New Ideas in Psychology 68 (2023) 100992
A ailable online 2 No embe 2022
0732-118X/© 2022 The Au ho s. Published by Else ie L d. This is an open access a icle unde he CC BY-NC-ND license (h p://c ea i ecommons.o g/licenses/by-
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Au is ic camou laging ac oss he spec um
☆
Valen ina Pe olini
a
,
*
, Ekaine Rod íguez-A menda iz
a
, Agus ín Vicen e
a
,
b
a
Uni e si y o he Basque Coun y (UPV/EHU) - Depa men o Linguis ics and Basque S udies - Cen o de In es igaci´
on Micaela Po illa Jus o V´
elez de Elo iaga Kalea,
1, 01006 Gas eiz, A aba, Spain
b
Ike basque Founda ion o Science - Bilbao, Spain
ARTICLE INFO
Keywo ds:
Camou laging
Au ism
Masking
Compensa ion
Passing
He e ogenei y
ABSTRACT
Camou laging may be cha ac e ized as a se o ac ions and s a egies mo e o less consciously adop ed by some
au is ic people o na iga e he neu o ypical social wo ld. Despi e he inc eased in e es ha his phenomenon has
ga ne ed, i s na u e emains elusi e and in need o concep ual cla i ica ion. In his pape , we aim o pu o wa d
an inclusi e iew o camou laging ha does jus ice o i s complexi y while also e lec ing he he e ogenei y o
au ism as a condi ion. Fi s , we o e an o e iew o he main cha ac e iza ions o camou laging. This o e iew
shows ha cu en cha ac e iza ions ail o pain a cohesi e pic u e, and ha di e en accoun s emphasize
di e en aspec s o he phenomenon. Second, we explo e he analogy be ween camou laging and passing, which
we ake o be illumina ing o desc ibe some o ms o camou laging, while p obably obscu ing he s udy o o he s.
Thi d, we ex end he discussion abou camou laging o cu en ly unde s udied g oups ac oss he au is ic spec-
um – i.e., child en, and adul s wi h linguis ic and/o in ellec ual disabili ies. We a gue ha camou laging in
such g oups may di e om wha he cu en li e a u e desc ibes as ypical ins ances o camou laging. We
conclude by e isi ing he na u e o camou laging in ligh o such unde s udied g oups, and we o e some
sugges ions on how o mo e esea ch o wa d.
1. In oduc ion
Au is ic spec um condi ions a e cha ac e ized by di icul ies in he
domain o social in e ac ion and communica ion ac oss se e al con ex s.
Some common challenges include ini ia ing and main aining con e sa-
ions, sha ing in e es s o emo ions, unde s anding ela ionships, and
esponding app op ia ely o social in e ac ions (APA, 2022). Some
au is ic people epo adop ing speci ic s a egies o na iga e he neu-
o ypical social wo ld, o he poin ha hey appea non-au is ic o less
au is ic in some ci cums ances. This phenomenon has come o be known
in he li e a u e as camou laging, masking, o compensa ion (Hull e al.,
2017; Lai e al., 2017; Li ings on e al., 2019; Pea son & Rose, 2021;
Sedgewick e al., 2021), al hough i cu en ly escapes a gene al
de ini ion (Williams, 2021; Ai e al., 2022; see Cook e al., 2021 o a
ecen comp ehensi e e iew). Camou laging and ela ed phenomena
ha e been also ho oughly discussed in i s -pe son accoun s on a ious
pla o ms including books, blogs, online magazines, and social media
campaigns (see Holliday-Willey, 1999; Ni ode, 2019; he
# ake hemasko campaign o a ew examples).
1
The bu geoning li e a u e on camou laging ends o cha ac e ize he
phenomenon in di e en ways, unde sco ing a signi ican deg ee o
complexi y. In his pape , we aim o pu o wa d an inclusi e iew o
camou laging ha does jus ice o such complexi y while also e lec ing
he he e ogenei y o au ism as a condi ion. In §1 we o e an o e iew o
he main cha ac e iza ions being o e ed in he li e a u e, and we ocus
on how di e en esea che s desc ibe he cons uc . This o e iew
☆
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on, g an numbe s: PID2021-122233OB-I00; PID2021-128950OB-I00; Minis e io de Ciencia,
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on y Uni e sidades: pos doc o al ellowship IJC2020-043408-I (Valen ina Pe olini); BBVA Founda ion G an s o Scien i ic Resea ch P ojec s 2021 Call
(RILITEA); and by he Basque Go e nmen , g an numbe IT1537-22.
