Empathy Deficits in Autistic Children and Children with Callous-unemotional Traits: Recommendations for Clinicians and Research

Abstract

Empathy deficits are common among individuals with autism spectrum disorder (ASD) and individuals with callous-unemotional (CU) traits. These deficits can have serious social consequences for affected individuals. The similarities related to these deficits have led researchers to question the co-morbidity of CU traits in autistic individuals; however, evidence suggests that the underlying etiological origins of the empathy deficits in ASD and CU traits are not one in the same. Empathy imbalance theory can be used to explain these differing etiological origins. Empathy imbalance theory posits that there is a distinction between cognitive empathy, or the ability to perspective-take and recognize the emotions of others, and affective empathy, or the ability to empathize with and understand others. Autistic individuals do not seem to be impaired in their ability to demonstrate affective empathy but tend to struggle with cognitive empathy. On the other hand, cognitive empathy appears intact in individuals with CU traits, yet these individuals’ affective empathy levels appear impaired. This paper provides a brief overview of the literature on the distinct etiological origins of the empathy deficits in ASD and CU traits, considers the negative repercussions of misidentifying CU traits in autistic children including clinical implications, and concludes with recommendations for clinicians and directions for future research.