‘Children with autism do see that someone is sad’

Leiden autism expert Carolien Rieffe discovered that children suffering from Autism Spectrum Disorder (ASD) are most definitely moved by another person’s emotions, but that they react to it differently from their more normally developing peers. This insight leads to a different type of diagnosis and treatment.

No automatic empathy

People with ASD have trouble processing emotions. Until recently researchers thought that they were much less affected by another person’s emotions, but that is not true, as shown by Carolien Rieffe’s study on children. Rieffe is Professor of Social and Emotional Development in children with hearing or communication disabilities. ‘Children with ASD most definitely notice that someone is sad or disappointed, but they do not use this information in the way we observe in other children.’ Other people’s sadness or visible pain does not automatically lead to pity or an empathic response. ‘It often greatly upsets them, and they become angry or even react aggressively.’

Children with ASD tend to withdraw in social situations

Children with ASD tend to withdraw in social situations

Problematic behaviour

This different kind of reaction can lead to problematic behaviour. Normally developing children will generally not bully other children if it makes them feel guilty. But children with this disorder tend on the contrary to display more difficult behaviour when they experience strong emotions. As a result of these confusing feelings, many of these children will try to avoid this kind of trigger by withdrawing from other children. Rieffe: ‘In principle it's a clever strategy, because you avoid the emotional overstimulation, but it does lead to isolation. As a result, these children often miss social learning opportunities.’ Rieffe's future research will focus on investigating the causes of this different kind of emotional processing.

Frustration assignments

Autism cannot be cured, but a correct diagnosis and suitable treatment can help children and adults to live with their condition better. In collaboration with the Autism Centre, Rieffe’s research group is testing the strengths and weaknesses of children with ASD as compared to those of normally developing children. For lack of suitable testing materials, the research group developed most of the tests themselves. The researchers worked with children between the ages of 1 and 6 and they followed them for a period of four years, once a year. How do you test very young children? ‘We give them a number of assignments, and observe how they respond,’ says Lizet Ketelaar. She is a PhD researcher in Development Psychology and she helped develop the new testing materials. The children were, for instance, given frustration assignments. ‘They had to complete a puzzle that they thought would be easy, but it turned out that there was something wrong with it. We observed their reactions.’


The researchers observed which emotions the children display when they think they have broken a toy.

The researchers observed which emotions the children display when they think they have broken a toy.

In addition, the researchers measured how the children react to other people’s emotions. ‘The investigators would for instance pretend to be hurt and observe whether the children displayed empathy. Parents, daycare centre staff members and teachers also answered questions about how the children function in everyday life.’ On the basis of this study, the Emotieweb website is going live around 15 April. After following training, professionals can use the tests on the website to test a child or to compare his or her functioning with that of other children. Ketelaar: ‘We wanted our research to serve as a bridge to the clinical environment.’ 


Rieffe is also using students for her research. They are trained to carry out the socio-emotional tests with normally developing children. Eefje Rietveld, third-year student in psychology, is helping collect data and she is writing her bachelor’s thesis on the socio-emotional functioning of children with ASD and normally developing children. Rietveld: ‘This is a great opportunity for me to see how these things work in practice. I notice for instance how quickly children develop. Children who are just a few months older can already do so much more than before. But there can also be significant differences between children of the same age.’

See also

‘An understanding and safe environment is vital'

Hanna Swaab, Professor of Neuropedagogy and Developmental Disorders, is investigating the factors which determine how children develop autism. ‘Autism is a congenital disorder but how strongly it impedes development depends to large degree on the environment,’ she says. ‘An understanding and safe environment is vital. Every autistic child requires a different approach to learn to deal with other people. We are gaining increasing insight into the disturbed functions, structures and processes in the brain that cause autism and other developmental disorders. This growing insight offers the possibility to treat autistic children and the family in which they grow up. For instance, we started helping children to train the relevant brain functions, so that they can adapt more easily.’

More frequent diagnosis of autism due to better detection

Robert Vermeiren, Leiden Professor of Child and Adolescent Psychiatry is also studying autism and in this context, he is looking primarily at the biological factors relating to empathy and recognising emotions. In addition he is also involved in the discussion surrounding the diagnosis of autism or ADHD, which are both becoming more frequent. This is due partially to the fact that symptoms are now detected better. In addition he points to a possible link with other factors, such as the increased age of fathers when they conceive their children. The number of genetic abnormalities in semen triples after the age of 40. In addition to his scientific publications, Vermeiren also blogs about his research.

(28 March 2013 - LvP)

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Last Modified: 03-04-2013