Facial Expressions and Misunderstandings Across Neurotypes

It is often assumed that as human beings we can judge what other people are thinking and feeling, simply by looking at their facial expression. From when we are very young, we may be taught that upturned mouth equals happy, downturned mouth equals sad. However, reality is often much more complex than this.

Much research has focused on how autistic people may struggle with emotional recognition in others. This could mean for example, interpreting facial expressions, gestures or tone of voice in a way which is different to that which is being displayed. A sad face could be interpreted as angry, anxiety could be interpreted as excitement, or a sudden change in mood may be missed completely. Many theories have been used to explain why these misunderstandings occur, including deficit-based models, and those which assume autistic individuals lack ‘theory of mind’ (Baron-Cohen et al., 1985).

However, a growing body of evidence is starting to recognise the ways that non-autistic people may also struggle with emotional recognition, particularly in regard to the facial expressions of autistic people. There is, as Damian Milton coined the term, a double empathy problem (Milton, 2017).

Having our emotions correctly identified by others allows them to react in a way which develops connection, understanding and empathy. Understanding difficulties in cross-neurotype emotional recognition is therefore of great significance if we want to strengthen cross-neurotype relationships.

Whilst some misunderstandings appear to occur due to processing and communication differences, recent research indicates there are measurable physical differences in how autistic and non-autistic people express emotions on their face. For example, Keating et al, (2026) identified that autistic people may rely more upon the mouth, rather than eyebrow region when communicating emotions such as anger. They may express more of a mouth frown, but less of a brow movement. Additionally, when reading the emotional expressions of others, autistic people may themselves be more likely to study and focus on the other person’s mouth, consequently missing brow movements.

Additionally, alexithymia was found to link with less differentiation in facial expressions, for example a less pronounced smile when happy, and less distinction between angry and happy facial expressions. Alexithymia is linked with difficulty in recognising one’s own emotions, and this appears to result in more ambiguous facial expressions. This can be thought of as a kind of affective mismatching, whereby there is a mismatch between outer expression and internal emotional state, for example someone may appear calm when they are actually stressed (Trevisan et al., 2018).

So, what do these differences mean in terms of building empathy and strong relationships across neurotypes?

Perhaps most importantly, these findings indicate the importance of both autistic and non-autistic people relying on wider contextual cues than facial expression alone. An autistic person focusing on their partner’s face may incorrectly assume their partner is angry with them. Meanwhile their non-autistic partner may assume they are unhappy when they are actually enjoying something a lot.

If there is uncertainty about somebody’s emotional state, it may be helpful to explicitly ask about this, providing multiple methods for communication. Somebody may be able to verbally tell you how they feel, or express this through writing, drawing or an AAC device, even if this does not match the facial expression you think they are showing. Equally someone may be unsure how they feel, and this is okay too. Garvey (2023), speaks of the detective habit, whereby it may be helpful to work backwards from an event in order to identify how you are feeling, looking at a variety of factors to build up a clearer picture of one’s own thoughts and feelings.

Finally, it seems important to recognise that there are a variety of ways people may present facial expressions and all of these are of equal value. Understanding each other is an interpersonal task, requiring an open-mindedness that we won’t all express our emotions in the same way. It is not a deficit to misunderstand each other. It is a sign that we may need to widen the ways we can understand the situation.

Theory of Mind:

Theory of mind is the ability to understand that other people have different internal mental states to ourselves. This means recognising that someone has their own thoughts, emotions and intentions which influence their behaviour.

Double Empathy Problem:

The double empathy problem is a term coined by autistic psychologist Damian Milton. This challenges the narrative that communication difficulties between autistic and non-autistic people are caused by a deficit in the autistic person’s communication. Instead, the difficulties can be seen as happening because of two people who communicate and experience the world differently from one another. It is not a lack of empathy, but a difference in processing style which can cause communication difficulty.

Alexithymia:

Alexithymia is characterised by difficulties in being able to understand or describe one’s emotions or internal bodily states. This is not the same thing as a lack of feeling. Many autistic people may experience emotions intensely but have some difficulties in being able to identify or express their experience.

Baron-Cohen, S., Leslie, A. M., & Frith, U. (1985). Does the autistic child have a “theory of mind?”  Cognition, 21(1), 37–46.

Garvey, N. (2023). Looking after Your Autistic Self: A Personalised Self-Care Approach to Managing Your Sensory and Emotional Well-Being (1st ed). Jessica Kingsley Publishers.

Keating, C. T., Sowden-Carvalho, S., O’Donghue, H., & Cook, J. L. (2026). Mismatching Expressions: Spatiotemporal and Kinematic Differences in Autistic and Non-Autistic Facial Expressions. Autism Research, 10.

Milton, D. (2017). A mismatch of salience: Explorations from the nature of autism from theory to practice. Pavilion.

Trevisan, D. A., Hoskyn, M., & Birmingham, E. (2018). Facial Expression Production in Autism: A Meta-Analysis. Autism Research, 11(12), 1586–1601.

Heather Connolly-Smith is a writer, therapist and specialist university mentor for neurodivergent students. She is particularly interested in neuroaffirmative practice and the importance of systemic change to support the wellbeing of autistic people.