Empathy in Adolescent Girls with Autism; Quantity and Quality of Their Reactions

Background: Autism in girls is receiving increasing attention internationally, but it is still unclear where or how behavior with their male counterpart coincides or deviates. Better social skills in girls have frequently been noted as an possible feature that makes it more difficult to detect autism in females. Another issue that might disguise female autism is that girls without autism react differently to another person in distress than boys. Whereas girls more often offer emotional support, boys more often tend to solve the problem (Banerjee, Rieffe, Meerum Terwogt, Gerlein, & Voutsina, 2006). The question is to what extent this also applies to girls with autism.

Objectives: In this study we examined the extend to which girls with autism act in line with girls without autism, and react emotion-focused to pain in another person; or whether they show the more male oriented behavior and react more problem-focused.

Methods: We presented female and male adolescents (mean age 13 years old, range 110-161 months) with and without autism with an in-vivo empathy task. The experimenter pretended to hurt herself and participants’ reactions were video-taped. Based on these recordings, we coded the extent to which the participants paid attention to the event/experimenter when she was showing a pain reaction. In addition, we coded the extent to which participants reacted to the experimenter’s pain (emotion-focused), or tried to offer a solution for the problem (problem-focused).

Results: Most female adolescents reacted empathically, regardless their diagnoses of autism or not, and almost all reactions were emotion-focused. Yet, half of the male adolescents in both groups did not react to the distress in the experimenter. Moreover, many male adolescents also avoided to make eye contact with her. Within the group of male adolescents who did react to the event, many gave a problem-focused reaction. The remaining male adolescents gave emotion-focused reactions, but less often than the female adolescents.

Conclusions: The outcomes showed that empathic reactions to a pain episode differ quantitatively and qualitatively between female and male adolescents, in line with the literature on community populations. This finding also extends to adolescents with autism. These outcomes can shed more light on the different phenotype of girls with autism.