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What is the Most Defining Characteristic of Autism Spectrum Disorder in Adults?

The most common difficulty for adults with Autism Spectrum Disorder is understanding how other people think and feel.
Difficulty putting oneself in the mind of another person is what defines Autism Spectrum Disorder in adults

There is a certain danger in reducing a complex condition like Autism Spectrum Disorder to one defining characteristic. Hardly anything can be boiled down to one basic, core problem. Yet, sometimes it helps to understand something as broad and seemingly abstract as ASD by pulling out from the mix, one concept that encapsulates what this condition is all about. That concept is cognitive empathy.

By way of explaining what this means, I want to be clear that the word empathy, as used in the term “cognitive empathy”, does not refer to feeling what someone else feels. It is not about sharing the feelings of others. Rather, cognitive empathy indicates the ability to put oneself into someone else’s place and see things from their perspective, recognize how they think and feel, the assumptions they may have, their expectations and beliefs, and imagine the world as they see it. It has to do with noticing and understanding another person’s mental state based on what they say, how they say it, and the implications of their actions.

Here is an example of cogntive empathy. Janet has been in Zoom meetings all day. At dinner, Tom asks what she thinks about the news of the day, not noticing her tired look, her distracted staring out the window, the way she picks at her dinner. It is as if the signals of her fatigue and distractability go unnoticed by him. He doesn’t pick up what’s going on with her, even though it’s fairly obvious what that is.

This simple vignette may appear to some like a fairly common occurance-one person not paying a whole lot of attention to cues that are easily noticeable, and in truth something like this is fairly common. It’s also not terribly bad or wrong. We’ve all failed to notice how someone seems to be feeling or what they might be thinking. For adults with ASD, however, “missing” what’s going on with other people occurs repeatedly, consistently, and to a greater degree than is the case with most people.

Hans Asperger, who first described the condition that gave rise to the term, Asperger’s syndrome (Autism Spectrum Disorder), wrote, “the essential abnormality in autism is a disturbance of the lively relationship with the whole environment.” Around the same time, Leo Kanner published his work on autism, writing, “There is, from the start, an extreme autistic aloneness that, wherever possible, disregards, ignores, shuts out anything that comes to the child from outside.”

Although Asperger and Kanner were studying fairly disturbed children and depicting a broad view of these children’s reactions to their environment, they both were describing the problem of cognitive empathy. According to Asperger and Kanner, people with autism don’t notice what is happening around them, and when it comes to other people, what those people think, feel, believe, desire, and so forth.

Cognitive empathy is also known as a problem of the Theory of Mind. In fact, these two terms are, for all practical purposes, interchangeable. Theory of Mind is defined as recognizing that others have minds that are different from our own. It is the understanding that people have thoughts, feelings, and perspectives that differ from ours. It allows us to recognize and predict the behaviors of others based on what we think they may be thinking. Adults with Austism Spectrum Disorder are said to have a deficit in their ability to “theorize” or understand, the minds of others. This is why Tom doesn’t notice Janet’s tiredness, based on the way she looks, nor does he recognize that having spent the day in video conferences, she was likely to be exhausted.

As I said earlier, it not always ideal to take something complex and narrow it down to one defining feature, but in the case of ASD, the idea of cognitive empathy goes a long ways towards explaining what is most common among adults with this condition.


Dr. Kenneth Roberson

Dr. Kenneth Roberson is an Adult Autism Psychologist in San Francisco with over 30 years of experience. Click below to ask a question or schedule an appointment.

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