Abstract

Difficulties in social interaction have been recognized as a core feature of autism, with traditional theories locating the root cause within the autistic “mind”. The ‘Double Empathy Problem’ theory (Milton et al., 2022) reframes these challenges as bidirectional communication breakdowns in mixed-neurotype interactions. This presentation examines this bidirectional challenge through a systematic review of qualitative studies (107 studies; 1,798 participants) and two experimental research projects using the Empathic Accuracy paradigm. Specifically, we investigated invisible aspects of mixed-neurotype interactions versus the effect of disclosing autism on empathy. The review revealed “invisible” challenges that profoundly impact autistic students in educational settings, such as loneliness (reported even when students appeared included), and a twofold negative impact of camouflaging: poor mental health outcomes from masking autistic traits during social interactions, and hiding these struggles. The review also identified positive features, particularly meaningful mixed-neurotype friendships and the positive effect of autism disclosure to peers. In a series of experiments (N=235; N=271) we also investigated more closely how non-autistic people empathize with autistic people, and how autism disclosure affects non-autistic individuals’ empathy and social interest towards an autistic social target. We found that disclosure improved self-reported empathy and empathic accuracy – non-autistic participants better understood autistic individuals’ emotions when aware of their diagnosis. However, the impact on social interest varied across populations, revealing complex dynamics between disclosure, understanding, and social connection (see our recently published paper for more details: https://link.springer.com/article/10.1007/s10803-025-06802-2).