How to teach empathy to an autistic child

How to teach empathy to an autistic child

Empathy signifies the ability to identify oneself with the emotional state of another person as well as to understand and value this person’s feelings, behaviour and motives. It is the ability to share other people’s feelings and the capacity to infer and respond appropriately to what they might be thinking or feeling.

Spoken interaction and communication is not a precondition for empathy to be displayed. Empathy can be established simply by observing and listening to another person, while paying attention to his / her body language, gestures and facial expressions.

Modern researchers usually distinguish between two components of empathy, affective empathy and cognitive empathy. Affective empathy is broadly defined as the capacity to identify with other people’s feelings and respond appropriately to their emotional state. Cognitive empathy is generally defined as the ability to infer what other people are thinking or feeling, the capacity to understand what mental state other people are in. It is the skill that allows us to view and evaluate a situation from another person’s standpoint or perspective. Studies have demonstrated that people with autism spectrum disorders experience difficulties in developing the above skills.

Empathy is a vital skill that enables people to live a more enriched and successful life. It can significantly contribute to more effective social interaction, as people with well-developed empathy skills are more likely to exhibit a genuine interest in the state of others, even if this entails that they will have to compromise their own interests.

Empathy is a life-essential skill, offering a vast potential to:

  • mitigate stereotypes and prejudices,
  • reduce levels of aggression and bullying among children,
  • encourage people to take up challenges for the sake of others and
  • mitigate social inequality.

How to teach empathy to an autistic child

Stages in the development of empathy:

Empathy skills emerge early in life and are demonstrated in different ways at each age, following a developmental model which is generally compatible with the model pertaining to cognitive development. As children grow, their capacity for empathy i.e. their ability to interpret and value other people’s feelings is expanded.

Nurturing empathy skills can have multiple benefits, one of which is that it can significantly contribute to children’s better school attainment and more effective social interaction. Regarding the development of empathy, the capacity to perceive and consider other people’s feelings becomes more evident as we build an awareness of our own emotions and the ability to accept them.

How to teach empathy to an autistic child

According to Hoffman, there are four main stages in empathy development:

1st year: “Emotional contagion” – Children tend to reflexively imitate the emotions they witness in their immediate environment (e.g. by crying when they hear another baby crying) but they have not yet fully developed the ability to differentiate between their own feelings and others’ feelings.

2nd year: Children become increasingly aware that others’ feelings are distinct from their own feelings and may make unsolicited efforts to comfort other people in distress.

3-5 years: The development of speech helps children to express their feelings more clearly. They can now display empathy for people they have never met before.

6-9 years: Children are aware that the feelings of others stem from these people’s prior experiences and lives, rather than just from the immediate situation they are in. They take an interest in facts concerning the living conditions of other people, such as poverty, disease or freedom suppression. They may also start displaying an interest for social and political issues.

The “Empathy Map” is a tool that companies usually utilise in order to gain a deeper understanding of their customer base. Originally developed by Dave Gray, it has gained significant popularity over the past few years because of its effectiveness.

The aim of the Empathy Map is to encourage your learners to engage in deeper thinking about the person they are trying to empathise with. This is achieved through a set of questions that encourage learners to reflect on:

– how this person THINKS & FEELS,

– what this person HEARS from the people around him/her,

– what this person SEES and

– what this person SAYS & DOES.

Therefore, the Empathy Map consists of 4 distinct sections, each including a set of questions covering the thematic areas of THINKING/FEELING, HEARING, SEEING and SAYING/DOING.

If you are looking for an easy-to-use pack to spark your children’s interest in empathising with others, PICTURE CARDS | Developing Empathy will be a valuable addition to your library!

Practice-focused and engaging, this resource provides you with a brilliantly easy-to-use set of materials to help you strengthen your children’s empathy skills in a fun and interactive way!

Empathy

Empathy is a socially relevant skill for all of us but must be taught specifically to children and young people with autism because it enhances their ability to engage in other critical prosocial behaviours and activities.

