Empathy

Having difficulty understanding others' emotions?

Is your child:

  • Not understanding why someone is crying?
  • Having trouble understanding other people’s emotions?
  • Misidentifying emotions of characters in a book?
  • Noticing every tiny detail in a story but not the perspective of characters?
  • Seeming to lack empathy?
  • Not showing care and concern for others?
  • Making rude comments to peers without realizing it?
  • Getting in trouble for pushing kids out of his or her way in line for recess?
  • Not knowing how to respond to the emotions of peers? For example, if a friend cries about grandma passing away, might your child miss the opportunity to offer comfort and instead say, “Well, she was really old” or “that’s the life cycle”?

LET'S TALK ABOUT IT

Children who have difficulty being part of a back-and-forth conversation may be having difficulty with emotional awareness and emotional reciprocity. Emotional awareness and reciprocity means knowing your own feelings about a topic, being able to read other’s emotions, and offering emotional support as needed.

Young children use words like sad and happy. They notice if someone else is crying or upset. Children with social reciprocity offer comfort and ask questions about people’s feelings. As they get older, children get better and better at identifying and understanding a vast range of emotions. Children and teenagers can express and understand complex emotional states.

Some children seem to be disconnected emotionally. If you ask how they feel, you get “I don’t know” as a response. Your child may say he “never thinks about feelings.” He might puzzle over the question or give a highly intellectual answer.

CLINICAL DESCRIPTION

Emotional reciprocity and emotional awareness may be absent or impaired for a number of reasons. These skills are important. To make strong connections with others, it is helpful to be able to understand how the other person feels and to be empathetic when considering the other person’s emotional experience.

If a person is only able to focus on her own emotions and not on other peoples’ emotions, it may feel unpleasant to be with her. If someone is unable to have insight into his own emotions or someone else’s, making a deeper social connection is very challenging.

Children, teens, and adults with Autism Spectrum Disorders often struggle with emotional awareness and emotional reciprocity. When evaluated through tasks on the ADOS-2, a person might say, “I don’t know” to all emotion questions.

He might describe things that make him feel happy or afraid but fail to offer any explanation of what it feels like. Someone who says “skiing makes me happy” may respond to “what does happy feel like?” with “it feels like getting on a pair of skis.” This response is an action not an emotion.

For comparison, here is a response that includes awareness of emotion. Happy feels like “a light feeling in my chest and a warm ray of sunshine touching my heart.”

Inattention associated with ADHD could also lead to some of these challenges because failing to pay attention to the other person impacts your ability to notice emotions. Anxiety, depression, or trauma may lead to impaired emotional reciprocity because it is better to bury those feelings, it is hard to trust others and it is emotionally painful to consider anyone’s feelings.

In differentiating the emotional and the ASD-related causes for this deficit, consider whether the individual is literal and concrete or emotionally wounded/traumatized or anxious [1].

WHAT TO DO IF YOUR CHILD STRUGGLES WITH UNDERSTANDING EMOTIONS

To help your child with empathy, practice with storybook characters and movie actors. You can read stories with a younger child and discuss the plot afterward, focusing on the emotions and not just on the details of the story. Try watching a T.V. show with no volume and see if your child can guess how the characters are feeling.

Comment on your own feelings and why you feel that way. “Mom is really stressed out because of this traffic. I’m going to take a deep breath and try to find a fun song for us to listen to on the radio.”

It can be helpful to name and label your child’s feelings and to help him determine what may have triggered that emotion. For example, “You look really excited, and you have a lot of energy. I wonder if you are excited about Mary’s birthday.”

Research shows that labeling strong emotions can help to bring down the intensity, which is the foundation of the new term ‘name it to tame it’ by Dan Siegel and Tina Payne-Bryson [6]. For more significant problems with empathy, it would be a good idea to reach out to the school counselor or school psychologist and to consider having your child join a lunch bunch or social skills group to practice empathy skills.

