Neuro-affirmative support for autism, the double empathy problem and monotropism
Open accessAbstract
Conceptualising autism within a neurodiversity approach raises fundamental questions regarding the nature of the goals pursued in autism support and who is responsible for achieving these goals. The Double Empathy Problem considers deficits in social communication as residing between autistic and non-autistic communicators, rather than solely within the autistic individual. This is important as autistic individuals can have different perceptions of what appropriate goals for autism support should be, when compared to (non-autistic) family, friends and professionals. Monotropism highlights the importance of engaging with the interests of the autistic individual when considering support. This perspective considers the extent to which autistic individuals can self-set and self-achieve autism support goals? Social narratives have a specific goal and explicit description of how to achieve this goal and what the outcome of achieving the goal will be. The Stories Online For Autism app (SOFA-app.com) develops and delivers social narratives for autistic individuals. The SOFA-app has proven to be highly acceptable and effective in supporting autistic individuals. Initially our research focussed on family, friends and professionals developing autism support for autistic children. Subsequently we extended this methodology to explore the self-set goals of autistic adults and children as well as capacity to self-achieve these goals successfully. Digital support for the development and delivery of social narratives to support self-set goals for autistic individuals is recommended. Addressing the Double Empathy Problem and supporting self-set goals are also considered alongside the implications of preferences associated with Monotropism to argue this approach can be considered neuro-affirmative.
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Attention may become strongly focused on specific tasks or interests.
“attention may become strongly focused on specific tasks or interests (Brosnan and Camilleri, 2025)”
From The system-level organisational design framework: a neuro-cognitive trait interaction approach to workplace inclusion for autistic people (2026) · cites this paper as Brosnan and Camilleri, 2025
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Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
On the ontological status of autism: the ‘double empathy problem’
Milton, D. E. M. (2012) · Disability & Society · doi:10.1080/09687599.2012.710008 · Cited by 2,082 · see citing works
Annual Research Review: Shifting from ‘normal science’ to neurodiversity in autism science
Pellicano, E., & den Houting, J. (2022) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13534 · Cited by 744 · cited 1× · see citing works
“…approaches that consider disability as emerging from an interaction of individual and context, allowing interventions to either change individuals in limited ways (e.g., teaching skills, using medication to manage dif fi culties) or to change environments and societies (4; see also 5 – 7 ).”
Social Stories: Improving Responses of Students with Autism with Accurate Social Information
Gray, C. A., & Garand, J. D. (1993) · Focus on Autism and Other Developmental Disabilities · doi:10.1177/108835769300800101 · Cited by 707 · see citing works
The Neurodiversity Approach(es): What Are They and What Do They Mean for Researchers?
Dwyer, P. (2022) · Human Development · doi:10.1159/000523723 · Cited by 672 · see citing works
Attention, monotropism and the diagnostic criteria for autism
Murray, D., Lesser, M., & Lawson, W. (2005) · Autism · doi:10.1177/1362361305051398 · Cited by 558 · see citing works
Autistic peer-to-peer information transfer is highly effective
Crompton, C. J., Ropar, D., Evans-Williams, C. V., Flynn, E. G., & Fletcher-Watson, S. (2020) · Autism · doi:10.1177/1362361320919286 · Cited by 524 · see citing works
Leadbitter, K., Buckle, K. L., Ellis, C., & Dekker, M. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.635690 · Cited by 417 · see citing works
