Camouflaging Autism

Autism is frequently conceptualized as a litany of odd behaviors, mannerisms and observable traits that distinguish an autistic person from a “normal” one. Historically, much credence has been placed in undoing those abnormal attributes so that the autistic individual can blend in. Many autistic people have successfully “camouflaged” their autism by mimicking socio-cultural appropriate behaviors such as making eye contact, engaging in standard greetings, minding their facial expressions, restraining their stimming and generally suppressing their autistic traits. Camouflaging extends to emulating executive functioning behaviors such as the organization, planning, and pacing of tasks in work and home environments.

Camouflaging is utterly exhausting and takes a heavy toll on an autistic individual, contributing to low self-esteem, anxiety and depression. The autistic person absorbs the notion that it is not okay to be themselves. It can also delay diagnosis when they hear disbelieving comments such as “You don’t seem autistic!” or “You’re too social to be autistic.” Sadly, their success at blending in creates barriers in self-acceptance and receiving help. Studies have verified that it is not the experience of being autistic that creates distress, but the pressure to conform and blend in with neurotypical peers, burying their true selves in shame.

The burgeoning diagnosis of girls with autism can be attributed to their success at masking their autism. Indeed, girls and women have been under-counted in autism statistics because they are so adept at camouflage. Socialized to be “good girls,” they frequently suffer from perfectionism and often aren’t diagnosed until their teens or early adulthood, when the pressure of sublimating their autism manifests as eating disorders or other mental health alarms.

Autism luminary Dr. Tony Atwood, points to the necessity of creating proper diagnostic tools to screen for autism in girls and women. He and his colleagues developed the Questionnaire of Autism Spectrum Conditions or Q-ASC (Ormond et al 2018) to differentiate between the girls and boys profile of autism. The questionnaire indicates that females with autism, in comparison to boys with autism, gained greater scores on questions reflecting these domains:

1. Gender identity (more in the 5-12 year old range)
2. Sensory sensitivity
3. Social masking
4. Imagination
5. Imitation
6. Talent in music and languages

This knowledge helps identify girls who need intervention and can lead to understanding how girls and women blend into the mainstream so facilely. It makes sense that perfectionist girls with imagination and talent in music and languages can fly under the radar of being deeply troubled and in need of help.

Within the last three years, it’s been recognized that boys, as well as girls, camouflage their autism and I suspect it can be correlated to introversion vs extroversion.

I have twins with autism. In school, one was extroverted and volatile and the other introverted and veritably invisible. The first didn’t have a prayer of masking his disability, but the second put all his energy into it. I remember his grade school IEP declaring that “he will make eye contact once a day” or “engage a classmate in conversation three times a week.”

I personally found these goals cringe-worthy. My son was deeply humiliated by his diagnosis and the unwanted attention he garnered by being pulled out of class for services and riding the short bus. He learned to play the game of being “normal,” but it took a real toll on his self-esteem to the point that in high school, he disavowed even being autistic insisting the diagnosis was “wrong.” Fortunately, as a young adult he’s overcome that way of thinking and has finally made peace with himself.

There’s a heartening trend in autism towards not forcing ASD individuals to reshape themselves to fit in with the larger population, but to allow and even encourage them to be themselves, recognizing that they have unique and extraordinary contributions to make to our society.