* Co esponding au ho .
E-mail add esses: [email p o ec ed] (V. Pe olini), [email p o ec ed] (E. Rod íguez-A menda iz), [email p o ec ed] (A. Vicen e).
1
Many au ho s o i s -pe son accoun s and many pa icipan s in ecen s udies on camou laging iden i y as women. This ac has b ough some esea che s o see
camou laging as a po en ial explana ion o why women ha e been unde diagnosed o misdiagnosed wi h au ism h oughou his o y (Baldwin & Cos ley, 2016;
Ba giela e al., 2016; Hille e al., 2016). Howe e , o he esea che s challenge his idea bo h by poin ing a expe iences o camou laging in people who do no
iden i y as women (Pea son & Rose, 2021), o by s essing po en ial sel -selec ion issues in exis ing s udies (Fombonne, 2020). Mo e e idence is he e o e needed
be o e we can es ablish whe he camou laging should be seen as a p ima ily emale phenomenon.
Con en s lis s a ailable a ScienceDi ec
New Ideas in Psychology
jou nal homepage: www.else ie .com/loca e/newideapsych
h ps://doi.o g/10.1016/j.newideapsych.2022.100992
Recei ed 13 June 2022; Recei ed in e ised o m 17 Oc obe 2022; Accep ed 22 Oc obe 2022
New Ideas in Psychology 68 (2023) 100992
2
shows ha cu en cha ac e iza ions ail o pain a cohesi e pic u e, and
ha di e en accoun s emphasize di e en – a imes alue-laden – as-
pec s. In §2 we explo e he analogy be ween camou laging and passing,
which we ake o be illumina ing o desc ibe he dynamics in ol ed in
some o ms o camou laging. Ye , we a e wa y o some ecen a emp s
a s e ching such an analogy oo b oadly. In §3 we ex end he discussion
abou camou laging o cu en ly unde s udied g oups ac oss he au is ic
spec um. These a e child en, and adul s who – because o di e en
e bal and in ellec ual abili ies – do no usually sel - epo abou hei
own camou laging. Finally, in §4 we e isi he na u e o camou laging
in ligh o such unde s udied g oups, and we o e some sugges ions on
how o mo e esea ch o wa d.
1.1. S a e o he a
Gi en ha sys ema ic esea ch on camou laging is s ill ela i ely
ecen , i is unsu p ising o wi ness se e al cha ac e iza ions ha
emphasize di e en aspec s o he cons uc . A quick e iew o he
exis ing li e a u e shows ha mul iple dimensions o camou laging a e
discussed in di e en s udies, including aims (Li ings on & Happ´
e,
2017; Hull e al., 2017), deg ee o success (Lai e al., 2021), con ex s in
which camou laging occu s (Cage & T oxell-Whi man, 2019), s a egies
being used (Li ings on e al., 2019), and deg ees o consciousness and
e o in ol ed (Pea son & Rose, 2021). No ably, some o hese di-
mensions ea u e mo e o less di ec ly in he way in which camou laging
is cha ac e ized. This is pa icula ly p ominen in he case o aims, as
se e al accoun s o camou laging desc ibe he phenomenon by e e ing
o i s hypo hesized pu poses. As Williams (2021) pu s i : “Camou laging
is a mul idimensional cons uc ha is bound oge he only by he
in ended goal o i s cons i uen beha io s (i.e., o appea less o e ly
au is ic” (p. 2). This mos ly o igina es om he esul s o ini ial quali-
a i e s udies de ised o explo e he phenomenon (Hull e al., 2017,
2019), whe e indi iduals who sel - epo edly camou laged a e asked o
de ine hei expe ience. Responses end o all in o wo main hemes:
camou laging was expe ienced as a way o hiding o masking au is ic
ai s (e.g., a oid s imming in public), and as a compensa o y beha io
including a ange o mo e o less delibe a e s a egies o manage social
si ua ions (e.g., employing sc ip s o di e en social scena ios).
2
Based
on he esul s o hese and o he quali a i e s udies, masking and
compensa ing ha e come o be unde s ood as he wo co e componen s
o camou laging (Cook e al., 2021; Hull e al., 2021).
