Understanding embarrassment among those with autism: breaking down the complex emotion of embarrassment among those with autism.

Hillier et al. (2002) asked autistic adults to judge embarrassing stories. They looked at two parts of embarrassment: knowing others are watching and feeling bad for someone else.

The team compared answers from autistic adults, non-autistic adults, and adults with intellectual disability. They wanted to see who could spot the social slip-up and who could feel the other person's shame.

Autistic adults knew an audience was present, but they struggled with empathic embarrassment. In plain words, they could tell the actor was on stage, yet they did not cringe along with them.

Results were mixed: some parts of embarrassment were fine, others were missing. This split pattern shows the emotion is not all-or-nothing in autism.

Hillier et al. (2002) ran a direct replication in the same year and got similar mixed ratings, adding theory-of-mind scores to predict who could explain the why behind the shame.

Adler et al. (2015) narrowed the lens thirteen years later and found autistic adults over-rated their own empathic embarrassment while still misjudging the actor's feelings, confirming the original blind spot.

Capio et al. (2013) extended the idea to vicarious embarrassment. They showed autistic adults felt normal second-hand shame for accidents, but their embarrassment dropped when the act was intentional, pointing to a mentalizing gap rather than a total empathy loss.

You can use these findings in social-skills groups right away. Break perspective-taking into two clear drills: first teach clients to notice when eyes are on them, then teach them to imagine how the other person feels about the blunder. Use video clips of accidental versus intentional mistakes and ask, "Was that on purpose? How does he feel now?" This split keeps tasks small, measurable, and tied to real-life social safety.