While the challenges of being able to take on another’s perspective, and being able to adjust your interaction accordingly, may misrepresent the expressions of empathy of the children or young people with autism, individuals with autism often do have capacity for empathy. The emphasis, however, is how the “more knowledgeable other” supports the child or young person and the quality of the explanation of the context. (Peter Vermeulen, Context Blindness)

This can be taught by through a variety of media:

  1. making the child or young person with autism aware – providing them with appropriate vocabulary through your comments and awareness of feelings, emotional states, recognition of others’ facial expressions and non-verbal cues.
  • Emotion Thermometer v1
  • Emotion Thermometer v2
  1. Using YouTube videos to describe and discuss a range of social scenarios
  2. Video Modelling
  3. Video Self Modelling Indiana Resource Center for Autism offers a guide to support parents and education professionals to develop this effective and evolving strategy which will support the child or young person with autism across his or her lifetime and a variety of novel situations. https://www.iidc.indiana.edu/pages/video-self-modeling-how-to-and-examples

Bellini and Akullian (2007) found that video modelling and video self-modelling promote skill acquisition and that skills acquired are maintained over time (Video Modelling and Video Self-Modelling)

Reciprocity

Reciprocity, which could be defined as recognising and effectively facilitating the needs of both ourselves and others, is a prerequisite skill when initiating, repairing and maintaining relationships. The teaching and learning process to acquire this skill begins early in development, from a parent cooing at the newborn, to peekaboo, object permanence games in infancy to conversations about daily life with children and young people. The skill adapts and matures the more frequently it is used.

Reciprocity can be taught and learned, remembering that children and young people with autism need explicit teaching and learning examples if he or she is to become socially included. Create a “two-way street” where communication is dependent on all parties interacting. The process can begin with Turn Taking, an example would include,

How to teach empathy to an autistic child

Playing with Others

Top Tip for teaching reciprocity is to

  1. Expect it,
  2. Highlight it, and then
  3. Help it happen

As the child or young person with autism develops, the process of reciprocity will become more complex, it is a developmental process that will take time and practice in a variety of educational and community settings across a range of topics and with many different people.

Read previous: ← Self-advocacy

By working together, we can ensure the best possible outcomes for our children and young people with autism

Raise a child who cares about how their actions impact others.

THE BASICS

  • The Importance of Empathy
  • Find a therapist near me

The goal is to raise a child who is conscientious. A child who truly cares about the way his or her actions impact others is, generally, a child with solid character.

Usually this type of child feels immediate and deep remorse after a mistake and works hard to make it right. A deep streak of empathy usually runs through this sort of child.

But what about the kids who lack these capabilities? Helping them acquire the capacity for empathy is critical because it is key in maintaining close and healthy relationships.

There are about as many books about empathy as stars in the sky, so for the sake of time, parents need the secret. There is one essential way to help a child truly integrate empathy. It is for him or her to experience empathy from a parent. When a child experiences empathy, he or she gains the capacity to have empathy.

Empathy is honoring a person’s feeling state. Often, this is counterintuitive to parents who want to “fix” their child’s situation. Yet as odd as it sounds, honoring and resonating with a child’s feeling state is what helps them, not rescuing them from their problem. Empathy, itself, is healing. Fixing the child’s predicament, on the other hand, strips the child of their self-efficacy.

For example, my daughter, Molly, started to cry at bedtime a few months ago. I asked what was wrong and she told me that at recess, in front of everyone, her friend announced to the crowd that Molly was adopted, which meant that she had a mom who didn’t want her.

Although I was irate, I set that emotion aside, so I could be there for Molly. I held her close. Instead of telling her that the friend was a bully or that the friend had no right to say such things, I empathized. I gently said, “You are so hurt, so hurt. I’m here, honey. It hurts, I get it.” She snuggled close to me and I held her. I did not try to fix the problem by explaining that her friend’s perspective was wrong. I did not attempt to convince her of a different opinion. I just honored the pain.

After a few seconds, I empathized again, “It must have hurt so much to feel so alone and different. I’m so sorry, honey. I wish I would’ve been there.” Molly cried and hugged me tighter.

