Anecdotal clinical and autobiographical observations suggest that women show more social interest, heightened emotional or affective empathy, increased imagination, better masking of social difficulties, different contents of narrow interests, and more friendships than autistic men (3). But when a person has autism, anxiety symptoms can be hard to see. Another sign of social masking is the visible display of observation. © 2005-2021 Healthline Media a Red Ventures Company. We’ll explain what it usually means and how it’s different from and…, Autism is usually detected by the time children age 3 or 4 and common signs begin to piece together a puzzle. In places where neurodiversity is not understood or welcomed, autistic people often feel the need to present or perform social behaviors that are considered neurotypical. The short- and long-term consequences of masking include exhaustion, negative mental health effects, and a deterioration of one’s sense of self (5, 2, 7). J Autism Dev Disord. This may include anxiety, depression, exhaustion, a loss of identity, and suicidal thoughts. Masking is when we mimic habits, body language, and language of non-autistic people in order to fit in. Autism Masking and Mental Health in Women with Autism Why anxiety, depression, and suicidality can be linked to autistic camouflaging. Geurts HM, Jansen MD. Masking is not a beneficial behavior in the long run and scientists now echo what autistic advocates have been saying for decades: that it should not be encouraged for people diagnosed with ASC, as masking poses a serious threat to mental health, wellbeing and development of identity. 2017;47(8):2519-2534. The motivations for masking autistic traits are largely socially motivated - including avoiding negative social consequences like bullying, as well as increasing connections with others, success at work, and success in relationships. If you’re one of those people, then I’m about to blow your minds with a second concept: Nobody grows out of Autism and a child cannot be trained out of it. What Is a Communication Board and How Does It Help? Sometimes masking focuses on hiding behaviors that people feel won’t be accepted. Retrieved from, Lai, M., Ameis, S. H. & Szatmari, P. (2017) Adolescents with Autism Spectrum Disorder: A Clinical Handbook. “Behavioural observations suggest that girls camouflage their social difficulties (e.g. Masking requires a substantial cognitive effort (6), which can be exhausting and may lead to “increased stress responses, meltdown due to social overload, anxiety and depression, and even a negative impact on the development of one’s identity” (1). Retrieved from, Baron-Cohen, S. (2017). Why is masking an issue? Masking may help at times, but regular camouflaging can have serious effects on mental and physical health. « Autism is not only an impairment, it is also a dis-ability which can become a handicap » (« l’autisme n’est pas seulement une atteinte, c’est aussi une limitation ou une incapacité qui peut devenir un handicap »). •Girls with autism tend to “mask” more than boys on the spectrum. 2017). https://journals.sagepub.com/doi/pdf/10.1177/1362361316671012, https://link.springer.com/content/pdf/10.1007%2Fs10803-017-3166-5.pdf, http://www.oxfordclinicalpsych.com/view/10.1093/med-psych/9780190624828.001.0001/med-9780190624828-chapter-12?print=pdf, http://docs.autismresearchcentre.com/papers/2017_Warrier_The-Genetics-of-Autism.pdf, Lai, M., Lombardo M. V., Ruigrok, A. N.V., Chakrabarti, B., Auyeung, B., Szatmari, P., . Nothing had prepared Tracey Stewart for her daughter's diagnosis, thanks to Jessica's expert masking of the warning signs. But suddenly everything … PDD-NOS once referred to a high-functioning form of…, There are signs of autism in babies. More studies and research on masking are so needed in order to better understand the long-term impacts on the wellbeing of individuals who mask and how we can create societies that allow people to be their authentic selves (2). This diagnostic imbalance likely has a variety of causes. In short, masking involves suppressing certain parts of oneself and performing other behaviors. Baron-Cohen, S. (2016). Journal of Autism and Developmental Disorders, 49, 1899–1911. Our website services, content, and products are for informational purposes only. Behavior that deviates from these norms is met with negative consequences. doi:10.1007/s10803-017-3342-7. Time spent learning neurotypical behaviors is time not invested in other kinds of personal development. The demands of masking may be one reason that it’s been demonstrated that autistic women are more likely to experience internalised challenges, like anxiety and depression, than men who are more likely to have external difficulties, such as hyperactivity and behavioral challenges. This is likely one of the reasons that women or girls tend to be underdiagnosed; they may ‘fly under the radar’ due to the insufficient knowledge of gendered behavioral characteristics of autism. When people feel they have to compensate for autism characteristics, they have to invest a lot of time and energy in trying to “pass” as neurotypical. Cage, E., Troxell-Whitman, Z. •Students who mask are often misdiagnosed because they have camouflaged their symptoms. It is being so tired you can’t move, you can’t think, so tired you can sleep for days, so tired there is nothing left. Matthew Siegel calls for anxiety tests and treatments that are tailored to people with autism. One of which may be biological sex differences, but another reason that is strongly supported by current research, may be due to under- or mis-recognition of autism in women. Maybe it’s personal safety. People who camouflage regularly often say they feel drained and exhausted by the effort of trying to conform to neurotypical standards of behavior. Autism, 24(2), 352–363. Hull, L., Lai, M.