This concep ual di e ence be ween masking and compensa ion
should no be seen as acking a eal dicho omy, as i is plausible ha
mos episodes o camou laging a e a blend o bo h ing edien s: he
pe son e o ully implemen s some s a egies o na iga e social con-
ex s, while a he same ime ying o conceal some ai s. One o hese
ing edien s may p e ail o e he o he depending on a hos o ac o s: in
some cases, ea o being s igma ized o excluded may be he main
d i ing o ce; in o he cases, ying o eel good wi h o he s migh ake
p ecedence. Complexi y in e ms o aims is also unde sco ed by esul s
ob ained h ough quan i a i e measu es, such as he Camou laging
Au is ic T ai s Ques ionnai e o CAT-Q, a 25-i em sel - epo ques ion-
nai e aimed a measu ing camou laging a emp s, e o s, o in en ions
(see Hull e al., 2019). O he measu es, known as disc epancy measu es,
a e a ge ed mo e di ec ly a compensa ion as hey aim o compa e an
indi idual’s obse ed beha io (e.g., in a diagnos ic se ing) wi h hei
social-cogni i e pe o mance (e.g., sco es on a heo y o mind o exec-
u i e unc ioning ask).
O e all, bo h quan i a i e and quali a i e s udies epo a complex
pic u e, wi h some esponden s emphasizing ha hey camou lage o
a oid appea ing au is ic in on o o he s, while o he s s ess he need
o social con ac (see Libsack e al., 2021; Cook e al., 2021 o some
ecen e iews). This may e y well a y ac oss con ex s: an au is ic
child may camou lage a school mos ly - maybe e en uniquely - ou o
ea , whe eas he same child may camou lage wi h he main pu pose o
i ing in when in e ac ing wi h hei long ime iends. A ailable da a
con i m signi ican a ia ion in his espec , wi h indi iduals who epo
camou laging in a wide ange o o mal and in o mal con ex s (e.g., a
wo k, wi h s ange s, online, wi h a oman ic pa ne ) and indi iduals
who epo di e en deg ees o “swi ching” among con ex s (Cage &
T oxell-Whi man, 2019).
3
S a ing om he co e componen s o masking and compensa ing,
esea che s ha e u he e ined hei cha ac e iza ions o include
a ying deg ees o dep h. Fo ins ance, Li ings on and Happ´
e (2017)
dis inguish be ween shallow and deep compensa ion. The o me is
supposed o encompass mo e igid and supe icial s a egies (e.g.,
mimicking o he people’s beha io in social se ings), while he la e
comp ises mo e lexible skills and he e o ul gene a ion o no el social
esponses o na iga e di icul si ua ions (e.g., ely on one’s cogni i e
s eng hs – such as memo y o a en ion o de ail – o bypass social
di icul ies). Such a ine -g ained classi ica ion – along wi h quali a i e
da a collec ed by he same esea ch g oup (Li ings on e al., 2019) –
allows o a po en ially signi ican dis inc ion be ween masking and
compensa ion beha io s. Masking could be seen as a o m o shallow
compensa ion, mos ly cha ac e ized by hiding au is ic ai s and by
egula ing one’s beha io o make i mo e accep able by neu o ypical
s anda ds (e.g., a oiding social e en s, e aining om pa icipa ing in a
con e sa ion, supp essing ges u es – see Appendix in Li ings on e al.,
2019 o mo e examples). Deep compensa ion would a he in ol e he
c ea ion o no el s a egies and he gene a ion o complex beha io s
ha a e esponsi e o he social se ing a hand (e.g., c ea ing and
upda ing ca alogs o sc ip s o in e p e o he people’s beha io , see
Rose’s desc ip ion o hei Memo y Rolodex® as an example - Rose,
2017).
