How Does Literal Thinking Affect Emotional Expression in Autism?

PostedDecember 13, 2025

UpdatedDecember 13, 2025

ByMy Patient Advice

Author: Hannah Smith, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Literal thinking, interpreting language and social cues exactly as they’re presented is a common cognitive style in autism. According to NHS guidance, autistic people often find figurative language, sarcasm, or implied emotional meaning difficult to interpret. This can make it harder to understand or express emotions in the way others expect, even though feelings themselves are just as strong.

How Literal Thinking Shapes Emotional Awareness

NICE guidance for adults (CG142) and young people (NG170) both recognise that literal or concrete thinking can reduce emotional inference the ability to “read between the lines” in conversation. For instance, a statement like “I’m fine” may be taken at face value, even when the speaker’s tone suggests otherwise.
Research published in The Lancet Psychiatry (2023) and the Journal of Autism and Developmental Disorders (PubMed) shows that this style of processing is linked to reduced emotional recognition not from a lack of empathy, but from differences in how emotional cues are understood and expressed.

Improving Emotional Expression

Evidence from the National Autistic Society and Mayo Clinic highlights practical approaches to build emotional awareness, including:

Speech and language therapy, to teach emotional vocabulary and improve pragmatic language.

Social communication training, including social stories and peer mentoring.

Cognitive behavioural therapy (CBT), to develop insight into emotional cues and manage emotional regulation.

Visual supports, such as emotion charts or expression cards, to make abstract emotions more concrete.

These interventions help bridge the gap between emotional understanding and expression, empowering autistic people to communicate feelings more confidently and clearly.

If you or someone you know is exploring whether autism may explain differences in communication or emotion, Autism Detect offers private online autism assessments for adults and children, with aftercare services focused on social and emotional development.

Takeaway:

Literal thinking doesn’t mean a lack of emotion; it reflects a different way of understanding. With structured support, autistic people can enhance emotional recognition, improve self-expression, and connect with others on their own authentic terms.

Hannah Smith, MSc

Author

Hannah Smith is a clinical psychologist with a Master’s in Clinical Psychology and over three years of experience in behaviour therapy, special education, and inclusive practices. She specialises in Applied Behavior Analysis (ABA), Cognitive Behavioural Therapy (CBT), and inclusive education strategies. Hannah has worked extensively with children and adults with Autism Spectrum Disorder (ASD), ADHD, Down syndrome, and intellectual disabilities, delivering evidence-based interventions to support development, mental health, and well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.