-C., Baron-Cohen, S., Allison, C., Smith, P., Petrides, K., & Mandy, W. (2020). In fact, some autism advocates think the best way to prevent the damaging health effects of masking is to make the world a safer and more supportive place for people who function differently — in short, to reduce the need to pretend and camouflage. Some people may also feel they have to hide neurodiverse behaviors in order to be accepted. Autism spectrum condition (ASC) encompasses a wide range of neurological differences that affect the way people communicate, learn, and interact with others. First, they will observe; then, when they feel that they can begin to copy, they will most likely test whether the approach they have chosen will work before using it on a bigger scale. Masking or camouflaging is artificially performing social behavior that is deemed to be more socially acceptable (by neurotypical standards) or hiding behavior that might be viewed as socially unacceptable (1). With the new ICD-11, the measures used to assess ASC have been changed and sectioned into six distinctive expressions that now enable specialists to assess challenges and traits individually. Some research suggests that autistic girls and women may be more inclined to develop friendships than autistic boys and men. Signs and symptoms include: Stimming (overt self stimulating and self soothing/comforting) behaviours like foot tapping, hair stroking, head... Communication or social problems. In fact, research indicates that trauma can actually make ASD symptoms more challenging to live with. It's common in people who don't have an autism diagnosis, and sometimes, masking keeps people from getting the help they need. Posted Apr 26, 2021 | Reviewed by Devon Frye Masking is a complex and costly survival strategy for autistic people. This may include anxiety, depression, exhaustion, a loss of identity, and suicidal thoughts. Le camouflage social chez les personnes autistes est un terme utilisé pour décrire les comportements qui consistent à cacher ou masquer des aspects de soi même (notamment ses caractéristiques autistiques) vis-à-vis d’autrui pour « traverser » les interactions sociales quotidiennes (Hull et al. When children wear a lion mask they roar - even if their usual personality is a shy one. It is a reaction to the fact that our society has very ingrained notions of what is preferable and expected behavior. Social Masking: Why is autism missed in girls? There’s been some debate about why girls and women may mask autistic traits more than boys and men do. Masking itself consists of a combination of camouflaging and compensation techniques where a person works to control impulses, act ‘neurotypical’, rehearse answers to questions or conversations, and mimic others. Inside you feel completely empty; there is just … Whatever the motivation, an autistic person may feel they must hide differences or change the way they naturally act — often because their living or working environment doesn’t tolerate, support, or respect neurodiversity. A misdiagnosis of mental health difficulties may happen. Today, I will talk about trauma and masking. Masking may be common in places where there’s little support for neurodiversity, or where people on the autism spectrum are under direct threat. Masking among men with Autism Spectrum Disorder is a coping strategy in the face of societal misunderstanding. This behavior is not always intentional which can lead to confusion about a person’s identity. Masking is not letting any of this show. Social communication and interaction symptoms Children and adults with autism often have difficulty connecting with others. The reality is that ‘(f)or many autistic people, camouflaging is experienced as an obligation, rather than a choice. Last medically reviewed on March 10, 2021, Autism spectrum disorders (ASDs) are neurological conditions that affect a person’s ability to communicate with others. For some, medication may also play a role. Disliking uncomfortable clothes. by The Autism Service When you wear a mask you hide your actual face - the person you are - and often you take on the persona of the new face you are wearing. Late diagnostic practices focused on the core ASC characteristics that were established based largely from behavioural presentation in males may not reflect upon the female behavioural presentation, resulting in the overlooking of those who did not meet the male-typical behavioural presentation (2). Hand flapping, avoiding eye contact, and experiencing meltdowns due to routine changes are all common parts of life with autism. It generally involves intentionally learning neurotypical behaviors and mimicking them in social situations. The cost is exhaustion. We need to … Many children with autism have sensory issues relating to clothing … Camouflaging or using social imitation strategies includes imitations like “making eye contact during conversation, using learned phrases or pre-prepared jokes in conversation, mimicking other’s social behaviour, imitating facial expressions or gestures, and learning and following social scripts” (1). This diagnostic imbalance likely has a variety of causes. Retrieved from, Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron‑Cohen, S., Lai, M. & Mandy W. (2017). The Centers for Disease Control and Prevention (CDC) lists some of these differences as: Finding a mental health professional with the training and experience to meet your individual needs