Assessing Camouflaging in Autistic Adults: A Pathway to Positive Self-Identity

Camouflaging, the conscious or unconscious masking of autistic traits, can help autistic adults navigate social demands in the short term. Yet growing evidence shows that sustained camouflaging often carries a heavy emotional and physical toll. By learning to recognise and assess camouflaging, therapists and autistic individuals can gently unmask safely, build authentic self-understanding, and safeguard mental well-being.

What Is Camouflaging and Why Does It Matter?

Autistic camouflaging refers to the strategies people use to hide autistic differences in social interactions. From suppressing hand-flapping and scripting small talk to mirroring facial expressions, these efforts can feel essential in job interviews, classrooms, or casual conversations.

A recent systematic review of 29 quantitative studies found three key patterns:

• Adults with higher autistic traits report more camouflaging.
• Autistic women and girls tend to camouflage more than autistic men and boys (though everyone can camouflage).
• Greater self-reported camouflaging is linked to higher rates of anxiety, depression, and emotional exhaustion.

Understanding how and when camouflaging occurs is the first step toward reducing its long-term risks and fostering a positive, authentic self-identity.

Balancing Short-Term Benefits with Long-Term Risks

Camouflaging strategies often deliver immediate gains:

• Smoother social interactions
• Reduced risk of exclusion or bullying
• Improved job or academic opportunities

However, over time, routine masking can lead to:

• Chronic anxiety and depression
• Autistic burnout marked by physical fatigue and emotional depletion
• A sense of identity confusion or “imposter” feelings

Assessment helps individuals and clinicians weigh those short-term perks against the hidden costs, guiding a healthier path forward.

Strategies for Assessing Camouflaging

Therapists can integrate assessment of camouflaging into standard intake and diagnostic interviews without disrupting rapport. Below we include an Assessment Guide. Key steps to using the Guide include:

1. Normalise the conversation
   Introduce camouflaging as a common experience among autistic people, something many use to get by in a predominantly non-autistic world.
2. Use open-ended prompts
   Encourage reflection with questions like,
   1. 1. “In what situations do you feel you ‘put on’ a different social persona?”
      2. “Have you ever scripted parts of a conversation in advance?”
3. Explore across contexts
   Camouflaging varies by setting. Ask about work, family gatherings, online interactions, and unstructured social events.
4. Combine self-report with observation
   Pair subjective accounts with your own observations of speech patterns, body language, and eye contact to gain a fuller picture.
5. Be mindful of fatigue
   Even thinking about camouflaging can be exhausting. Some clients prefer to reflect on their answers in their own time in solitude. Others prefer to discuss, but over time. Offer sensory tools to assist with energy and awareness during the discussion.

An Assessment Guide

Therapists unfamiliar with autism may be unsure what to ask to understand the camouflaging profile of their client. Autistic adults who have masked for a long time can be unaware of when and how they mask; the process has become their ‘norm.’  If their process feels natural and does not cause exhaustion and stress, it is likely that they have made the style their own and further assessment may be minimal or not necessary. However, we have found that most autistic adults who extensively camouflage have paid the high costs of poor mental and physical health and dissociation from their authentic self. They desperately wish to unmask, but do not know who they are underneath the mask. To help, we have created a Guide they can go through on their own or with their therapist to pinpoint where camouflaging shows up. The questionnaire is based on our own experience and the research of Cook, Crane, Hull, Bourne, & Mandy (2022).

From Assessment to Support

Once camouflaging patterns are clear, the journey shifts toward:

• Building safe spaces where masking is unnecessary – these may be online only initially, or with one trusted friend, family member or partner.
• Cultivating self-acceptance, helping clients embrace their autistic identity without apology. This process takes time and is aided by the discovery of autistic friends, a neuro-affirming community, and ongoing support of trusted family members and friends.
• Strengthening coping skills that don’t rely solely on masking, such as pacing social engagement and self-advocacy.
• Monitoring mental health to intervene early if fatigue, anxiety, or burnout emerge.

By mapping out each individual’s camouflage profile, therapists and autistic adults can work together to ease chronic masking, preserve mental health, and nurture the unmasked self.

Camouflaging helps autistic adults to cope, but often at the cost of the expression of their authentic autistic self. We provide this assessment guide as a first step toward a more sustainable, self-affirming way of living and thriving.

Assessment Guide: Camouflaging in Autistic Adults

Partially adapted from Cook et al (2021).

These domains and prompts are intended to support clinicians in identifying potential social camouflaging behaviours during clinical interviews. They reflect self-reported strategies used by autistic adults to adapt to neurotypical expectations in everyday interactions.

