Citation
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, 2519–2534. doi: 10.1007/s10803-017-3166-5
Key findings
- Camouflaging was described by participants as involving two distinct components: compensation (actively developing strategies to navigate social situations) and masking (hiding autistic traits or presenting a non-autistic persona).
- Participants described a wide range of specific camouflaging behaviours, including: forcing eye contact or faking it by looking at the bridge of the nose; learning social scripts from television and films; rehearsing conversations in advance; monitoring and consciously adjusting facial expressions and body language; suppressing stimming; and concealing sensory distress.
- Motivations for camouflaging included wanting to form connections with others, avoiding stigma, and meeting the expectations of work or educational settings.
- Consequences included exhaustion (camouflaging was described as intensely effortful), anxiety and mental health difficulties, and a profound sense of identity loss — participants described not knowing who they “really” were beneath the mask.
- Both autistic men and women reported camouflaging, though the study highlighted that it may contribute particularly to delayed diagnosis in women.
Method in brief
This was a qualitative study using an online survey distributed through the Cambridge Autism Research Database and social media. A total of 92 adults (55 diagnosed autistic, 17 self-identified, 20 non-autistic with high autistic traits) responded to open-ended questions about their experiences of social camouflaging. Responses were analysed using reflexive thematic analysis.
Relevance
This paper is foundational to the field of camouflaging research. It was the first systematic qualitative investigation of the lived experience of camouflaging in autistic adults, and the themes it identified — compensation, masking, exhaustion, identity confusion — have been consistently replicated in subsequent research. The paper directly informed the development of the CAT-Q (Hull et al., 2019), the field’s primary self-report measure of camouflaging.
For practitioners, the paper provides concrete, recognisable descriptions of what camouflaging looks like from the inside. The finding that camouflaging is associated with identity loss is particularly important for understanding autistic people who present well socially but report profound distress — they may not be “fine,” they may be performing.
For sensory processing work specifically, the paper is relevant because participants described masking sensory distress as part of their broader camouflaging — enduring painful environments without showing discomfort, suppressing the urge to cover ears or leave a room. This suggests that sensory assessments conducted in social settings may underestimate sensory difficulties in people who are actively hiding them.
Limitations
- The sample was self-selected and recruited online, skewing towards autistic adults who are articulate, connected to autism communities, and aware of the concept of camouflaging. The experiences of autistic people with intellectual disability or limited internet access are not represented.
- As a qualitative study, the findings describe the experiences of a particular group of participants and are not intended to be statistically generalisable.
- The study relied on participants’ retrospective self-report, which may be subject to memory biases and to the influence of existing narratives about camouflaging in autism communities.
- Gender was self-reported and the sample was predominantly female, which may have influenced the prominence of certain themes.