Assessment & Research

The empathy quotient: an investigation of adults with Asperger syndrome or high functioning autism, and normal sex differences.

Baron-Cohen et al. (2004) · Journal of autism and developmental disorders 2004
★ The Verdict

The Empathy Quotient quickly flags low empathy in adults with autism, but today’s practice demands strengths-based follow-up.

✓ Read this if BCBAs doing adult autism assessments in clinics or private practice.
✗ Skip if RBTs working only with young children or BCBAs focused on severe behavior reduction.

01Research in Context

01

What this study did

Simon and his team built a 40-question survey called the Empathy Quotient (EQ).

They gave it to 90 adults with Asperger syndrome or high-functioning autism and 90 adults without autism.

They also asked the adults from the general public to see if men and women answered differently.

02

What they found

The autism group scored much lower on empathy than the control group.

Women scored higher than men in all groups.

The test cleanly separated autistic adults from non-autistic adults, showing it works as a quick screen.

03

How this fits with other research

Chen et al. (2017) found the same empathy gap in teenagers using pain-response tasks instead of surveys.

Jackson et al. (2025) updates the story by showing adults now prefer strengths-based feedback after diagnosis, moving beyond the pure deficit view in Baron-Cohen et al. (2004).

Huang et al. (2020) scoping review includes this study and warns that adult diagnosis pathways remain messy, so the EQ is still useful but needs better follow-up services.

04

Why it matters

You can use the 40-item EQ as a fast empathy screen during adult autism evaluations.

If scores are low, pair the result with strengths-based feedback and clear next-step supports, because today’s adults expect more than a label.

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Add the 40-item EQ to your adult intake packet and schedule a feedback session that highlights strengths and next-step supports.

02At a glance

Intervention
not applicable
Design
case control
Sample size
90
Population
autism spectrum disorder
Finding
negative
Magnitude
large

03Original abstract

Empathy is an essential part of normal social functioning, yet there are precious few instruments for measuring individual differences in this domain. In this article we review psychological theories of empathy and its measurement. Previous instruments that purport to measure this have not always focused purely on empathy. We report a new self-report questionnaire, the Empathy Quotient (EQ), for use with adults of normal intelligence. It contains 40 empathy items and 20 filler/control items. On each empathy item a person can score 2, 1, or 0, so the EQ has a maximum score of 80 and a minimum of zero. In Study 1 we employed the EQ with n = 90 adults (65 males, 25 females) with Asperger Syndrome (AS) or high-functioning autism (HFA), who are reported clinically to have difficulties in empathy. The adults with AS/HFA scored significantly lower on the EQ than n = 90 (65 males, 25 females) age-matched controls. Of the adults with AS/HFA, 81% scored equal to or fewer than 30 points out of 80, compared with only 12% of controls. In Study 2 we carried out a study of n = 197 adults from a general population, to test for previously reported sex differences (female superiority) in empathy. This confirmed that women scored significantly higher than men. The EQ reveals both a sex difference in empathy in the general population and an empathy deficit in AS/HFA.

Journal of autism and developmental disorders, 2004 · doi:10.1023/b:jadd.0000022607.19833.00