Heasman, B., & Gillespie, A. (2019) · Autism · doi:10.1177/1362361318785172 · Cited by 316 · see citing works
Botha, M., Chapman, R., Giwa Onaiwu, M., Kapp, S. K., Stannard Ashley, A., & Walker, N. (2024) · Autism · doi:10.1177/13623613241237871 · Cited by 297 · see citing works
The ‘double empathy problem’: Ten years on
Milton, D., Gurbuz, E., & Lopez, B. (2022) · Autism · doi:10.1177/13623613221129123 · Cited by 281 · see citing works
Crompton, C. J., Sharp, M., Axbey, H., Fletcher‐Watson, S., Flynn, E., & Ropar, D. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.586171 · Cited by 262 · see citing works
Neurodivergence-informed therapy
Chapman, R., & Botha, M. (2023) · Developmental Medicine & Child Neurology · doi:10.1111/dmcn.15384 · Cited by 212 · see citing works
Schuck, R. K., Tagavi, D. M., Baiden, K. M. P., Dwyer, P., Williams, Z. J., Osuna, A., Ferguson, E. F., Jimenez Muñoz, M., Poyser, S. K., Johnson, J. F., et al. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05316-x · Cited by 208 · see citing works
Heasman, B., & Gillespie, A. (2018) · Autism · doi:10.1177/1362361317708287 · Cited by 163 · see citing works
Morrison, K. E., DeBrabander, K. M., Faso, D. J., & Sasson, N. J. (2019) · Autism · doi:10.1177/1362361318824104 · Cited by 129 · see citing works
Bölte, S., Lawson, W. B., Marschik, P. B., & Girdler, S. (2021) · BioEssays · doi:10.1002/bies.202000254 · Cited by 99 · see citing works
Constantin, A., Johnson, H., Smith, E., Lengyel, D., & Brosnan, M. (2017) · Computers in Human Behavior · doi:10.1016/j.chb.2017.05.030 · Cited by 86 · see citing works
Self-citationDwyer, P. S. R., Gurba, A. N., Kapp, S. K., Kilgallon, E., Hersh, L. H., Chang, D. S., Rivera, S. M., & Gillespie‐Lynch, K. (2024) · Autism · doi:10.1177/13623613241273029 · Cited by 85 · see citing works
Dawson, G., Franz, L., & Brandsen, S. (2022) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2022.2299 · Cited by 77 · see citing works
A framework for neurodiversity-affirming interventions for autistic individuals.
Lerner, M. D., Gurba, A. N., & Gassner, D. L. (2023) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000839 · Cited by 70 · see citing works
Pantazakos, T., & Vanaken, G.-J. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1225152 · Cited by 59 · see citing works
Hanrahan, R., Smith, E., Johnson, H., Constantin, A., & Brosnan, M. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04490-8 · Cited by 52 · see citing works
Self-citationNeurodiversity, Advocacy, Anti-Therapy
Chapman, R., & Bovell, V. (2022) · Autism and child psychopathology series · doi:10.1007/978-3-030-88538-0_67 · Cited by 48 · see citing works
Rapaport, H., Clapham, H., Adams, J., Lawson, W. B., Porayska‐Pomsta, K., & Pellicano, E. (2023) · Autism in Adulthood · doi:10.1089/aut.2023.0032 · Cited by 46 · see citing works
Najeeb, P., & Quadt, L. (2024) · Neurodiversity · doi:10.1177/27546330241233088 · Cited by 40 · see citing works
The Social Validity of Behavioral Interventions: Seeking Input from Autistic Adults
Baiden, K. M. P., Williams, Z. J., Schuck, R. K., Dwyer, P. S. R., & Wang, M. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06297-3 · Cited by 40 · see citing works
Chapple, M., Davis, P. M., Billington, J., Myrick, J. A., Ruddock, C., & Corcoran, R. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.708375 · Cited by 36 · see citing works
Chazin, K. T., Ledford, J. R., Wilson-Moses, J. M., Rajaraman, A., & Juárez, A. O. R. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06242-4 · Cited by 36 · see citing works
Do you feel me? Autism, empathic accuracy and the double empathy problem
Cheang, R., Skjevling, M., Blakemore, A. I. F., Kumari, V., & Puzzo, I. (2024) · Autism · doi:10.1177/13623613241252320 · Cited by 35 · see citing works
Thompson‐Hodgetts, S., Richards, K., & Park, E. (2017) · Disability and Rehabilitation · doi:10.1080/09638288.2017.1334836 · Cited by 35 · see citing works
Smith, E., Constantin, A., Johnson, H., & Brosnan, M. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04558-5 · Cited by 34 · see citing works
Self-citationThe double empathy problem: A derivation chain analysis and cautionary note.
