Autism & Developmental

Empathy in Autism Spectrum Disorder.

Harmsen (2019) · Journal of autism and developmental disorders 2019
★ The Verdict

Empathy in ASD shifts with sex, age, IQ, and severity — tailor your probe and goals accordingly.

✓ Read this if BCBAs who assess social-cognitive targets in verbal clients with ASD.
✗ Skip if Clinicians only running skill-acquisition drills with no social goals.

01Research in Context

01

What this study did

Harmsen (2019) read 61 papers on empathy in autism. The author stitched them into one story. The goal was to see how sex, age, IQ, and symptom severity change the empathy picture.

02

What they found

Empathy is not one-size-fits-all in ASD. Girls can look different from boys. Teens differ from toddlers. Higher IQ can mask gaps. Severe symptoms often mean bigger empathy struggles.

03

How this fits with other research

Conlon et al. (2019) and Kauschke et al. (2016) give live examples: girls with ASD use richer feeling words in stories than boys, backing the review’s sex point.

Lim et al. (2016) zoom in on young adults. Those who practice perspective-taking and lean on friends report smoother transitions — a real-world echo of the review’s call to weigh age and support.

Baixauli et al. (2016) meta-analysis shows high-functioning children lag far behind peers in narrative structure. That looks like a clash — the review says empathy varies, not always drops. The gap is method: the meta set a high bar for "good" story grammar, while the review counts any empathy signal, big or small.

04

Why it matters

Stop using one empathy probe for every client. Add sex-specific prompts — ask girls to tell a story, ask boys to act it out. Check developmental age, not just birth age. If IQ is high, dig deeper; surface skills may hide social gaps. These small shifts give you cleaner baseline data and sharper goals.

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Pick one client, run a short story-retell, note feeling words, then compare boy vs. girl norms for that age.

02At a glance

Intervention
not applicable
Design
narrative review
Population
autism spectrum disorder
Finding
not reported

03Original abstract

Empathy is an essential component of human social life. It requires the ability to understand another's mental state and respond with an appropriate emotion or action. Individuals with autism spectrum disorder (ASD) have been described to exhibit atypical empathic responses which limit communication and social interactions. This review highlights the clinical characteristics and mechanisms underlying empathy in ASD by summarizing 61 peer-reviewed articles. Studies characterized empathic differences due to sex, age, intelligence, and disorder severity and provided valuable insights into the roles that genetics, neural networks, and sensory processing have in eliciting empathy. This knowledge will lead to improved diagnostics and therapies to improve social cognition, emotional recognition, and the empathic response in patients with ASD.

Journal of autism and developmental disorders, 2019 · doi:10.1007/s10803-019-04087-w