Autism Camouflaging

Could it be possible to have autism your whole life and not know it?

Autism Camoflouge?

Not only is it possible, but a term called “Autism Camoflouging” may help explain why older people are diagnosed with autism after living their life apparently “symptom-free,” and why the rate is higher in women than men.

Masking Personality for Social Survival

Autism camouflaging is the process by which a person that would normally present autistic-like symptoms “masks” their personality by learning appropriate social behaviors, such as keeping eye contact during conversations, learning, and retelling jokes, and mimicking the facial expressions that they see in others. Though these are learned behaviors, the actions themselves are subconscious, with the autistic person having little-to-no knowledge of their conduct.

Is Autism Camouflaging Harmless?

Camouflage and Mental Health

Though it may seem harmless, autism camouflaging can have serious repercussions on the victim’s mental health, often manifesting itself in the form of depression, anxiety, or a severe form of mental exhaustion, due to the incredible amount of brain activity that is required to keep up the facade.

Boy vs. Girls Diagnosis

Scientists have long been puzzled about the rates of autism amongst boys as opposed to girls. Historically, researchers have concluded that boys may be simply more prone to autistic-like symptoms, but recent studies have shown that girls are naturally better at masking their symptoms than boys, which results in fewer girls receiving the help they so desperately need.

In the Journal of Autism

External and Internal Behaviors

In a recent study in the Journal of Autism, Meng-Chuan Lai and several other colleagues studied the external and internal behaviors of 30 male and 30 female subjects that had a clinical diagnosis of autism. The ages were relatively the same for each – 27.2 for males, 27.8 for female – and groups were matched on intelligence and lack of intellectual impairment.

External Indicators of Social Interactions

Using a host of tools that are commonly employed in autism research and an Autism Diagnostic Observation Schedule (ADOS), Lai and his team measured the external indicators of the subjects’ social interaction. They then used the Autism Spectrum Quotient (ASQ), which measures traits of autism, and the “Reading the Mind in the Eyes” test which determines how well the subject feels about their situation by studying their facial expressions. They then cross-tested the results of the ADOS with ASQ and “Reading the Mind in the Eyes” test to decipher whether or not the patient was successfully camouflaging their symptoms; a low ADOS score and poor performance on the ASQ and Eyes test indicated a positive result.

Result of ADOS score and ASQ Eyes Test

Women at High Rate

Per the initial expectation, women were confirmed to have a higher rate of camouflaging than their male counterparts, but other than that, the results were wildly inconsistent. While depression was normally taken as a sign of camouflaging, anxiety wasn’t, and even then the correlation was prominent only in men, leading the researchers to conclude that camouflaging had more negative consequences for men. Women had a greater association between executive function and camouflaging than men, but verbal intelligence was not affected in either group, and age played a little-to-no factor in the results as well.

Area of Disparity

One area in which there was a disparity between sexes was in the structure of the brain, with the rate of camouflaging significantly greater in women than in men; the smaller the temporal, cerebellar, and occipital brain regions, the more camouflaging was present. Researchers were at a loss to explain away this connection, but one theory is that those areas produce different personality traits in women than men, such as a difference in emotional processing. It should be pointed out, however, that these studies are preliminary, and further testing is necessary to validate or contradict any supposed theories.

What is Next?

First to Provide Evidence

Though the assumption heading into the study was that women participated in a higher rate of camouflaging then men, this study is the first of its kind to provide empirical evidence in the affirmative and supports the claims of pediatricians and other medical personnel that claim autistic women have better social skills than autistic men. There are still questions as to whether or not camouflaging is still female-dominated, so further studies may prove that men can engage in it as well.

A Study with “Real World” Rules

In order to conduct a complete study, “real-world” rules will have to be in play to allow for autistic subjects of all ages and intellectual ranges. Indeed, one of the reasons this study may have been inhibited is by its emphasis on only using patients that had zero intellectual disabilities; in reality, people that should be diagnosed with autism may be overlooked precisely because of their camouflaging. To remedy this, all different types of autistic people from everywhere on the spectrum must be considered in order to conduct a more thorough study, as well as provide better screening options for doctors to detect whether a patient is not autistic or just masking their own symptoms.

Subjective Bias in Perception Studies

Possible Bias in Studies

Every study that has to do with perception is prone to a certain level of subjective bias, and this experiment is no different. Gender bias is one possible example of this; if the people who conducted the ADOS screening rated girls at a higher level of autism because they acted more masculine, then the sample is skewed. Not only does there need to be a system of checks and balances to ensure subjective bias is minimized (though it can hardly ever be removed entirely), the sample size needs to be larger to allow for a more accurate average.

Understanding Signs will Help the Future

Either way, this study took autism research a giant leap forward in understanding the behavioral patterns of men as opposed to women and discovered that women had a greater tendency to mask their autism symptoms through a form of camouflage. This means girls will be more adept socially but could also be prone to depression or learning disabilities. Understanding the signs of not only autism but camouflaging as well will help doctors in the future give every child the treatment they need to succeed.