Dear Editor,

Autism spectrum conditions are frequently characterized as empathy disorders (e.g., Baron-Cohen and Wheelwright 2004; Decety and Moriguchi 2007). Although, thanks to the theory of mind hypothesis (Baron-Cohen 1995), it is widely accepted that people with autism tend to have weak cognitive empathy, there is now a range of theoretical views about autism and emotional empathy (EE). EE is an emotional response in an individual that stems from and parallels the emotional state of another individual. Theories positing (inter alia) that people with autism have weak EE include the “extreme male brain” theory (Baron-Cohen 2002) and the mirror neuron theory (Williams et al. 2001). In support of these theories, Minio-Paluello et al. (2009) reported that embodied pain empathy is absent in adults with Asperger syndrome. However, the video stimuli used in that study did not include facial, vocal, or gestural expressions of emotion. Other recent research indicates that people with Asperger syndrome have intact EE (Dziobek et al. 2008).

Two theoretical approaches explicitly propose that individuals with autism actually have heightened EE: the “empathy imbalance” hypothesis (Smith 2006, 2009) and the “intense world” hypothesis (Markram et al. 2007). The former hypothesis is derived from a Darwinian argument about human empathy and the latter hypothesis is based on neurophysiological findings in a rodent model of autism. Both hypotheses propose that children with autism have overwhelming EE and thus find it difficult to interact with others. Houzel’s (2000) psychoanalytic approach also seems to imply that children with autism have too much EE. Caldwell (2006), an experienced autism practitioner, has outlined a similar idea.

There is evidence that motor empathy (the tendency to automatically mimic the movements of another individual) and EE are inextricably linked (Nummenmaa et al. 2008). And there are now four empirical studies showing that people with autism spectrum conditions may have stronger EE/motor empathy than people with typical development. Capps et al. (1993) observed the faces of children with autism and children with typical development in a paradigm designed to elicit EE in the children. They found that the children with autism displayed much more empathic facial affect than the other children. Magnee et al. (2007) reported that the faces of adults with autism show heightened electromyographic responsiveness to the emotional expressions of others. Bird et al. (2007) found that adults with autism show heightened automatic mimicry of the hand movements of others. Bastiaansen et al. (2008) conducted a neuroimaging study in which the participants viewed movies of facial expressions of emotion: Adults with autism activated their neural mirror systems more strongly than participants with typical development. The researchers suggested that individuals with autism “may find the social world challenging not because it fails to engage them but because it overwhelms them” (p. 276).

Many people with autism and their caregivers believe that heightened EE is a feature of autism (Smith 2009). The simplest (and most far-reaching) explanation of the origin of these beliefs is that they are accurate. I predict that further empirical evidence of heightened EE in individuals with autism will emerge.