If your child really struggles with the empathy needed to form friendships, it may be worthwhile to consider an evaluation with a psychologist. It is possible that your child has an underlying disability that is at the root of these challenges.

SIMILAR SYMPTOMS

If your child is struggling with a similar problem, not directly addressed in this section, see the list below for links to information about other related symptom areas.

  • Social Communication (Socializing): children with limited empathy are likely to struggle with social communication and pragmatic skills
  • Attention [7,8] (Focusing): some children struggle with empathy because they are inattentive to other’s feelings, comments, and reactions
  • Restricted Patterns of Behavior or Interests (Repetitive Behavior, Perseverating, Rigidity, Rigid Behavior): some children lack empathy because they are preoccupied with their own interests and ideas
  • Anxiety (General Anxiety, Social Anxiety): some children lack empathy because they avoid social interaction due to their own anxiety. Lack of social practice may lead to poor perspective taking, which is a pre-requisite for empathy
  • Depression: many depressed individuals are internally focused and preoccupied, which may lead to poor perspective taking or empathy

POTENTIAL DISABILITIES

Children who have significant problems in this area may have any of the following potential disabilities. *Note, this does not serve as a diagnosis in any way. See ‘Where to Go for Help’ section for professionals who can diagnose or provide a referral.

  • ADHD: includes deficits in attention that can cause someone to miss important emotional cues (because of inattention). ADHD is characterized by challenges with sustained attention, hyperactivity and impulsivity [7, 8]
  • Autism Spectrum Disorder: includes deficits in social communication and restricted interests or behaviors. Challenges with empathy and social-emotional reciprocity influence social communication
  • Anxiety or Depression: includes significant symptoms of anxiety or depression that may lead to denial or avoidance of emotional topics
  • PTSD or Attachment: includes traumatic experiences. Individuals who have experienced something traumatic, including poor or inconsistent care, may appear to have blunted emotions and may struggle with emotional content that can be triggering or lead to re-experiencing negative events

WHERE TO GO FOR HELP

If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, the following professionals could help; they may offer diagnosis, treatment, or both.

  • CLEAR Child Psychology: to obtain a customized profile of concerns for your child, or to consult ‘live’ with a psychologist
  • Psychologist or Neuropsychologist: to provide an evaluation for diagnostic clarification
  • Psychotherapist: to provide CBT interventions have been shown to be effective in helping children with ASD make gains in recognizing and understanding emotions, improving perspective taking and social skills and managing co-occurring depression and anxiety

These professionals may recommend the following tests for this symptom:

  • WISC-V: This measure of intelligence provides information on abilities in verbal comprehension, fluid reasoning, visual spatial, working memory, and processing speed. Understanding a child’s cognitive profile can help us understand strengths and weaknesses that may be associated with ASD. The WISC-V can also help guide what other measures need to be administered to get a better picture of overall functioning. This test may be very broad, including language, motor, attention, memory, executive functioning, sensory processing, emotions, behavior, and more.
  • ADOS-2 Module 3: This measure is an assessment of social communication and restricted, repetitive behavior. This test is used to rule in or out the presence of an Autism Spectrum Disorder. The ADOS-2 gives information that can guide the formation of treatment goals
  • Roberts, BASC-3, Clinical Interview, RCMAS, CDI-2, Human Figure Drawing, Brief Projective Measures: These measures are projective assessments and emotional assessments that include drawing tasks, open-ended questions, interviews, rating scales, and sometimes storytelling, as part of a neuropsychological or psychological evaluation

LEARN MORE

[1] Kroncke, Willard, & Huckabee (2016). Assessment of autism spectrum disorder: Critical issues in clinical forensic and school settings. Springer, San Francisco.

[2] Baker, Jed. (Retrieved 2017). Social skills books and resources for ASD.

http://socialskillstrainingproject.com/books.html

[3] Ozonoff, Sally & Dawson, Geraldine & McPartland, James C. (2014). A parent’s guide to high functioning autism spectrum disorder: How to meet the challenges and help your child thrive.

