An area of research that has yet to be uncovered that I think is really interesting is masking/camouflaging behavior in low-income autistic people. It would be interesting to see if low-income people are more likely to mask autistic traits and feel more pressure to live up to certain social expectations than higher-income people do. The intersection of socio-economic status and camouflaging behavior is something that I find really interesting.

Camouflaging in low-income autistic people 

Camouflaging/masking in autistic women is very common, however, there have been very few studies that have investigated this concept. Autism is diagnosed more commonly in boys, which likely has to do with the diagnostic criteria not being sensitive to the way that autism presents in girls. 

This study aimed to understand how autistic women are impacted by camouflaging and if they have different experiences of diagnosis when compared to men. 

The study found that on average, women take longer to suspect autism and longer to receive a correct diagnosis of autism. Women are more likely to receive incorrect diagnoses of other psychiatric disorders before they are correctly diagnosed with autism. When the study tested camouflaging behavior using the CAT-Q, they found that camouflaging predicted anxiety and depression in women. An additional finding was that camouflaging did not predict early identification of autism, which suggests that there are other factors at play that are leading to women being diagnosed later in life.

This study provides a good start for understanding camouflaging behaviors in women, however much more research needs to be done on this concept. A limitation of the study was that it was not able to compare women to non-binary people due to a small sample size and it also was conducted on a sample of level 1 autistic people, so we cannot determine how camouflaging effects autistic people with higher support needs. 

Camouflaging/masking in autistic women 

Autistic burnout is a common experience, yet it is vastly understudied. There are very few studies that explore autistic burnout and the way that burnout presents uniquely in the autistic community. This study undertook a thematic analysis of social media users posts regarding autistic burnout to better understand the construct. 

The participants in this study included adults who had shared posts about autistic burnout on Twitter and Wrong Planet. Many themes were discovered in the analysis, and an overarching theme was insufficient awareness of autism which led to negative expereinces among autistic people, ultimately leading to autistic burnout. 

Some other themes that were uncovered in this analysis include negative stereotypes and stimga surrounding autism, which led many to try to pass as being non-autistic. Autistic burnout was viewed as a chronic and recurring condition that had effects on mental health and well-being. In some cases, autistic burnout led to positive outcomes such as improved self-awareness, self-care, self-esteem, and confidence in self-advocacy skills. 

Participants also shared about their complex relationship with masking, as masking was seen as something that contributed to burnout but also something that people relied on. People tried to find a balance between living authentically and the stigma of showing autistic traits. 

This research also built on previous research that showed a strong relationship between autistic burnout and suicidality. More research is needed to determine the exact nature of this relationship. 

A thematic analysis of autistic burnout 

The author of this text poses a unique way of viewing autistic masking. They view autism as being a visible neurominority group. Within that neurominority group, camouflaging is defined as a form of assimilation to neurotypical social norms. 

This study undertook an analysis of tweets from the #TakeTheMaskOff movement in 2018. The tweets revealed autistic people's perceptions of and attitudes towards masking. Analysis of the tweets revealed that autistic people's awareness of neurotypical people's negative responses to them compelled them to mask more. Autistic people in these tweets reported experiencing discrimination against stigmatized minority traits, such as self-stimulatory behaviors, and thus repressed those traits. Autistic people reported engaging in camouflaging behaviors to avoid negative consequences. Many autistic people viewed camouflaging as protecting them from discrimination and neurotypical violence. 

In conclusion, this article provides some useful insights into autistic masking and the neurominority status. More research needs to be done on the concept of neurominority status to determine if neurodiverse people identify with this label. 

Autistic masking and minority group model of neurodiversity 

Camouflaging (also known as masking) is a practice where an autistic person attempts to hide their autistic traits in an attempt to appear more neurotypical and fit in with neurotypical communities. Camouflaging has been associated with negative mental health outcomes in autistic populations, including autistic burnout and suicidality. There have been few systematic reviews investigating this concept up to this point, and the present study provides a much needed analysis of camouflaging in autistic adults.

This systematic review showed that camouflaging autistic traits was more common among females than males. Reasons for camouflaging included making friends, being accepted, safety, and resilience. The research showed that women engage in camouflaging to serve a functional purpose whilst men engage in camouflaging to be more comfortable in social situations. 