1. Concealing Autistic Traits (Masking)

• Do you tend to limit conversations about your thoughts and emotions?
• Do you try to keep your movements (e.g. fidgeting, hand gestures) to a minimum during social situations?
• Do you try to suppress the urge to provide precise or detailed facts when speaking?
• Do you stop yourself from doing things you find soothing, like rocking or leg movements when you are with others?
• Do you dress, do your hair or make-up to align with what is more commonly accepted?
• Do you try to suppress your natural tone of voice, inflection, or speech rhythm to sound more “typical”?
• Do you deliberately avoid mentioning your autism diagnosis unless directly asked?
• Do you worry that certain behaviours or traits might make others uncomfortable or judge you?

2. Low-Risk Engagement Strategies (Cautious Social Approaches)

• Do you maintain eye contact or use strategies that simulate eye contact?
• Do you mirror the speech or body language of the person you’re speaking with?
• Do you smile or nod frequently during conversation?
• Do you use short verbal cues like “yeah” or “okay” to signal interest?
• Do you tend to steer conversation toward topics that interest the other person?
• Do you avoid expressing disagreement, even when you hold a different opinion?
• Do you try to prevent silence in conversations by filling gaps or changing topics quickly?
• Do you try to make yourself appear interested in topics you find unengaging to maintain social harmony?
• Do you adjust your facial expressions even when they do not match your internal state?

3. Adopting Conventional Communication Styles

• Do you apologise or explain yourself a lot?
• Do you try to avoid disagreement or expressing dissatisfaction for feat of judgement?
• Do you engage in small talk, even though you hate it?
• Do you avoid asking about other people’s personal lives or sharing opinions that could be seen as controversial?
• Do you play down your own knowledge or avoid sounding like an “expert”?
• Do you steer clear of using humour or jokes?
• Do you consciously model your communication style on what seems typical or expected?
• Do you intentionally adjust how you use gestures, facial expressions, tone of voice, or pacing of speech?
• Do you rehearse conversations or mentally prepare scripts before social situations?
• Do you imitate expressions or gestures you have seen others use because they seem effective?
• Do you notice that you have very different ‘personas” depending on whom you are speaking with?
• Do you monitor how you are being perceived during a conversation and adjust your behaviour accordingly?

4. Strategically Managing Social Impressions (Active Social Effort)

• Do you make a point of asking questions to keep the interaction going?
• Do you look for shared experiences or interests to build a connection?
• Do you monitor your speaking and listening to maintain a balance?
• Do you prefer to talk about topics you are confident in or have practiced?
• Do you use prepared phrases, anecdotes, or familiar scripts to navigate conversations?
• Do you use humour strategically to manage how others perceive you?
• Do you consciously avoid talking about your deep interests to prevent being seen as “too intense”?
• Do you feel pressure to appear socially skilled, even when it takes a lot of effort?
• Do you reflect after social interactions to analyse how you were perceived?

5. Motivation and Impact

• These questions explore the underlying motivation and impact of camouflaging, supporting deeper clinical insight.
• What motivates you to use these strategies in social settings (e.g. fear of rejection or negative perceptions, desire for connection)?
• Do you find these strategies help you feel more accepted or connected to others?
• Do you feel exhausted or “not yourself” after social interactions?
• Have you ever felt that people do not really know the “real you” because of how much you adapt?
• Do you use different strategies in different settings (e.g. work vs family vs public)?

Where to from here?

Half-Day Workshop: Autism: Developing a Positive Self-Identity

Research shows that autistic people who embrace their autism experience improved wellbeing, self-esteem, and life satisfaction. Yet many face barriers such as masking, stigma, and misunderstanding.

In this half-day workshop, we explore:

• Common barriers to developing a positive autistic identity and how to overcome them
• The impact of language on thinking and self-perception
• Safe unmasking strategies to preserve energy and increase self-knowledge
• Practices to build self-awareness, self-compassion, and recognise autistic strengths

Suitable for autistic people of all ages, their families, educators, and clinicians.

References

Cook, J., Hull, L., Crane, L., & Mandy, W. (2021). Camouflaging in autism: A systematic review. Clinical Psychology Review, 89, 102080. https://doi.org/10.1016/j.cpr.2021.102080

Cook, J., Crane, L., Hull, L., Bourne, L., & Mandy, W. (2022). Self-reported camouflaging behaviours used by autistic adults during everyday social interactions. Autism, 26(2), 406–421. https://doi.org/10.1177/13623613211026754