Insights of a Neurodivergent Clinician

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The Double Empathy Problem: Why Autistic Communication is a Difference not a Deficit

Growing up, I often found myself struggling to connect with the people around me. My comfort zone was a narrow strip, a few subjects that I could talk about without stumbling. In the fundamentalist circles I moved through, it was perfectly normal to be obsessed with Jesus, so no one really noticed my trouble with social connections. The words people used to describe me —“shy and timid” but also “intense and passionate”— painted a confusing picture. I knew something was off when I couldn't connect as easily as others, especially in group settings. But when I found someone who shared my passion for Jesus and social justice, it was like discovering conversational anchors in which I could ground myself.

It felt as if I didn’t have social ligaments — those crucial connectors that help our joints and muscles move together smoothly. Once we got into the muscle movement of conversation, I was fine. But it was the transitions—the gentle pivots, the art of entering and exiting conversations—that left me stumbling.

To protect myself, I built a wall of judgment around my struggles. I convinced myself I was too deep for small talk, that I didn’t need to connect with those who skimmed the surface. But deep down, this hard exterior was just armor for the sensitive, awkward soul beneath.

When I was diagnosed with Autism as an adult, it was like someone finally handed me a map to the terrain I’d been wandering my entire life. Suddenly, the disconnect I’d felt all those years made sense. And then, I found the Autistic community — a gathering of people who, like me, swam in the deep waters of conversation. There, among others who shared my wavelength, I discovered something powerful: I found my people. With them, connection came naturally. There was no need to force it, no need to pretend. I could just be. I had found my community.

I now realize it wasn’t a flaw in me, and it wasn’t as simple as categorizing people into “deep” and “shallow” and dismissing the latter. The undercurrent that shaped much of my life was the challenge of navigating the invisible waters of cross-neurotype interactions. I’ve come to understand that my social struggles stem from something known as the double empathy problem — a mutual misunderstanding between people with different neurologies. This revelation unlocked a new kind of empathy, not just for myself, but for others as well.


The History of Autistic Communication 

When Autism gained more formal recognition in the 1940s, many of the children Leo Kanner observed had high-support needs (what would now be considered Level 2 or 3 Autism). Most were non-speaking or had very limited speech. Their communication patterns were often less fluid, characterized by echolalia—repeated words or phrases—and simpler, more fragmented sentence structures. 

Kanner’s early observations emphasized these communication challenges, particularly delays in spoken language and atypical use of language. This focus on language development and communication issues shaped the early diagnostic criteria for Autism, contributing to the perception that Autism was primarily associated with language deficits.

Around the same time, Hans Asperger, working independently in Austria, described a different group of children who didn’t have speech delays but who had distinct social communication styles, often characterized by intense focus on specific topics and a more formal use of language. He described these children as “little professors.” Although Asperger’s work wasn’t widely known in the English-speaking world until much later, it led to the introduction of “Asperger’s Syndrome” as a separate diagnosis.*

As our understanding of Autism has evolved, so has the language we use to describe it. The current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has merged Autism and Asperger’s under the broader category of Autism Spectrum Disorder (ASD). However, one of the diagnostic criteria still includes “deficits in social communication and social interaction,” reflecting some of the older perspectives.


The Rise and Critique of the Theory of Mind Hypothesis

As the understanding of Autism evolved, so did the theories attempting to explain the social and communication challenges associated with it. One of the most influential theories to emerge was the Theory of Mind (ToM) hypothesis, which gained prominence in the 1990s. This theory suggests that Autistic people struggle with understanding that others have thoughts, feelings, and perspectives different from their own — a concept referred to as mindblindness.

Simon Baron-Cohen, a key proponent of this theory, later expanded it to suggest that Theory of Mind is just one part of a broader skill set: empathy. He proposed that in Autism, there is an imbalance between empathizing—the ability to perceive, understand, and respond to the emotions of others—and systemizing, the ability to understand how systems work. This assumption led to widespread misconceptions that Autistic people were incapable of feeling or expressing empathy, reinforcing stereotypes that have persisted for decades.

Over time, the Theory of Mind hypothesis began to face significant criticism. Both researchers and the Autistic community pointed out that it oversimplifies the complex communication differences between Autistic and non-Autistic (allistic) people. Critics argued that while Autistic individuals might process social information differently, this doesn’t mean they lack empathy or the ability to understand others' perspectives.

