Rethinking autism – and our role in understanding it

April is World Autism Acceptance Month. It is a moment that has shifted from awareness to acceptance – a distinction worth pausing on.

Awareness tells us something exists. Acceptance asks us what we do about it.

Walk into almost any school staffroom, workplace, or family gathering and ask what people know about autism. Very often, early in the conversation, a familiar idea emerges – that autistic people struggle to empathise, prefer to be alone, or do not seek connection in the same way as others.

For decades, autism has often been understood in ways that don’t fully reflect lived experience. It is time to look at that again.

In more than two decades as a teacher, researcher, and clinical psychologist working with autistic individuals, their families, and the systems around them, I have repeatedly seen the gap between these assumptions and reality. And that gap matters.

The idea that autistic people lack empathy has been one of the most persistent narratives in how we understand neurodevelopment. It shapes how teachers respond in classrooms, how employers interpret behaviour in the workplace, and how families make sense of difference at home. Over time, these interpretations shape expectations, relationships, and opportunities in ways that can be limiting.

Over the past decade, research has offered a clearer and more nuanced understanding. In 2012, researcher Dr Damian Milton described what is now known as the double empathy problem – a theory that reframes the difficulty not as something located within autistic people, but as a mutual mismatch in communication and understanding between autistic and non-autistic individuals. In practice, this can look like an autistic person expressing care or interest in ways that feel unfamiliar to non-autistic others – through detailed focus, directness, or different eye contact – while those same behaviours are interpreted as indifference or disengagement. Neither person is failing to connect; they are simply working from different social grammars.

When autistic people interact with one another, studies increasingly suggest that communication can be as effective and meaningful as it is between non-autistic people. The difficulty tends to arise across neurological differences – between autistic and non-autistic people – not within them.

Think about what that means in everyday life. Most of the people an autistic person encounters – at school, at work, in public spaces – will be non-autistic. That means spending much of your day being interpreted through frameworks that may not fit how you think, what you need, or how you experience the world.

Over time, being repeatedly misunderstood can shape how safe it feels to engage. Some people may begin to step back from interaction – not because they lack interest in connection, but because connection has so often been difficult or misaligned.

And then, from the outside, that withdrawal can be read as preference.

This is, in many cases, a misreading of circumstance as character.

In my clinical work in Dubai, I regularly meet parents supporting children who are warm, thoughtful, and relational, yet persistently described in terms of what they lack. I meet children who come home from school exhausted – not because their day was academically hard, but because navigating a world not built for how they think and communicate takes a toll that rarely shows up on the surface. I also work with people navigating these questions later in life – sometimes only recently identified, often carrying years of self-doubt that begins to make sense once the right framework is in place. The distress that emerges in these spaces is not a function of autism itself, but of the environments in which that autism is interpreted.

Autistic people tell and show me, regularly, how much connection and belonging matter – how much it matters when it is found, and how painful it is when it is not. What differs is not the need, but how it is expressed – and too often misread by others. What is needed, then, is not a change in the person, but a shift in the conditions around them – environments where different ways of communicating and relating are met with curiosity rather than correction.

The costs of that misinterpretation are measurable and significant. According to the National Autistic Society, eight in ten autistic people experience mental health problems, more than half avoid going out due to anxiety, and only around one in four autistic pupils feel happy at school. Just three in ten autistic adults are in any form of paid work. These are not inevitable features of autism. They are, in large part, the consequences of environments not designed with autistic people in mind.

But acceptance – real acceptance – points somewhere further than simply reducing harm. The autistic people I work with don’t just want to be tolerated or accommodated. They bring ways of thinking, attending, and connecting that are genuinely distinctive – and genuinely valuable. Moving beyond acceptance means recognising that difference is not merely something to be managed, but something worth understanding, and at its best, worth celebrating.

At a broader level, this is about dignity – recognising that there is more than one coherent way for a human brain to work, and that difference does not need to be framed as deficit.

The shift this invites is not about assigning blame, but about shared responsibility. It asks those of us in the neurological majority – educators, employers, clinicians, and communities – to reflect on how we interpret behaviour, and to develop what might be called neurological humility: an honest recognition that our own ways of communicating and making sense of the world are not universal, and that assuming otherwise has costs. In practice, this might mean an employer pausing before reading a direct email as rude, a teacher reconsidering whether a child’s silence reflects disinterest or discomfort, or a clinician taking care not to interpret difference as disorder.

That concept – neurological humility – feels particularly relevant in the UAE, a country that has built its identity around navigating difference – across cultures, languages, and ways of seeing the world. The question of how to understand those who think and communicate differently is not new here – and extending that same curiosity to neurological difference is very much part of that story. In clinical practice in Dubai, I see families where a late or recent diagnosis reshapes years of family history – where behaviours that caused conflict or confusion are suddenly legible in a new way. That capacity for curiosity across difference is exactly what autistic children and adults need from the people around them.

Acceptance Month is an opportunity to deepen that – to move beyond awareness and toward genuine understanding of autistic experience, and what the world around them might do differently.

The shift from awareness to acceptance is not just semantic. Awareness observes. Acceptance responds. Valuing celebrates.

And that is where we should be heading.

Autistic people are not missing empathy. More often, what has been missing is shared understanding.

That distinction matters.

Dr Dan Sheppard is a Clinical Psychologist and Neurodiversity Specialist based in Dubai