Livingston, L. A., Hargitai, L. D., & Shah, P. (2025) · Psychological Review · doi:10.1037/rev0000468 · Cited by 34 · see citing works
Marshall, D., Wright, B., Allgar, V., Adamson, J., Williams, C., Ainsworth, H., Cook, L., Varley, D., Hackney, L., Dempster, P., et al. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-011748 · Cited by 33 · see citing works
Waddington, H. L., Minnell, H., Patrick, L., van der Meer, L. A. J., Monk, R., Woods, L., & Whitehouse, A. (2023) · Autism · doi:10.1177/13623613231168920 · Cited by 33 · see citing works
Shogren, K. A., Dean, E. E., Burke, K. M., Raley, S. K., & Taylor, J. L. (2021) · Intellectual and developmental disabilities · doi:10.1352/1934-9556-59.1.7 · Cited by 32 · see citing works
Smith, E., Toms, P., Constantin, A., Johnson, H., Harding, E., & Brosnan, M. (2020) · Research in Autism · doi:10.1016/j.rasd.2020.101533 · Cited by 26 · see citing works
Self-citationLee, C. E., Shogren, K. A., Segal, J., Pezzimenti, F., Aleman‐Tovar, J., & Taylor, J. L. (2021) · Autism · doi:10.1177/13623613211024492 · Cited by 25 · see citing works
Thompson‐Hodgetts, S., & Park, E. (2016) · Disability and Rehabilitation · doi:10.3109/09638288.2016.1161084 · Cited by 24 · see citing works
Camilleri, L. J., Maras, K., & Brosnan, M. (2021) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-020-00235-6 · Cited by 22 · see citing works
Self-citationHersh, L., Dwyer, P., Kapp, S. K., Shevchuk-Hill, S., Gurba, A. N., Kilgallon, E., Mair, A. P. A., Chang, D. S., Rivera, S. M., & Gillespie‐Lynch, K. (2024) · Autism in Adulthood · doi:10.1089/aut.2023.0202 · Cited by 18 · see citing works
Milton, D. E. M., Heasman, B., & Sheppard, E. (2020) · Springer eBooks · doi:10.1007/978-1-4614-6435-8_102273-2 · Cited by 16 · see citing works
Camilleri, L. J., Maras, K., & Brosnan, M. (2022) · PLoS ONE · doi:10.1371/journal.pone.0262598 · Cited by 14 · see citing works
Self-citationTowards a neurodiversity-affirmative conceptualisation of psycho-education in the context of autism
Plas, L. V. D., Vanaken, G., Steyaert, J. G., Hens, K., & Noens, I. L. J. (2024) · Research in Autism · doi:10.1016/j.rasd.2024.102391 · Cited by 14 · see citing works
A rule-based theoretical account of social stories to address the double empathy problem
Camilleri, L. J., Maras, K., & Brosnan, M. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1085355 · Cited by 13 · see citing works
Self-citationEffective digital support for autism: digital social stories
Camilleri, L. J., Maras, K., & Brosnan, M. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1272157 · Cited by 13 · see citing works
Self-citationHenderson, T. B., Ludden, B. J., & Romero, R. A. A. (2023) · Behavior Analysis in Practice · doi:10.1007/s40617-023-00787-z · Cited by 12 · see citing works
Camilleri, L. J., Maras, K., & Brosnan, M. (2024) · Frontiers in Digital Health · doi:10.3389/fdgth.2024.1355795 · Cited by 10 · see citing works
Self-citationSchuck, R. K., Geng, A., Doss, Y., Lin, F., Crousore, H., Baiden, K. M. P., Dwyer, P., Williams, Z., & Wang, M. (2024) · Neurodiversity · doi:10.1177/27546330241266718 · Cited by 10 · see citing works
Neuroaffirming services for autistic people.
