Empathic responding in preschool-aged children with familial risk for autism.

Individuals with autism spectrum disorder (ASD) show deficits in social and emotional reciprocity, which often include empathic responding. The younger siblings of children with ASD (high-risk siblings) are at elevated risk for ASD and for subclinical deficits in social-emotional functioning. Higher levels of empathy in high-risk siblings during the second and third years of life predict fewer ASD symptoms and likelihood of diagnosis. We conducted a multi-method investigation of empathic responding to an examiner's accident in 30 low-risk and 48 high-risk siblings with (n = 12) and without ASD outcomes (n = 36) at 4-6 years of age. Empathic responding was measured through behavioral observation and parent report. Prosocial behavior did not differ by ASD outcome. Children with ASD exhibited lower levels of personal distress than high-risk and low-risk siblings without ASD. Per parent report, high-risk siblings without ASD demonstrated higher levels of empathic responding than low-risk children, while the ASD group did not differ from children without ASD on this measure. Higher levels of observed empathic concern, but not prosocial behavior, were associated with lower Social Affect scores on the Autism Diagnostic Observation Schedule in high-risk children. Results suggest that ASD diagnosis and symptoms are associated with reduced emotional responsiveness to an adult's distress, but not associated with deficits in prosocial behavior at preschool age. Results do not support the idea that empathic responding is negatively impacted in a broader autism phenotype. Findings extend previous research by suggesting that empathy may be a protective factor in the social-emotional development of children with familial risk for ASD. Autism Res 2017, 10: 1621-1628.