Research also found that language ability, rather than Autism itself, often influenced test scores on Theory of Mind assessments, raising questions about the validity of these tests. Additionally, these tests proved problematic because Theory of Mind involves multiple complex components, making it difficult to assess the concept comprehensively with a single measure.

Further complicating matters, some findings related to empathy were later linked to alexithymia—a condition characterized by difficulty identifying and describing emotions—rather than attributable to Autism itself. Over the years, this theory, along with the science and studies supporting it, has faced significant backlash and criticism from both the Autistic and research communities.


Interventions for Autistic Communication

Despite these theories being questioned in recent years, their impact has left a lasting legacy in how we think about and support Autistic people. The belief that Autism involves a deficit in social interactions and communication has significantly influenced how we attempt to support Autistic children. Historically, the prevailing idea has been that Autistic individuals need to be taught how to interact and communicate "correctly," as though they were doing it wrong. Consequently, a great deal of energy has been (and still is) devoted to teaching Autistic people to mimic the behaviors of their allistic peers in an effort to eliminate any perceived "deficit" in communication.


Toward New Understandings 

While this theory has largely been debunked as overly simplistic and problematic, diagnostic manuals often take time to catch up with current research and the lived experiences of Autistic people. What we now know is that these so-called “communication deficits” aren’t deficits—they’re simply differences in how we communicate and interact. Emerging research supports the idea that Autistic people socialize and communicate not worse than allistic people, but differently.

These communication differences can include variations in tone, expressiveness, use of verbal speech, directness, the style of reciprocity, and a general disinterest in small talk. In the past, these differences were often misinterpreted as deficits, leading to the belief that they hindered an Autistic person’s interactions not only with allistic people but also with other Autistic individuals.

For too long, the burden of difficulty in cross-neurotype communication was placed squarely on the Autistic person’s shoulders.


What is Really Happening

Autistic people had a different story to tell. Sure, they acknowledged that talking to allistic people — like I did — could feel like trying to dance to music you couldn’t quite hear. Conversations were often like navigating a dense fog, where the landmarks of social interaction were just out of sight. The rules of engagement were elusive, and the unspoken norms? Well, they felt more like hidden traps than social cues to follow.

But something changed when we were with our own. Connecting with other Autistic people felt natural, familiar — like finding a place where you didn’t have to explain yourself. Whether we met in person or found each other online, the confusion lifted. Conversations flowed, and there was a deep, unspoken understanding that had been missing with allistic folks.

For me, finding other Autistic people was like discovering a new way of communicating, one that didn’t require constant translation. I could bond, laugh, joke, and dive deep in ways I hadn’t before. These connections were effortless and fulfilling — and deeply authentic.

These observations suggest that it wasn’t that Autistic people couldn’t connect with others. It was more that crossing neurotype lines — trying to connect with allistic people — was where the real challenge lay. Just as we struggle to connect with allistic people, they also struggle to connect with us. 

But when Autistic people come together, those struggles tend to lift. The challenge wasn’t in our ability to connect; it was in navigating the differences between Autistic and allistic ways of relating.


The Space Between Autistics and Allistics

Dr. Damian Milton, an Autistic researcher and father to an Autistic child, brought a fresh perspective to the table with his concept of the "double empathy problem." He recognized that the difficulties Autistic people experience with “theory of mind” and “empathy” aren’t unique to Autistic people— they’re struggles that can arise anytime people from different backgrounds or ways of thinking try to understand one another.

Understanding someone’s feelings or perspective is hard enough when they speak your language and share your culture. When they don’t, it can feel like you’re trying to understand a coded message while also sorting out how to respond and translate your response!

Milton saw this same dynamic at play between Autistic and allistic (non-Autistic) people. He proposed that the communication differences weren’t about a deficit on the part of Autistic individuals but were actually rooted in a disconnect — a space between the two neurotypes.

Some have described this space as a kind of cultural gap. Just as people from different cultures can misunderstand each other, Autistic and allistic people often experience a similar disconnect. Autistic people tend to perceive the world differently, express emotions uniquely, and communicate in a straightforward, literal manner.

What allistic people might interpret as a "deficit" in social skills is more accurately a difference in social norms and expectations. It’s similar to how, in the past, people from different cultures were often labeled as rude simply because their customs were misunderstood.

For instance, while Autistic people are often thought to lack empathy, they might actually find allistic expressions of empathy intrusive or overwhelming. It’s not that empathy is missing; it’s that the way it’s expressed and received can feel like two different languages.

