Exploring Empathy in Music Therapy for Children with Autism Spectrum Disorder


  • Alyssa Hawkins University of Vienna



The clinical view of autism spectrum disorder (ASD) characterizes it as a social communication condition that presents with repetitive interests and actions. It is commonly assumed that people on the autism spectrum experience difficulties understanding the emotions or perspectives of others. Yet, the conception that people with ASD “lack” empathy neglects not only the reported experiences of autistic people but also fails to account for attentional, emotional processing, and other behavioral or cognitive differences that influence how they interact with the world [1]. Moreover, the “double empathy problem” asserts that the social impairments that exist in ASD may be better understood as a bidirectional failure of understanding between individuals of two differing dispositions (e.g., neurotypes) that both parties struggle to overcome [2]. By recontextualizing social difficulties associated with ASD as intersubjective breakdowns in mutual understanding, we may be able to understand cross-neurotype interactions in a new light.

Music therapy (MT) is an intervention for various conditions, including ASD. It is correlated with improvements in core symptoms of ASD, particularly for younger individuals, but its mechanisms are not well understood [3]. We are interested in examining whether (and by what means) musical interaction facilitates empathy and mutual understanding between an autistic child and a non-autistic therapist during MT.


The Music for Autism (M4A) project is a randomized control trial replication study that will assess functional connectivity, biological, and behavioral outcomes of MT compared to play therapy in 80 autistic children aged 6-12 [3]. As a part of this study, the current project aims to determine whether musical interactions provide a way for a child with ASD and their music therapist to cope with the double empathy problem. To this end, treatment process variables from treatment fidelity videos will be analyzed against treatment outcomes.

Expected Results

As musical interactions entail joint attention and action, we anticipate that music creation provides a nonverbal “middle ground” for social reciprocity that facilitates empathy and understanding in therapeutic settings.


[1] S. Fletcher-Watson and G. Bird, “Autism and empathy: What are the real links?,” Autism, vol. 24, no. 1, pp. 3–6, 2020. doi:10.1177/1362361319883506

[2] D. Milton, E. Gurbuz, and B. López, “The ‘double empathy problem’: Ten Years on,” Autism, vol. 26, no. 8, pp. 1901–1903, 2022. doi:10.1177/13623613221129123

[3] A. Groessing et al., Design and implementation of a replication study: The music for autism (M4A) binational assessor-blinded randomised crossover trial, 2023. doi:10.21203/rs.3.rs-2478719/v1