Trying not to look ‘different’: The impact of camouflaging in autism
It is common in those on the autistic spectrum to camouflage their disorder either by hiding unwanted autistic behaviours, or explicitly using more behaviours they consider to be socially acceptable, in an attempt to ‘put on their best normal’(1). Camouflaging is perceived by autistic people as a way of both compensating for, and masking their disorder. This includes portraying the right kinds of expressions, planning every conversation, and attempting to play the appropriate role, which can understandably lead to the feeling that they are not being their true self(1). Still, despite complications with identity, camouflaging is deemed as an opportunity to connect and assimilate with others as a functioning member of society, while avoiding drawing attention to themselves as ‘different’(1).
However, the consequences of camouflaging in autism are extensive, with research finding that camouflaging is linked to increases in stress(2,3), anxiety(2,3), depression(4), exhaustion(5) and suicidal ideation(6). This is influenced by the levels of effort required to mask the disorder, with some seeking solitude to avoid worrying about how they are perceived by others(1). Moreover, there is a tendency to stereotype what autism looks like, with many people naïve to the idea that it can be camouflaged. In some cases, the use of camouflaging has led to a clinical diagnosis being missed(1). This may be disproportionately so for females, as the male-to-female ratio of children with autism is 3:1(7). Females may appear to have fewer, or less obvious difficulties with both making and maintaining friendships, as well as understanding social interactions, by mimicking typical peers(8), particularly regarding communication techniques(9). To support this, camouflaging behaviours are more prevalent in autistic females, than males on the school playground(10).
Overall, it is pivotal that awareness of both the prevalence and consequences of camouflaging in autism is increased, as this could have strong implications on both social and learning development, particularly in children and adolescents. More specifically, in an educational setting, if efforts are focused on appearing ‘normal’, it is sensible to speculate that this may have a negative influence on their engagement with education and consequent learning and memory. Still, as this is a relatively new research area, further research is required to identify such causal relationships, as well as the role of therapy, i.e. the explicit learning of social skills, in order to alleviate the perceived need to camouflage.
References
1. 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).
2. Cage, E., DiMonaco, J., & Newell, V. (2017). Experiences of autism acceptance and mental health in autistic adults. Journal of Autism and Developmental Disorders, 5-8.
3. Cage, E., & Troxell-Whitman, Z. (2019). Understanding the reasons, contexts, and costs of camouflaging for autistic adults. Journal of Autism and Developmental Disorders.
4. Lai, M.-C., Lombardo, M. V, Pasco, G., Ruigrok, A. N. V, Wheelwright, S. J., Sadek, S. A., … Baron-Cohen, S. (2011). A behavioural comparison of male and female adults with high functioning autism spectrum conditions. PloSOne, 6(6), e20835.
5. Bargiela, S., Steward, R., & Mandy, W. (2016). The experiences of late-diagnosed women with Autism Spectrum Conditions: An investigation of the female autism phenotype. Journal of Autism and Developmental Disorders, 46(10), 3281–3294.
6. Cassidy, S., Bradley, L., Shaw, R., & Baron-Cohen, S. (2018). Risk markers for suicidality in autistic adults. Molecular Autism, 9(42), 1–14.
7. Loomes, R., Hull, L., & Mandy, W. P. L. (2017). What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 56(6), 466-474.
8. Sedgewick, F., Hill, V., Yates, R., Pickering, L., & Pellicano, E. (2016). Gender differences in the social motivation and friendship experiences of autistic and non-autistic adolescents. Journal of autism and developmental disorders, 46(4), 1297-1306.
9. Parish-Morris, J., Liberman, M. Y., Cieri, C., Herrington, J. D., Yerys, B. E., Bateman, L., … Schultz, R. T. (2017). Linguistic camouflage in girls with autism spectrum disorder. Molecular Autism, 8(1), 48.
10. Dean, M., Harwood, R., & Kasari, C. (2017). The art of camouflage: Gender differences in the social behaviours of girls and boys with autism spectrum disorder. Autism, 21(6), 678–689.