“I love you mom,” she said. I told her that I loved her too and that I adored her heart. We cuddled for a while longer and I asked her what I could do to help. She thought about it and asked me to talk to her friend’s mom about the situation. And I did.

At school, Molly did not retaliate. She avoided the friend but did not reciprocate the cruelty. She also continued to tell me when she was angry, sad, disappointed, worried, and frustrated, so I could help.

Telling a child not to feel the way they do does not help them. Feelings are the essence of who a person is. Saying things like, “don’t be mad” or “don’t be sad” or “you’re too sensitive” compounds the hurt, anger, or sadness, because the child feels alone in it. Sensing when a child is angry or frustrated and saying “You are frustrated, I get it, I would be too,” allows them to feel understood, connected to the parent and less alone. Feeling understood empowers a child to carry on.

Sympathy or feeling sorry for a child may instill a sense of entitlement in the child. When a parent feels compelled to fix the problem for the child, the parent puts themselves in a position of power. They take control of the situation, which strips a child of their agency and teaches them to play the victim when things go wrong. Empathizing, on the other hand, heals the child because they no longer feel alone, and they feel close to the parent because the parent authentically understands.

THE BASICS

  • The Importance of Empathy
  • Find a therapist near me

Parents cannot save a child from feeling hurt, angry, disappointed, or sad. These are normal and common emotions. Yet when a parent is emotionally in tune with the child as he or she experiences these emotions, it allows the child to feel less alone. It also connects the child and parent, fostering closeness.

A child who consistently receives empathy gains the ability to regulate negative emotions in a healthy way. They also readily integrate the ability to have empathy for others.

How to teach empathy to an autistic child

I recently read a book recommended by our elementary school counselor called, “Unselfie: Why Empathetic Kids Succeed in Our All-About-Me-World.” The premise of the book says society is becoming less empathetic and more self-absorbed. The author, Michele Borba, EdD, calls this the selfie syndrome.

Borba describes nine essential empathy habitsemotional literacy, moral identity, perspective taking, moral imagination, self-regulation, kindness, collaboration, moral courage and leadership—which educators and caregivers can develop and nurture in children to instill in them the “empathy advantage.” The book presents various empathy-building activities to help kids connect and feel with others. Borba says cultivating empathy leads to raising successful, resilient kids and the foundation for empathy is face-to-face human connection.

“Unselfie” speaks primarily to parents and educators, but I found numerous applications for SLPs. As I read, I thought about the layers upon layers of cognitive-communication skills involved in developing empathy. The skills required to communicate empathy go beyond basic expressive and receptive language. Joint attention, theory of mind, executive function, emotional regulation and social language are all vital parts of communicating empathy.

A few of the Essential Empathy Habits described in the book stood out to me and best exemplify how closely cognitive-communication skills interrelate with putting empathy into practice:

  • Emotional literacy: the ability to recognize and understand the feelings and needs of yourself and others.
  • Perspective taking: stepping into others’ shoes to understand their feelings, thoughts and views.
  • Self-regulation: the ability to manage strong emotions and reduce personal stress to help others.

Emotional literacy begins with joint attention, an important developmental step in the acquisition of basic speech and language skills. This requires a child to coordinate their attention with others to share emotion, attention and intention. Joint attention teaches children the importance of communication, when and where to look for social cues and how to read others’ facial expressions.

Joint attention goes hand-in-hand with development of theory of mind: the ability to recognize that other people have thoughts and ideas different from our own. Theory of mind allows us to understand our communication partners’ ideas, feelings and perspectives, and ultimately respond in thoughtful, meaningful ways.

Taking others’ perspectives into consideration is also a part of executive function. Executive function skills involve deliberately planning and executing our words, actions and behaviors. Executive function activates the thought processes behind self-regulation, such as thought organization, strategic thinking, problem solving and mental flexibility. These kinds of insight help our students to regulate their emotions by observing others and reflecting on their own actions to appropriately modify their behavior.

