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Difficulties in social cognition are well recognized in individuals with autism spectrum conditions (henceforth "autism"). Here we focus on one crucial aspect of social cognition: the ability to empathize with the feelings of another. In contrast to theory of mind, a capacity that has often been observed to be impaired in individuals with autism, much less is known about the capacity of individuals with autism for affect sharing. Based on previous data suggesting that empathy deficits in autism are a function of interoceptive deficits related to alexithymia, we aimed to investigate empathic brain responses in autistic and control participants with high and low degrees of alexithymia. Using functional magnetic resonance imaging, we measured empathic brain responses with an "empathy for pain" paradigm assessing empathic brain responses in a real-life social setting that does not rely on attention to, or recognition of, facial affect cues. Confirming previous findings, empathic brain responses to the suffering of others were associated with increased activation in left anterior insula and the strength of this signal was predictive of the degree of alexithymia in both autistic and control groups but did not vary as a function of group. Importantly, there was no difference in the degree of empathy between autistic and control groups after accounting for alexithymia. These findings suggest that empathy deficits observed in autism may be due to the large comorbidity between alexithymic traits and autism, rather than representing a necessary feature of the social impairments in autism.

Evidence from typical development and neuroimaging studies suggests that level 2 visual perspective taking--the knowledge that different people may see the same thing differently at the same time--is a mentalising task. Thus, we would expect children with autism, who fail typical mentalising tasks like false belief, to perform poorly on level 2 visual perspective taking as well. However, prior data on this issue are inconclusive. We re-examined this question, testing a group of 23 young autistic children, aged around 8 years with a verbal mental age of around 4 years and three groups of typical children (n = 60) ranging in age from 4 to 8 years on a level 2 visual perspective task and a closely matched mental rotation task. The results demonstrate that autistic children have difficulty with visual perspective taking compared to a task requiring mental rotation, relative to typical children. Furthermore, performance on the level 2 visual perspective taking task correlated with theory of mind performance. These findings resolve discrepancies in previous studies of visual perspective taking in autism, and demonstrate that level 2 visual perspective taking is a mentalising task. (Contains 1 table and 2 figures.)

Recent studies have suggested an uneven profile of executive dysfunction in autism spectrum disorders (ASD). For example, some authors have reported deficits on newly developed tests of executive function sensitive to rostral prefrontal function, despite spared, or even superior, performance on other tests. We investigated the performance of a group of high-functioning participants with ASD (N = 15) and an age- and IQ-matched control group (N = 18) on two executive function tests, whilst undergoing functional magnetic resonance imaging (fMRI). Behaviourally, there were no significant differences between the two groups. In a classical test of executive function (random response generation), BOLD signal differed between the groups in the cerebellum but not in the frontal lobes. However, on a new test of executive function (selection between stimulus-oriented and stimulus-independent thought), the ASD group exhibited significantly greater signal-change in medial rostral prefrontal cortex (especially Brodmann Area 10) in the comparison of stimulus-oriented versus stimulus-independent attention. In addition, the new test (but not the classical test) provided evidence for abnormal functional organisation of medial prefrontal cortex in ASD. These results underline the heterogeneity of different tests of executive function, and suggest that executive functioning in ASD is associated with task-specific functional change. (Contains 6 figures and 5 tables.)

The goal-directed theory of imitation (GOADI) states that copying of action outcomes (e.g., turning a light switch) takes priority over imitation of the means by which those outcomes are achieved (e.g., choice of effector or grip). The object [fewer than] effector [fewer than] grip error pattern in the pen-and-cups task provides strong support for GOADI. Experiment 1 replicated this effect using video stimuli. Experiment 2 showed that shifting the color cue from objects to effectors makes imitation of effector selection more accurate than imitation of object and grip selection. Experiment 3 replicated this result when participants were required to describe actions. Experiment 4 indicated that, when participants are imitating and describing actions, enhancing grip discriminability makes grip selection the most accurately executed component of the task. Consistent with theories that hypothesize that imitation relies on task-general mechanisms (e.g., the associative sequence learning model, ideomotor theory), these findings suggest that imitation is no more or less goal directed than other tasks involving action observation.

The motor mirror neuron system supports imitation and goal understanding in typical adults. Recently, it has been proposed that a deficit in this mirror neuron system might contribute to poor imitation performance in children with autistic spectrum disorders (ASD) and might be a cause of poor social abilities in these children. We aimed to test this hypothesis by examining the performance of 25 children with ASD and 31 typical children of the same verbal mental age on four action representation tasks and a theory of mind battery. Both typical and autistic children had the same tendency to imitate an adult's goals, to imitate in a mirror fashion and to imitate grasps in a motor planning task. Children with ASD showed superior performance on a gesture recognition task. These imitation and gesture recognition tasks all rely on the mirror neuron system in typical adults, but performance was not impaired in children with ASD. In contrast, the ASD group were impaired on the theory of mind tasks. These results provide clear evidence against a general imitation impairment and a global mirror neuron system deficit in children with autism. We suggest this data can best be understood in terms of multiple brain systems for different types of imitation and action understanding, and that the ability to understand and imitate the goals of hand actions is intact in children with ASD. (Contains 4 figures and 1 table.)