Chellappa, S. (2023) · Lancet psychiatry · doi:10.1016/s2215-0366(23)00405-4 · Cited by 9 · see citing works
Camilleri, L., Maras, K., & Brosnan, M. (2021) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2021.104104 · Cited by 7 · see citing works
Self-citationThe autism worldview dilemma: to normalise or not to normalise, that is the questionPreprint
Chown, N., Murphy, S., & Suckle, E. (2023) · doi:10.31235/osf.io/musf5 · Cited by 7 · see citing works
Camilleri, L. J., Maras, K., & Brosnan, M. (2024) · Autism in Adulthood · doi:10.1089/aut.2023.0063 · Cited by 7 · see citing works
Self-citationPerspectives of autistic students and their teachers on self-determination and peer support
Kiblen, J. C., Shogren, K. A., Scott, L. A., Kan, D. D. D., Bossen, B., & Hume, K. (2024) · Research in Autism · doi:10.1016/j.rasd.2024.102438 · Cited by 7 · see citing works
Social Story Intervention Through the Neurodiversity Lens
McCadden, E. R. (2024) · Topics in Language Disorders · doi:10.1097/tld.0000000000000355 · Cited by 3 · see citing works
Autism and the ‘double empathy problem’
Milton, D., Waldock, K., & Keates, N. (2023) · Conversations on Empathy · doi:10.4324/9781003189978-6
Flagged first, then by citations
Research works printed but not linked: 1
- [24]Lawson WB. Autism and Being Monotropic: What Medical and Other Practitioners Need to Know. Singapore: Springer Nature Singapore (2025).
Cited by
Sorted by citations
Saure, E., & Keski‐Rahkonen, A. (2025) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000001042 · Cited by 8 · see citing works
Tōjisha‐Kenkyū on Autism in Japan: Against Epistemic Injustices and Tokenism
Ayaya, S. (2025) · Journal of Social Issues · doi:10.1111/josi.70026 · Cited by 8 · see citing works
Potts, B., Skelton, E., Pavlopoulou, G., Karaminis, T. N., & Malamateniou, C. (2025) · Journal of medical imaging and radiation sciences · doi:10.1016/j.jmir.2025.102009 · Cited by 6 · see citing works
Research by autistic researchers: an “insider’s view” into autism. The autistic way of being
Lawson, W. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1664507 · Cited by 3 · see citing works
Symptom change in depression and anxiety during psychological therapy for autistic adults
Pender, R., Baou, C. E., O’Nions, E., Spector, A. E., Buckman, J. E. J., Richards, M., Pilling, S., John, A., Stott, J. C. H., Saunders, R., et al. (2026) · Nature Mental Health · doi:10.1038/s44220-025-00567-4 · Cited by 3 · see citing works
Neurodiversity and Adults on the Autism Spectrum
Fung, L. K. (2026) · Psychiatric Annals · doi:10.3928/00485713-20260113-01 · Cited by 2 · see citing works
Bales, D. L., & Kouijzer, M. E. J. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1743200 · Cited by 2 · see citing works
Dark, J. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1826284
Fan, Y., Shu, L.-T., & Zhang, S. (2025) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-025-07178-z
Welch, C., Shanmugarajah, K., & Li, M.-Z. (2026) · Occupational Therapy in Health Care · doi:10.1080/07380577.2026.2623234
Driving Support Interventions for Autistic People: Systematic Review and Participatory Synthesis
Arthur, T., Harris, D., Robinson, S., Brosnan, M., Sheppard, E., Vine, S., Buckingham, G., Wilson, M., Ordovás-Montañés, M., Meléndez‐Torres, G. J., et al. (2026) · Autism in Adulthood · doi:10.1177/25739581261434228
Self-citationDisentangling Autism and Alexithymia in Empathy Research: A Systematic Review
Gonzalez, D., Muñoz, C., Ortega, N., Palacios, C., Oliveros, J. C., & Santiesteban, I. (2026) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-026-00584-8
Therapist Co-Regulation in Autism Intervention: A Theoretical Model
Sindelar, M. T., & Sales, B. (2026) · Psychiatry International · doi:10.3390/psychiatryint7050211
- Authors
- Brosnan, M., & Camilleri, L. J.
- Affiliations
- University of Bath (GB)
- University of Malta (MT)
- Corresponding author
- Brosnan, Mark
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2025-03-13
- Volume
- 16
- Pages
- 1538875-1538875
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC11966444
- OpenAlex
- W4408417644
- Cited by
- 14
- References
- 55
- Citations by year
- 2026: 9 · 2025: 5
- FWCI
- 7.98
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- autism spectrum disorder, double empathy problem, monotropism, neurodiversity, social narratives, self-set goals, autism support, digital support, autistic adults, children with autism, social communication deficits
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