As SLPs, we know these skills are underdeveloped in students with autism spectrum disorder. Empathy building activities present huge challenges for students with autism because they first need to understand shared attention and perspective taking. Students with autism may not identify nonverbal social cues so showing and sharing emotion through facial expression and body language can be difficult. Consequently, peers may perceive kids with autism as disinterested or unsympathetic.

As concrete thinkers, students with autism often need explicit instruction in feeling vocabulary—happy, sad, excited, disappointed, anxious—and visuals to illustrate social events and ideas—loss, change, friendship and relationship. Regulating emotions requires students with autism to use complex, sometimes abstract, executive functions. Experiencing strong emotions, without the right cognitive tools to manage them, can result in impulsivity, stress, dysregulation and often, isolation from their peers—the exact face-to-face interaction imperative to practicing empathy.

We know the important role that empathy plays in our students’ success and quality of life. We’ve identified some of the necessary cognitive-communication skills required for students to develop and effectively communicate empathy. Students with autism find many of these skills challenging.

What strategies can we use to help these students communicate their feelings and understand others’ feelings? For students who want to connect and feel with others, but don’t know how, what tools can we give them? What visual supports and social stories can we use to explain what it means to be empathetic? How can we use what we already know about autism intervention, such as using explicit instruction and positive reinforcement, to nurture empathy?

As SLPs, how can we give our students with autism the empathy advantage?

Kylie Grace Davis, MS, CCC-SLP, works for the Montrose County School District in western Colorado. Her previous clinical experience includes skilled rehabilitation services, mobile modified barium swallow studies and tracheostomy management in long-term acute care hospitals in Denver. [email protected]

My son is fifteen years old and has Asperger’s syndrome. As other parents will know, most children with an Autism Spectrum Disorder will have a lot of trouble seeing things from another person’s perspective. Examples? Daniel has an obsession with mobile phones and just loves to talk about them for hours. He has a lot of trouble understanding that others will quickly get bored and can fly into a rage or simply not speak to that person for days.

If his sister is watching her favorite tv program, he’ll just stroll in and change the channel. I don’t believe it is deliberately obnoxious behavior – he just can’t grasp that she could possibly like that program because he doesn’t.

Lack of friends

As a parent, I desperately want Daniel to learn empathy for others. He doesn’t. really have good friends as it is, and it is easy to see why people often find people with Aspergers syndrome aloof, abrupt, uncaring and selfish. The sad part is that I know he really wants friends, to fit in, to be part of the happy banter of growing teenagers. But his inability to empathize with others is a major reason he drives away the very people he wants to be close to.

I’m a firm believer in acknowledging you may have a disorder, but that just means you have to work harder to compensate for it. I take every opportunity I can to help Daniel see things from inside someone else’s shoes. Along with mobile phones, he is obsessed with soapies. So I watch them with him, and we make a game out of guessing how the various actors feel when others are unpleasant to them.

When Daniel does something hurtful toward his sister, I go with a scenario where a similar thing has been done to him by someone bigger than he is. I keep gently reminding Daniel that there are lots of rules (and he loves rules!) in how we get along with people. I say he will have to work harder than some other kids but that he is very intelligent and I believe he can do it.

The long road to empathy with others

Do these strategies work? We are seeing an improvement in his behavior Last year, he was suspended from school when he vandalized a teacher’s car. He earnestly believed that the teacher had been unfair in the classroom, and scratching the car was apparently a just punishment. He now accepts that this must have been very frustrating for the teacher, as he himself was very angry when his sister bumped his computer off the desk and ruined the hard drive. Being able to appreciate the pain of others, and linking to situations of your own pain, are simply taken for granted by everyone. But I know what a huge cognitive leap this is for Daniel, and I like to think that our strategies are paying off.

Daniel is desperate to make friends, so we are currently working on listening skills. I try to give him concrete examples of friendship skills:
• Find out what the other person’s hobbies are
• Make sure you don’t talk more than 50% of the time
• Don’t talk about mobile phones for more than a few minutes
• Watch for signs of boredom ie. lack of eye contact, fidgeting.
We are seeing small signs of improvement. Daniel will let his sister talk for a few sentences before he interrupts her nowadays, and is starting to appreciate that others can share the air space.

uncertain future with asperger’s

As parents, we are worried about Daniel’s future – will he hold down work, get into relationships, be happy and independent? All we can do take the focus off worrying and concentrate on helping him learn these vital life skills.

