Double empathy problem

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The theory of the double empathy problem is a psychological and sociological theory first coined in 2012 by Damian Milton, an autistic autism researcher.^[2] This theory proposes that many of the difficulties autistic individuals face when socializing with non-autistic individuals are due, in part, to a lack of mutual understanding between the two groups, meaning that most autistic people struggle to understand and empathize with non-autistic people, whereas most non-autistic people also struggle to understand and empathize with autistic people. This lack of mutual understanding may stem from bidirectional differences in dispositions (e.g., communication style, social-cognitive characteristics), and experiences between autistic and non-autistic individuals, as opposed to always being an inherent deficit.^[3]

Apart from findings that consistently demonstrated mismatch effects (e.g. in empathy and in social interactions),^[4] some studies have provided evidence for matching effects between autistic individuals, although findings for matching effects with experimental methods are more mixed.^[5] Studies from the 2010s and 2020s have shown that most autistic individuals are able to interact effectively,^[6] communicate effectively,^[7] empathize well or build good rapport,^{[8][9][10][11][12][13]} and display social reciprocity^[14] with most other autistic individuals.^[2][15] A 2024 systematic review of 52 papers found that most autistic people have generally positive interpersonal relations and communication experiences when interacting with most autistic people, and autistic-autistic interactions were generally associated with better quality of life (e.g., mental health and emotional well-being) across various domains.^[16] This theory and subsequent findings challenge the commonly held belief that the social skills of all autistic individuals are inherently and universally impaired across contexts, as well as the theory of "mind-blindness" proposed by prominent autism researcher Simon Baron-Cohen in the mid-1990s, which suggested that empathy and theory of mind are universally impaired in autistic individuals.^{[17][18][19][20]}

The double empathy concept and related concepts such as bidirectional social interaction have been supported by or partially supported by a substantial number of studies in the 2010s and 2020s, with mostly consistent findings in mismatch effects as well as some supportive but also mixed findings in matching effects between autistic people.^[5][16] The theory and related concepts have the potential to shift goals of interventions (e.g., more emphasis on bridging the double empathy gap and improving intergroup relations to enhance social interaction outcomes as well as peer support services to promote well-being) and public psychoeducation or stigma reduction regarding autism.^{[3][16][21][22][23][24][25][26][27][28][29]} In recognition of the findings that support the double empathy theory, Baron-Cohen positively recognized the theory and related findings in multiple autism research articles^{[30][31][32][33]} and podcasts^[34][35] since the late 2010s.