Consistent with previous literature, camouflaging was found to have impacts on anxiety and stress and was found to be associated with suicidality. More research is needed on camouflaging to understand it and it's impacts on autistic people, but the current study is a good starting point for understanding camouflaging. 

Grand Valley State University

Autism spectrum disorder is a neurodevelopmental disorder that is characterized by differences in social communicative functioning and repetitive interests, behaviors, and routines.

It is called a developmental disorder because symptoms usually appear during the developmental period. The disorder is lifelong, and can be diagnosed at any age.

Research on the causes of autism is ongoing and current research shows a genetic component.

Autism Spectrum Disorder 

Alaghband-rad, J., Hajikarim-Hamedani, A., Motamed, M. (2023). Camouflage and masking behavior in adult autism. Frontiers in Psychiatry, 14, 1-9. https://doi.org/10.3389/fpsyt.2023.1108110

Reference: Camouflaging/masking in autistic adults

The overlap of autism and LGBTQ+ identity is an intersectional issue. 

- Recent studies have shown that there is a higher prevalence of ASD among people who are gender diverse 
- There may be an association between gender dysphoria and autism
- Some research suggests that gender variance is not associated specifically with ASD, but with neurodevelopmental disorders more broadly 
- More research is needed in order to gain a nuanced understanding of the intersection between ASD and LGBTQ+ identity

Autism & LGBTQ+ Identity 

Interventions for autism have historically not included input from autistic people and have not met the needs of autistic communities. 

Interventions like Applied Behavioral Analysis (ABA) have not included autistic people in the design or implementation of interventions and have long been critiqued for being harmful to autistic people. 

Recently, neurodiversity-affirming interventions (NAIS) have started to arise. These interventions challenge researchers and clinicians to include autistic people's input in all stages of the intervention process.  

Neurodiversity-affirming interventions should focus on the strengths of the individuals and focus on attaining independence, rather that achieving normalcy. 

Future research and practice should align with the experiences, priorities, and goals of the autistic population. 

Neurodiversity-affirming interventions for autism 

Autism interventions are strategies, therapies, or programs designed to improve the quality of life of individuals with Autism Spectrum Disorder. 

Autism interventions can be behavioral, educational, medical, or therapeutic. 

Interventions are typically individualized and evidence-based. 

Examples of interventions include 
- Applied Behavioral Analysis (ABA)

- Speech and language therapy 

- Occupational therapy 

Autism interventions 

References for Autism Spectrum Disorder 

As post-secondary environments start to adopt neurodiversity-affirming frameworks, more and more students on the autism spectrum are starting to enroll in university. However, these students may not have the support services that they need to succeed and may face many mental health issues. 

Current research shows that autistic students are often isolated and face loneliness, along with victimization. The current study (White et al., 2011) shows that the rate of students currently in the college environment with undiagnosed ASD is anywhere from 0.7%-1.9%. This shows that there are many students entering college who are autistic and are undiagnosed.

In the college environment, ASD is highly correlated with co-occurring mental health issues, including high social anxiety, depression, and aggression. 

This is an important piece of research that highlights the need for more attention to autism in the college environment. 

Autism & College 

Camouflaging/masking in autistic adults

There are a variety of health disparities that members of the autistic community face. These health disparities may make it more difficult to access quality services that meet the needs of autistic populations. Autistic adults have higher rates of chronic health conditions and psychiatric conditions (Wier, 2022), yet they report worse quality healthcare experiences than non-autistic adults.  Research shows that autistic people commonly view that their providers have limited knowledge on autism and working with autistic people (McLean et al. 2024). Many organizational components of the healthcare environment, such as length of appointments and access to consistent and comprehensive care, affected the health outcomes of autistic people and were barriers to accessing quality care (McLean et al., 2024). In addition to that, members of disadvantaged populations, such as those from BIPOC communities, LGBTQ+ communities, and those of low socioeconomic status, are at greater risk for experiencing healthcare disparities (Bishop-Fitzpatrick & Hind, 2017; Hall et al., 2020; Wallich et al., 2023). 


Some interventions to improve the healthcare outcomes of autistic people that researchers have suggested include lengthening appointment times, providing training for providers, and adding online options for appointment management (McLean et al., 2024). In addition, interventions can be put in place to make the healthcare environment more accessible and affirming to autistic people, including adding sensory rooms and providing funding for accessible transportation.

Learn Before

Related

Learn After