University of Cambridge

Aims: To test the different components of empathy in autism

Background: The ARC began work in this area by studying ‘theory of mind’ (ToM) deficits in autism ToM is the ability to attribute mental states to others, to infer what someone else is thinking or feeling. It is one of the two major components of empathy, sometimes known as ‘cognitive empathy’.

The other major component is known as ‘affective empathy’, or the drive to respond with an appropriate emotion to someone else’s mental states.

Method: We use questionnaires such as the Empathy Quotient (EQ). We have developed different versions of the EQ for different age groups. We study the cognitive component using tests of emotion recognition and mental state inference, including the Reading the Mind in the Eyes Test (RMET). We are also relating measures of empathy to brain activity using fMRI, and testing its genetic associations, and its correlation with prenatal hormone levels. We have also developed novel teaching methods for helping cognitive empathy to develop, using educational software and children’s animation.

Results: We find that in autistic people, it is primarily cognitive empathy that is impaired, whilst affective empathy is intact. In autistic people with intellectual disability, both components of empathy may be impaired. fMRI studies reveal distinct brain regions associated with cognitive empathy, and our genetic studies show significant genetic associations with scores on the EQ and on the RMET. We have recently developed a new measure of cognitive empathy, called the Reading the Mind in the Faces Test (RMFT) which we are currently evaluating in autistic and typical individuals.

Importance: This line of research helps to quantify empathy and to understand the biological and psychological determinants of empathy.

Relevance: This work has already led to empathy teaching (using DVDs) and to clinical application.

Funding: The Autism Research Trust; the Shirley Foundation; the Department of Culture, Media and Sport

Staff Members

Selected Publications

  • Culture-Sex Interaction and the Self-Report Empathy in Australians and Mainland Chinese, Frontiers in Psychology 10, 396 (2019), Q Zhao, D L Neumann, Y Cao, S Baron-Cohen, C Yan, R C K Chan, D H K Shum
  • Testing the Empathizing-Systemizing theory of sex differences and the Extreme Male Brain theory of autism in half a million people, PNAS 115, 12152-7 (2018), D M Greenberg, V Warrier, C Allison, S Baron-Cohen
  • Elevated empathy in adults following childhood trauma, PLoS ONE https://doi.org/10.1371/journal.pone.0203886 (2018), D M Greenberg, S Baron-Cohen, N Rosenberg, P Fonagy, P J Rentfrow
  • Genome-wide analyses of self-reported empathy: correlations with autism, schizophrenia, and anorexia nervosa, Translational Psychiatry 10.1038/s41398-017-0082-6 (2018), V Warrier, R Toro, B Chakrabarti, the iPSYCH-Broad autism group, A D Břrglum, J Grove, the 23andMe Research Team, D A Hinds, T Bourgeron, S Baron-Cohen
  • Testosterone reduces functional connectivity during the ‘Reading the Mind in the Eyes’ Test, Psychoneuroendocrinology 68:194-201 (2016), P. Bos, D. Hofman, E. Hermans, E. Montoya, S. Baron-Cohen, J. van Honk
  • Do Adults with High Functioning Autism or Asperger Syndrome Differ in Empathy and Emotion Recognition?, Journal of Autism and Developmental Disorders 46:1931-1940 (2016), C Montgomery, C Allison, M-C Lai, S Cassidy, P Langdon, S Baron-Cohen
  • The “Reading the Mind in the Eyes” Test: Complete Absence of Typical Sex Difference in

400 Men and Women with Autism, PLoS ONE 10(8):e0136521 (2015), S Baron-Cohen, D Bowen, R Holt, C Allison, B Auyeung, M Lombardo, P Smith, M-C Lai

This article was co-authored by Laura Marusinec, MD. Dr. Marusinec is a board certified Pediatrician at the Children’s Hospital of Wisconsin, where she is on the Clinical Practice Council. She received her M.D. from the Medical College of Wisconsin School of Medicine in 1995 and completed her residency at the Medical College of Wisconsin in Pediatrics in 1998. She is a member of the American Medical Writers Association and the Society for Pediatric Urgent Care.

