Empathy and Autism

Is Empathy a Teachable Feeling?
April 8, 2019

Mirror, mirror on the wall, who shows the most empathy of all? For many of us, empathy is an intuitive reaction to someone else’s emotional state. For example, when you watch your child playing in a soccer game, and they miss the winning shot, you automatically take on their feelings of disappointment and embarrassment. On the other hand, when your child scores the big goal to win the game, you naturally assume their feelings of excitement and happiness. But what is empathy? And why is the experience of empathy more accessible for some people than others?

The Greater Good Science Center at the University of California Berkeley describes two types of empathy. Affective empathy includes “the sensations and feelings we get in response to others’ emotions,” while cognitive empathy is akin to “perspective taking.” Affective empathy is typically experienced from infancy, while cognitive empathy emerges between three to four years of age (Greater Good Science Center, 2019). While empathy allows us to very quickly understand another person’s thoughts, feelings, and intentions (Winerman, 2005), that doesn’t mean it is a simple process. In fact, Brené Brown, a research professor at the University of Houston, describes empathy as a vulnerable choice. She explains that in order to connect with someone else, you have to connect with something within yourself that knows the same feeling they are experiencing (Brown, 2019). And, this not necessarily an easy, or automatic, task.

There are many people who have difficulty expressing empathy- taking others’ perspectives, understanding the feelings of others, and communicating clearly about personal emotional states. For example, one of the defining criteria of Autism Spectrum Disorder (ASD) is persistent deficits in social communication and social interaction. This may manifest as challenges with social-emotional reciprocity, nonverbal communicative behaviors, and developing, understanding and maintaining relationships (American Psychiatric Association, 2013). Children diagnosed with ASD may have difficulty making eye contact, establishing friendships, and understanding the perspectives and feelings of others. These factors, or a combination of them, are often what compose an empathetic experience.

One possible explanation for why children diagnosed with ASD struggle with social communication and interaction, including the development and expression of empathy, may lie within the brain. Mirror neurons are specialized brain cells that have been linked to the experience of empathy. These cells fire in the brain both when we perform an action and when we witness someone else perform that same action. Mirror neurons may account for our abilities to “read” someone’s mind and feel empathy for that person. There is also evidence suggesting that these neurons can pick up on the intent behind other people’s actions. In other words, they may help us to infer from the context what another person is about to do (Winerman, 2005). In addition, imitation is an important function of mirror neurons, and also a common challenge for children with Autism. A personal with faulty or deficient mirror neurons has to take time to analyze movements before being able to copy them instead of being able to do so automatically (Dingfelder, 2005).

For instance, at the soccer game, a parent’s mirror neurons would fire when the child scores, or misses, a goal, sparking the same emotional experience of happiness or disappointment, respectively (this is affective empathy). The parent may be able to “know” when the child is going to kick the ball into the net based on examining the context (this is cognitive empathy). For example, if the child is being covered by the other team, but there is a teammate who is wide open next to the goal, you might predict that the child will pass the ball. If the child is on a “breakaway,” however, shooting straight at the net is more probable. In this example, a person without sufficiently active mirror neurons may have difficulty using the environmental context to understand the child’s intention, reading the child’s facial expressions, and being able to automatically attune to another’s emotional experience.

So, how can children diagnosed with Autism develop the expression of empathy, regardless of underlying neurological factors? While empathy is natural for some of us, these skills need to be explicitly taught, practiced, and systematically generalized for some children. First, it is important to teach the child to be aware- skills such as eye contact, joint attention, and responding to multiple cues are essential. Furthermore, adults should provide appropriate vocabulary, for example, through commentary of feelings, emotional states, recognition of others’ facial expressions, and nonverbal cues and body language (Autism Speaks, 2018). Additionally, specific prompts (for example, asking the child how they feel after they’ve just stubbed their toe, or yelling out “ow!” after you stubbed your toe) can be used to provide naturalistic opportunities to teach and practice the skill with your child. Other techniques include role play, perspective taking games, and use of books, videos and movies (think Disney’s “Inside Out”). For example, use books to help your child identify the feelings of the characters and to predict what they might do next. In addition, there are many professionally-based resources, such as structured social skills groups (like the CREATE program at Child Guidance Resource Centers) and therapies to build empathy’s prerequisite skills (pivotal response therapy aims to teach pivotal skills, like social initiation, that once learned often lead to benefits that extend far beyond the skills themselves). Michelle Garcia Winner, a speech-language pathologist, created a research-based Social Thinking Methodology to help foster the development of social skills such as self-awareness, perspective taking, and social-emotional understanding (Social Thinking, 2019). Lastly, be sure to utilize and practice these techniques and skills across environments, people, and situations in order to help promote the generalization of empathy. Whatever strategies you choose to use, it is important to remember that it is not necessarily that children with ASD “don’t care” about other people, rather their brains do not pick up on the same information as easily as typically developing brains do. While they may have difficulty expressing empathy, they often do have the capacity for empathy (Autism Speaks, 2018).

If your child has been diagnosed with Autism and is struggling to display appropriate social communication and interaction skills, such as empathy, consider exploring the resources below.

Autism Speaks- Social Skills

https://www.autismspeaks.org/social-skills-and-autism

Social Thinking- Michelle Garcia Winner

https://www.socialthinking.com

Child Guidance Resource Centers- CREATE Program

https://cgrc.org/service/create/

 

References

American Psychiatric Association. (2013). Autism Spectrum Disorder. In Diagnostic and

statistical manual of mental disorders (5th ed.) (pp. 50-59). Arlington, VA: Author.

Autism Speaks (2018). Strategies for Supporting Social Skill Development: School Community

Tool Kit. Retrieved from https://www.autismspeaks.org/tool-kit-excerpt/strategies-supporting-social-skill-development

 

Arjocu, F. (2009, August 18). Mirror Neurons. Retrieved from

https://www.youtube.com/watch?v=XzMqPYfeA-s&feature=youtu.be

Brown, B. (2019). RSA Short: Empathy. Retrieved from https://brenebrown.com/videos/rsa

short-empathy/

Dingfelder, S.F. (2005). Autism’s smoking gun? Retrieved from

https://www.apa.org/monitor/oct05/autism.aspx

Greater Good Science Center at the University of California Berkeley (2019). Empathy Defined.

In Greater Good Magazine- Science Based Insights for a Meaningful Life. Retrieved from https://greatergood.berkeley.edu/topic/empathy/definition#what-is-empathy

Social Thinking (2019). Teaching Social Competencies: More Than Social Skills. Retrieved from

https://www.socialthinking.com

Winerman, L. (2005). The mind’s mirror. American Psychological Association Monitor on

Psychology, 36 (9). Retrieved from https://www.apa.org/monitor/oct05/mirror.aspx

 

Jessica Listino, EdS, NCSP, BCBA, LBS, is a Nationally Certified School Psychologist, Board Certified Behavior Analyst, and Licensed Behavior Specialist. She works as a school psychologist in CORA’s Nonpublic School Services department, providing psychoeducational assessment and intervention services. Jessica also works as a Board Certified Behavior Analyst, specializing in the evaluation and treatment of children diagnosed with Autism Spectrum Disorder. Jessica is currently pursuing a doctoral degree in school psychology at the Philadelphia College of Osteopathic Medicine.

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