The Hidden Complexity of Autism: Understanding Masking

Masking, or camouflaging, is a common behavior seen in many people with autism spectrum disorder (ASD), also known as autism[1]. It involves suppressing or concealing natural behaviors, and instead, mimicking neurotypical behaviors to blend into social situations [2}]. Masking has profound implications for mental health, social relationships, and diagnostic processes.   

Why  People with Autism Engage in Masking 

Masking can be a coping strategy for people with autism who are trying to fit into social norms, prevent bullying, or just “blend in." [3]. It's often learned unconsciously through observation and becomes a method to avoid feeling different or excluded. However, while masking can provide immediate benefits, it can also lead to exhaustion, stress, and long-term mental health issues due to the pressure of maintaining the camouflage [4].  

The Impact of Masking  

The act of masking can make it difficult for people to receive a timely and accurate autism diagnosis, as it can disguise or minimize the signs typically associated with the condition [5]. This is particularly true for females with autism, who are often underdiagnosed due to societal expectations and gender biases in diagnostic criteria [6].  

Additionally, the constant effort to mask autism can contribute to mental health issues such as anxiety, depression, and identity confusion [7]. The continual stress of trying to “fit in” can take a significant toll on a person’s emotional well-being.  

Recognizing and Supporting Masking Behaviors  

Parents, educators, and healthcare providers who understand and recognize the signs of masking can support people with autism effectively. Because every person’s experience with autism and masking is unique, support strategies should be individualized and may involve promoting acceptance of neurodiversity, creating safe spaces where masking isn't necessary, and encouraging mental health support when needed [8]. 

Citations: 

1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.  

2. Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M. C., & Mandy, W. (2017). “Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions. Journal of Autism and Developmental Disorders, 47(8), 2519–2534. https://doi.org/10.1007/s10803-017-3166-5 

3. Cage, E., Di Monaco, J., & Newell, V. (2018). Experiences of Autism Acceptance and Mental Health in Autistic Adults. Journal of Autism and Developmental Disorders, 48(2), 473-484. doi:10.1007/s10803-017-3342-7 

4. Cassidy, S., Bradley, L., Shaw, R., & Baron-Cohen, S. (2018). Risk markers for suicidality in autistic adults. Molecular Autism, 9(1). doi:10.1186/s13229-018-0226-4 

5. Lai, M. C., Lombardo, M. V., Ruigrok, A. N., Chakrabarti, B., Wheelwright, S. J., Auyeung, B., Allison, C., & Baron-Cohen, S. (2015). Quantifying and exploring camouflaging in men and women with autism. Autism, 20(6), 690–702. doi: 10.1177/1362361316671012

6. Dean, M., Harwood, R., & Kasari, C. (2017). The art of camouflage: Gender differences in the social behaviors of girls and boys with autism spectrum disorder. Autism, 21(6), 678–689. https://doi.org/10.1177/1362361316671845 

7. Hull, L., Mandy, W., & Petrides, K. V. (2017). Behavioural and cognitive sex/gender differences in autism spectrum condition and typically developing males and females. Autism, 21(6), 706–727. https://doi.org/10.1177/1362361316669087 

8. Cage, E., & Troxell-Whitman, Z. (2019). Understanding the reasons, contexts and costs of camouflaging for autistic adults. Journal of Autism and Developmental Disorders, 49(5), 1899–1911. https://doi.org/10.1007/s10803-018-03878-x