Milton’s point is that this disconnect isn’t one-sided. It’s a double problem because both Autistic and allistic people struggle to understand each other’s ways of experiencing and expressing emotions. In other words, empathy is a two-way street.

But here’s where it gets tricky; because allistic ways of communicating and empathizing are considered the norm, they’re often seen as the "right" way. This has led to the expectation that Autistic people should adapt to allistic norms, often through "treatment plans" aimed at teaching them how to navigate allistic perspectives and make small talk like allistic people. 

Meanwhile, the reverse—expecting allistic people to understand or adapt to Autistic perspectives and communication — is rarely considered. Milton challenges this imbalance, suggesting that neurotypicals might actually be the ones lacking empathy for Autistic people.


The Implications of the Double Empathy Problem

Since Dr. Damian Milton introduced the theory of the "double empathy problem" in 2012, it has inspired significant research into the nuances of communication between Autistic and non-Autistic (allistic) individuals. Dr. Catherine Crompton has been a leading figure in this area, conducting key studies that shed light on these dynamics.

Cross-Neurotype Studies

Crompton's research involves pairing allistic and Autistic individuals and groups to perform various tasks, with a focus on measuring levels of connection (or rapport), communication breakdowns, and more. Some key findings include:

  • When paired in dyads to perform tasks together, Autistic individuals reported high levels of rapport with one another, while mixed-neurotype pairs experienced the most difficulty.

  • In groups of eight playing the "telephone game," mixed-neurotype groups struggled the most with communication, while purely Autistic and purely allistic groups experienced breakdowns at roughly the same time.

This research challenges traditional views on social communication, emphasizing the importance of mutual understanding and adaptation rather than one-sided expectations. For a deeper exploration of these studies—how they were conducted, the expanded results, and what they reveal about communication across neurotypes — read more here. **


Communication Difference Is Not a Deficit

As we've explored, the idea that communication difficulties between Autistic and allistic individuals stem from a deficit in Autistic social skills is being turned on its head. It's becoming increasingly clear that the challenges lie in the differences between us—in the shared, but often misunderstood, space where our worlds meet.

When we’re navigating the waters of cross-neurotype communication, it's essential to remember that neither side is inherently "wrong." By acknowledging that our struggles are rooted in these differences, not deficiencies, we can begin to bridge the gap. This understanding doesn’t just make interactions smoother; it paves the way for deeper connections and genuine rapport.

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References

Askham, A. V. (April, 2022 ). Theory of mind in autism: A research field reborn. The Transmitter.

Baron-Cohen S. (2002). The extreme male brain theory of autism. Trends in cognitive sciences, 6(6), 248–254. 

Crompton, C. J., Ropar, D., Evans-Williams, C. V., Flynn, E. G., & Fletcher-Watson, S. (2020). Autistic peer-to-peer information transfer is highly effective. Autism : the international journal of research and practice, 24(7), 1704–1712.

Crompton, C. J., Sharp, M., Axbey, H., Fletcher-Watson, S., Flynn, E. G., & Ropar, D. (2020). Neurotype-Matching but Not Being Autistic Influences Self and Observer Ratings of Interpersonal Rapport. Frontiers in Psychology, 11, 586171.

Milton, D. E. M. (2012). On the ontological status of autism: the ‘double empathy problem.’ Disability & Society, 27(6), 883–887. 

Silberman, S. (2015). NeuroTribes: The legacy of autism and the future of neurodiversity. Avery.

Footnotes

* Hans Asperger's work has come under scrutiny due to his associations with Nazi Germany, including the forced transfer of some children under his care to a facility where they were killed. Because of this, and the evolving understanding of Autism, many in the Autistic community do not prefer the term "Asperger's Syndrome." However, some people, particularly in countries where the term is still in use or where they received the diagnosis before it was incorporated into Autism Spectrum Disorder (ASD) in the DSM-5, continue to identify with this label.

**The double empathy problem was proposed by a speaking Autistic person. The participants in Dr. Crompton’s research were speaking Autistic individuals, and the studies did not specify the participants’ levels of support needs. Therefore, there is still much to learn about how these theories apply to non-speaking or minimally speaking Autistics, as well as those with higher support needs. More inclusive research is necessary to explore communication and cultural connections among Autistic people with varying communication abilities and support needs.