There are 19 references cited in this article, which can be found at the bottom of the page.

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Autism Spectrum Disorder (ASD) is a complex and multi-layered neurological variation that manifests differently from person to person. This creates a challenge when determining how to teach autistic children. Although each child is an individual who responds to teaching methods differently, there are a few strategies that are generally applied to help autistic children succeed in educational goals. These strategies build on the characteristics of autism, including differences in communication, social skills, behavior, and sensory issues.

How to teach empathy to an autistic child

Complex emotions and empathy. Guys, these are some seriously tricky concepts. Most typically developing humans just “get it,” but for our students with social communication disorders the struggle is real. When we instinctively understand empathy and complex emotions, teaching these emotional literacy skills to our students with Autism is a struggle.

So how do we find the words to teach something that we intrinsically know, but have rarely tried to articulate? First, we start by teaching emotional literacy. Emotional literacy is “the ability to recognize and understand the feelings and needs of yourself and others” (Davis, K.G. 2017). (You can read more about emotional literacy here). When I say we need to teach our students to understand their feelings, I am not talking about just happy, sad, and mad. We need to really delve into those complicated emotions such as frustration, anxiety, pride, and relief.

Here is how I would go about teaching emotional literacy skills to my students with Autism:

  1. Choose the emotions you want to target. Each person is different, so the emotions you choose are going to be individualized based on your student’s needs. Generally speaking, I try and choose an area of greatest need, or, I like to start with an easy concept and scaffold upon that skill into a more difficult one. For example, I might start with mad and then talk about frustration. Or I might start with scared and then introduce anxious.
  2. I always like to begin teaching a new task with an engaging introduction activity. Using GIFs is a really fun way to introduce emotions. GIPHY has both an app and a website that allows you to type in an emotion and watch GIFs for that particular emotion. This is a fun way to introduce a new emotion before you begin to talk about it in-depth.
  3. After a topic has been introduced, I begin to explicitly teach the targeted skill. When teaching emotions, I begin by defining the emotion and giving common examples. I also want my students to get really good at identifying situations that might make them feel the targeted emotion. For example, first I would explain that frustration is a feeling of upset or annoyance you experience when you can’t do something you want to do. Next, I would give examples of things I find frustrating, such as slow internet, long lines, or not being able to fall asleep. Then, I would have my students try and generate a list of things they find frustrating.
  4. Up until this point I have only been having students think about their feelings, but the next step is to encourage our students to think about how a situation might make someone else feel. I make a chart and have my students pick someone they know. We pick an emotion and list things that make us feel that way. Then we create a list of things that would make the person they picked feel that same emotion. We talk about why we think the other person might feel that way and we look for any similarities and differences. Going back to the frustration example, I would say that I feel frustrated when my baby cries. If the person I was comparing emotions with was my son, I might say that I think he feels frustrated when he can’t do a puzzle. My son and I probably both get frustrated when the baby cries, because it is loud. I don’t get frustrated by the puzzle, because I am able to do puzzles.
  5. Drill and practice. Continue to challenge your students to think about a wide range of situations and predict how those situations would make them feel.

This is so much information and we haven’t even talked about empathy yet! Stay tuned for the next blog post in this series to learn more about teaching empathy.

How to teach empathy to an autistic child

In the meantime, if you would like to learn more about teaching empathy and complex emotions, check out my resource “How to Teach Empathy and Complex Emotions”. This resource contains activities to help you teach complex emotions and empathy using the strategies outlined in this post.

I hope this post gave you a new perspective on teaching these emotional literacy skills to your students with Autism. If you have any other tips or strategies, please leave them in the comments below so everyone can learn something new!

Davis, K. G. (2017, April 6). Strategies for Helping Clients With Autism Learn Empathy. Retrieved from https://blog.asha.org/2017/04/06/strategies-for-helping-clients-with-autism-learn-empathy/

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