Amazon: https://www.amazon.com/Parents-High-Functioning-Autism-Spectrum-Disorder/dp/1462517471/

[4] Berns, Roberta M. (2010). Child, family, school, community: Socialization and support.

Amazon: https://www.amazon.com/Child-Family-School-Community-Socialization/dp/1305088972/

[4] Trawick-Smith, Jeffrey (2013). Early childhood development: A multicultural perspective.

Amazon: https://www.amazon.com/Early-Childhood-Development-Multicultural-Perspective/dp/0132868598/ref=dp_ob_title_bk

[5] Mendler, Allen (2013). Teaching your students how to have a conversation.

Amazon: http://www.edutopia.org/blog/teaching-your-students-conversation-allen-mendler

[6] UCLA PEERS Clinic https://www.semel.ucla.edu/peers

[7] Siegel, Daniel J. & Bryson, Tina Payne (2012). The whole brain child: 12 revolutionary strategies to nurture your child’s developing mind.

Amazon: https://www.amazon.com/Whole-Brain-Child-Revolutionary-Strategies-Developing/dp/0553386697/

[8] Giler, Janet Z. (2000). Socially ADDept: A manual for parents of children with ADHD and / or learning disabilities.

Amazon: https://www.amazon.com/Socially-ADDept-Children-Learning-Disabilities/dp/0966696921/

[9] Giler, Janet Z. (2011). Socially ADDept: Teaching social skills to children with ADHD, LD, and Asperger’s.

Amazon: https://www.amazon.com/Socially-ADDept-Teaching-Children-Aspergers/dp/047059683X/

[10] McKinnon, Kelly & Krempa, Janis L. (2002). Social Skills Solutions: A Hands-On Manual for Teaching Social Skills to Children with Autism.

Amazon: https://www.amazon.com/Social-Skills-Solutions-Hands-Teaching/dp/0966526694/

Children’s books on social skills:

Brown, Laurie Krasny & Brown, Marc (2001). How to be a friend: A guide to making friends and keeping them (Dino life guides for families).

Amazon: https://www.amazon.com/How-Be-Friend-Friends-Families/dp/0316111538/

Cooper, Scott (2005). Speak up and get along!: Learn the mighty might, thought chop, and more tools to make friends, stop teasing, and feel good about yourself.

Amazon: https://www.amazon.com/Speak-Up-Get-Along-Yourself/dp/1575421828/

Cook, Julia (2012). Making Friends is an art!: A children’s book on making friends (Happy to be, you and me).

Amazon: https://www.amazon.com/Making-Friends-Art-Childrens-Paperback/dp/B00DCVWAJI/

Meiners, Cheri. (2003). Understand and care.

Amazon: https://www.amazon.com/Understand-Care-Learning-Along-Book/dp/1575421313/

Gordon, Jon (2012). The energy bus for kids: A story about staying positive and overcoming challenges.

Amazon: https://www.amazon.com/Energy-Bus-Kids-Overcoming-Challenges/dp/1118287355/

 Rath, Tom & Reckmeyer, Mary (2009). How Full Is Your Bucket?

Amazon: https://www.amazon.com/How-Full-Your-Bucket-Kids/dp/1595620273/ref=sr_1_1?ie=UTF8&qid=1488153884&sr=8-1&keywords=book+how+full+is+your+bucket

Cuyler, Margery (2007). Kindness Is Cooler, Mrs. Ruler.

Amazon: https://www.amazon.com/Kindness-Cooler-Ruler-Margery-Cuyler/dp/0689873441/ref=sr_1_1?ie=UTF8&qid=1488153939&sr=8-1&keywords=book+kindness+is+cooler

Image Credit:
Description: little girl apologizes to offended boy
Image ID: #54390640 (iStock)
By: Alexytrener
When-does-a-child-learn-empathy
Previously licensed on: October 29, 2016
Stylized by Katie Harwood, exclusively for CLEAR Child Psychology

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