can sometimes be a challenge. While the movie promises a good time and pure comedy; its synopsis actually has some parallels with the act of “masking” among people on the autism spectrum. Since 2013, it's a part of the diagnosis of autism. The short- and long-term consequences of masking include exhaustion, negative mental health effects, and a deterioration of one’s sense of self (5, 2, 7). Camouflaging: ↑ Finding ways to hide autism or make it less visible to other people, even if the autistic person is not aware of doing this. Masking is described by those people as being mentally, physically, and emotionally draining; requiring intensive concentration, self … Masking may help socially and professionally in the short term, but may also harm mental health and a person’s sense of self-worth in the process. Cage E, Di Monaco J, Newell V. Experiences of Autism Acceptance and Mental Health in Autistic Adults. If playback doesn't begin shortly, try restarting your device. Autism is a life-long condition that affects the way in which a person communicates, relates to other people and makes sense of the world around them. La langue française permet moins que la langue de Shakespeare de se référer au modèle social pour penser « le handicap ». This can result in … Burnout is different from tired. What is masking? Over the years, the reported ratio of those who have received an autism diagnosis is 1 woman or girl to every 4-5 boys or men* (3). Masking autism may sometimes help protect autistic people from being “outed” or harassed at school or work. When I think of the word “masking”, I immediately remember the 1994 film The Mask starring the one and only Jim Carrey. It's common in people who don't have an autism diagnosis, and sometimes, masking keeps people from getting the help they need. Some people become so good at masking that their autism diagnosis is rescinded, and they lose necessary support. The character behind The Mask is a man who is constantly ridiculed in his everyday life. It is often motivated by a sense of alienation and threat, and frequently represents an attempt to avoid ostracism and attacks’ (2019). … The Genetics of Autism, Autism Research Centre. The lines between those conditions…, Autism treatment often involves a combination of different therapies. Gender differences in self-reported camouflaging in autistic and non-autistic adults. Masking, which is also called camouflaging or compensating, is a social survival strategy. Try these twelve tips to help ease mealtime stress for you and your autistic child. Many people think that men on the spectrum, because they are autistic, are not … Autism masking involves spotting those symptoms and working desperately to hide them. Maybe it’s a job opportunity. The motivation for masking was found to be foremost the desire to fit in and create connections with others (6, 2). Autistic women and girls may, as mentioned, be better at ‘camouflaging’ or ‘masking’ their symptoms, while displaying subtler characteristic behavioral presentation than men and boys (1). This is a huge gap, especially considering the higher likelihood of members of the autistic community being gender diverse. Hi, my name is Loren Snow and I’m autistic, ADHD, and have OCD. Either way, the cognitive and emotional effort affects people’s mental and physical health. We just get better at hiding it. Although there has been more research recently on autism masking, more studies need to be done to understand how sex and gender shape masking, as well as what masking looks like across the full gender spectrum. But sometimes a diagnosis isn’t made…, PDD-NOS was formerly a mild form of autism. A … 2018;48(2):473‐484. Girls with ADHD use masking – and other camouflaging techniques – to hide the fear of being different (weirdos), to avoid being bullied, and to hide feelings of shame. Masking is an unconscious act. Masking begins when a neurodiverse person recognizes that something important hinges on being perceived as neurotypical. Some people are so effective at masking that no one can tell they’re pretending or performing. While masking symptoms of autism can help teens integrate socially and feel like they’re living a “normal life,” a later diagnosis can lead to other mental health issues and difficulty receiving the help they need. It gets us through our days. However, the strain of trying to keep this up all day can be huge. One way to minimize the harmful effects of masking autism is to work toward a world in which neurodiversity is accepted, and people are treated with respect and kindness whether they communicate in neurotypical ways or not. People may mask their autism characteristics for many reasons — to boost their careers, connect with others, or avoid being stigmatized by other people. Recent research suggests that women on the autistic spectrum have a higher likelihood of subtler behavioral presentation than their male counterparts. Additionally, studies indicate that females are more likely than males to receive a misdiagnosis of other mental health conditions, such as personality disorders or eating disorders. Here’s a list of resources to help: The CDC reports that there is no cure for autism yet, and many in the autism community contend that neurodiversity itself doesn’t need to be cured. *This particular study did not consider non-binary or gender diverse people. Recognizing them is important because early intervention is key to helping autistic children succeed. For many autistic people, that experience is a daily reality. Some people are of the belief that Autism can be grown out, or that with the right support and interventions, Autism can