. J., Ackerman, R. A., Wilks, C. E. H., Dodd, M., Calderon, R., Ropar, D., Fletcher-Watson, S., Crompton, C. J., & Sasson, N. J. (2025). Rapport in same and mixed neurotype groups of autistic and non-autistic adults. Autism, 29(7), 1700–1710. https://doi.org/10.1177/13623613251320444

Milton, D. E. (2012). On the ontological status of autism: The ‘double empathy problem’. Disability & society, 27(6), 883-887. https://doi.org/10.1080/09687599.2012.710008

Milton, D., Gurbuz, E., & López, B. (2022). The ‘double empathy problem’: Ten years on. Autism, 26(8), 1901–1903. https://doi.org/10.1177/13623613221129123

Øverland, E., Andersen, P. N., Orm, S., Øie, M. G., Skogli, E. W., & Hauge, Å. L. (2026). “I have tried to fit in, but I just want to be me”: Development toward identity formation in young autistic adults. Autism in Adulthood, 8(3), 495–506. https://doi.org/10.1089/aut.2024.0156