A Commentary on Autism and Moral Development: What Can We Learn from the Sandy Hook School Shooting?

Michelle Hartley-McAndrew, MD, FAAP, Donald Crawford, PhD


The Sandy Hook Elementary School shooting has left many people wondering whether the shooter’s diagnosis along the autism spectrum is what caused the unthinkable crime that transpired.  This commentary explores moral development in both the typical and autism populations.  It reviews previous studies done on the autism population regarding their understanding of right and wrong actions even when they lack theory of mind.  A lack of empathy is often attributed to individuals with autism spectrum disorders, but many studies show that while they may fail to articulate another person’s point of view, they are not completely unresponsive to the distress or moral dilemmas of others.  This commentary aims to dispel any misunderstanding that autism spectrum disorder equals lack of empathy, which leads to violence.  It also hopes to alert the medical community treating those with autism spectrum disorders that the diagnosis of the patient may not end at autism alone.  Thus other personality disorders may be present requiring intensive treatment and referral.  

[N A J Med Sci. 2013;6(3):163-166.   DOI:  10.7156/najms.2013.0603163]


Sandy Hook, shooting, Autism, Asperger disorder, theory of mind, moral development

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Barron J. Children were all shot multiple times with a semiautomatic, officials say. (http://www.nytimes.com/2012/12/16/nyregion/gunman-kills-20-children-at-school-in-connecticut-28-dead-in-all.html). The New York Times. 2012. Accessed on 2/ 22, 2013.

Rochman B. Troubling legacy of Sandy Hook may be backlash against kids with autism”. http://www.cnn.com/2012/12/19/hearlth/shooting-autism/index.html). Accessed on 2/ 22/2013.

Blair RJ. Brief report: morality in the autistic child. J Autism Dev Disord. 1996;26(5):571-579.

Crain WC. Kohlberg’s Stages of Moral Development in Theories of Development: Concepts and Applications New Jersey: Prentice-Hall; 1985: 118-136.

Smetana JG. The Role of Parents in Moral Development: A Social Domain Analysis. J Moral Educ. 1999;28(3):311-321.

Damasio H, Grabowski T, Frank R, Galaburda AM, Damasio AR. The return of Phineas Gage: Clues about the brain from the skull of a famous patient. Science.1994;264(5162):1102-1105.

Greene J, Haidt J. How (and where) does moral judgment work? Trends Cogn Sci. 2002; 6(12):517-523.

Moll J, Zahn R, De Oliveira-Souza R, Krueger F, Grafman J. The neural basis of human moral cognition. Ann N Y Acad Sci. 2008;1124:161-180.

Hartley-McAndrew M, Weinstock A. A review of the neurobiological basis of autism. N A J Med Sci. 2011;4(3):107-111.

Baron-Cohen S, Leslie AM, Frith U. Does the Autistic Child have a “Theory of Mind”? Cognition. 1985;21(1):37-46.

Kennett J. Autism, Empathy and Moral Agency. Philos Q. 2002; 52(208):340-357.

Blair RJR. Psychophysiological responsiveness to the distress of others in children with autism. Pers Individ Dif. 1999;26(3):447-485.

Blair RJR. Responsiveness to distress cues in the child with psychopathic tendencies. Pers Individ Dif. 1999;27(1):135-145.

Grant CM, Boucher J, Riggs KJ, Grayson A. Moral understanding in children with autism. Autism. 2005;9(3):317-331.

Leslie AM, Mallon R, DiCorcia JA. Transgressors, victims, and cry babies: Is basic moral judgment spared in autism? Social Neuroscience. 2006;1(3-4):270-283.

Moran JM, Young LL, Saxe R, et al. Impaired theory of mind for moral judgment in high-functioning autism. Proc Natl Acad Sci USA. 2011;108(7):2688-2692.

Layfer OT. Comorbid psychiatric disorders in children with autism: Interview development and rates of disorders. J Autism Dev Disord. 2006;36(7):849-861.

Volkmar FR. Cohen DJ. Comorbid association of autism and schizophrenia. Am J Psychiatry. 1991;148(12):1705-1707.


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