be cured or lessened. It usually becomes apparent in the first three years of They might: Equipped with these observations and skills, an autistic person can then use them in social situations to varying effects. Quantifying and exploring camouflaging in men and women with autism. And the effort used to copy neurotypical interactions can quickly lead to social overload. Masking is maintaining that conversation. •Masking suppresses the natural state of the person with Autism. obvious self-stimulating behaviors (stims), extreme difficulties with speech and language, severe difficulties with social communication, or significant cognitive challenges, All rights reserved. There are only so many traits we can hide. You can also call or visit your nearest emergency room or psychiatric care center to speak with a mental health professional. Yet another reason why masking and social imitation strategies may lead to either missed or late diagnoses (2). We may feel pressure from others to pretend to be someone we’re not, so we create a version of ourselves that people are more likely to accept. The National Suicide Prevention Lifeline is available 24 hours a day at 800-273-8255. There is a strong correlation between autism and trauma. forcing or faking eye contact during conversations, imitating smiles and other facial expressions, developing a repertoire of rehearsed responses to questions, pushing through intense sensory discomfort including loud noises, making friends and other social connections, fitting in or feeling a sense of belonging, learn social cues from various forms of media, observe social interactions between people around them, monitor their own facial expressions and body language, adjust their tone of voice to match other people’s vocal patterns, preferring not to have eye contact or physical contact with other people, having difficulty recognizing or talking about emotions, repeating certain physical gestures or movements. Late-diagnosed individuals tend to suffer from concurrent mental health challenges, potentially related to long-term stress due to social overload in adaptation to daily life in neurotypical-centered society (1). https://www.verywellhealth.com/high-functioning-autism-260305 “Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions. Autobiographical observations and interviews with women, who have been diagnosed later in life indicate many women who have compensated and spent their whole lives feeling different until their children receive a diagnosis that they recognize themselves in (2). People across the entire gender spectrum engage in masking, studies show, but people who identify as women may mask more often than people who identify as men. These masking or compensation strategies are often very exhausting and come at a cost. Maybe it’s friendship. As adults, these tools are useful. In other cases, it focuses on preparing scripts and strategies to compensate for communication differences. Masking is appearing as normal as the next person, whatever normal may be. Over the years, the reported ratio of those who have received an autism diagnosis is 1 woman or girl to every 4-5 boys or men* (3). Academic research on autism has predominantly been carried out with male participants thus making the behavior and characteristics of autism gender stereotypical with a male-based behavioural characterization of autism. Anxiety is one of the most common mental health conditions, as well as one of the most treatable. But while camouflaging may have certain benefits, it’s important to note that there are significant costs. Symptoms can include disorganization, inattentiveness and isolation, decreased stress threshold, chronic fatigue, crying and suicidal remarks. Healthline Media does not provide medical advice, diagnosis, or treatment. Here are some of the effects of regular masking: If you’re experiencing suicidal thoughts, help is always available. The Development of Compensatory Strategies. Although masking has predominantly been described in relation to autistic women and girls, studies have reported that masking is not a gender-specific phenomenon(5). Hiding who you are is an uncomfortable and exhausting experience. Further, autistic people who report engaging in or having more “autistic traits,” that is behaviors such as, hand-flapping, rocking, and other traits that are stereotypic of the autism spectrum as defined by clinical measures (e.g., the ADOS and the Autism Quotient), are at higher risk of mental health symptoms and suicidality (Pelton & Cassidy, 2017; Takara & Condo, 2014). (2019). Autism masking involves spotting those symptoms and working desperately to hide them. Get facts and statistics on…, The diagnosis of autism spectrum disorder includes a number of conditions that used to be diagnosed separately. The ultimate cost of masking is burnout. Women are also often diagnosed much later in life, likely due to misrecognition, camouflaging, and an insufficient clinical knowledge of the traits of autistic girls and women (4). Huge gap, especially considering the higher likelihood of subtler behavioral presentation than their male.. Non-Autistic people in order to fit in first three years of Hiding who you are is an uncomfortable and experience. Suicidal thoughts indicates that trauma can actually make ASD symptoms more challenging to live with spectrum have serious! ” more than boys on the individual,... J autism Dev.! Autistic people, camouflaging is experienced as an obligation, rather than a choice health professional develop! Normal as the next person, whatever normal may be can have effects! 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