The impac o camou laging on men al heal h has also been discussed
ex ensi ely, especially in ela ion o he high le els o psychia ic
symp oms expe ienced by au is ic indi iduals, mos no ably anxie y,
dep ession, and bu nou (Hollocks e al., 2019; Hull e al., 2021; Mille
e al., 2021; Cage & T oxell-Whi man, 2019 - see Belche e al., 2022 o
a s udy on he impac o camou laging on imp essions). Exis ing
sel - epo s desc ibe he consequences o camou laging in a a ie y o
ways. Many esponden s quali y he expe ience as exhaus ing (B adley
2
An al e na i e way o cashing ou he dis inc ion be ween hiding and
compensa ing migh be o alk abou nega i e e sus posi i e camou laging be-
ha io s, whe e he o me imply supp essing some hing (e.g., s imming) and
he la e equi es an addi ion o one’s beha io al epe oi e (e.g., o cing eye
con ac ) – see Foss-Feig e al., 2016 o a simila p oposal ega ding o he
ea u es o au ism.
3
Con ex hus appea s o be ano he dimension o camou laging ha should
be explo ed in mo e dep h, also o be e unde s and which social con ex s a e
expe ienced as mo e (o less) e o ul o ha m ul by au is ic people (Cage e al.,
2022; Pea son & Rose, 2021). Se e al o he dimensions o camou laging ha e
been men ioned o a ying deg ees in he li e a u e and a e wo h explo ing in
mo e de ail. Fo ins ance, we need a be e unde s anding o whe he di e en
deg ees o consciousness a e in ol ed in di e en people o in he same pe son
ac oss di e en con ex s (Pea son & Rose, 2021), as well as o he po en ially
di e en deg ees o cogni i e-emo ional e o (B adley e al., 2021; Raymake
e al., 2020) and au hen ici y in ol ed (B adley e al., 2021; Lawson, 2020).
V. Pe olini e al.
New Ideas in Psychology 68 (2023) 100992
3
e al., 2021; Hull e al., 2017), cogni i ely axing, o di icul o keep up
o ex ended pe iods o ime (Li ings on e al., 2019). O he s desc ibe
camou laging as an adap i e coping mechanism which has allowed hem
o su i e and accomplish impo an goals and o employ necessa y
social skills (B adley e al., 2021; Hull e al., 2017; Mille e al., 2021).
S ill o he s exp ess an ambi alen a i ude owa ds camou laging (see
B adley e al., 2021; Lawson, 2020 o some i s -pe son accoun s).
We sugges ha di e en cha ac e iza ions o camou laging ha e an
e ec on how esea che s unde s and i s impac on men al heal h. Re-
sea che s who make a dis inc ion be ween masking and compensa ion,
o ins ance, end o hold a mo e posi i e iew o he la e wi h espec
o masking, which is seen as an ine ec i e and ul ima ely de imen al
s a egy. On hei iew, masking is unlikely o be kep up in he long un
and migh gi e ise o bu nou o anxie y issues, whe eas deep
compensa ion has he po en ial o become “second na u e” o e ime (,
p. 6 - Li ings on e al., 2019). Li ings on and colleagues seem willing o
g an ha some cases o camou laging may esul in po en ially adap i e
ajec o ies: “Despi e clinical implica ions, ou indings sugges ha
p e ious esea ch migh ha e o e emphasized he nega i e aspec s o
compensa ion. Many pa icipan s epo ed ha compensa ion was
undamen al o ul illing li e expe iences and deemed hei s a egies
success ul” (p. 11).
By con as , esea che s who ocus on camou laging qua masking
end o hold a mos ly nega i e iew o he phenomenon. In hese ac-
coun s, camou laging is p ima ily cha ac e ized as a o m o “concealing
an au is ic iden i y” (Cage & T oxell-Whi man, 2020) wi h a mo e
p onounced emphasis on “hiding o masking aspec s o onesel om
o he s” (Cage & T oxell-Whi man, 2019) o supp essing beha io ha
would be classi ied as di e gen by neu o ypical s anda ds (Pea son &
Rose, 2021). Some au ho s – such as Pea son and Rose (2021) – p opose
a b oade cha ac e iza ion o masking ha includes he supp ession o
beha io s as well as he p oduc ion o a ange o al e na i es. Howe e ,
gene ally speaking, esea che s who do no sha ply dis inguish be ween
masking and compensa ion – o who a e c i ical o he no ion o
compensa ion al oge he
4
– end o sha e he iew ha camou laging
has a p edominan ly nega i e impac and s ess i s co ela ions wi h
suicidali y, bu nou , and poo e men al heal h ou comes (Cage e al.,
2022; McC acken, 2021; Pea son & Rose, 2021; Radulski, 2022).
In he nex sec ion we assess whe he camou laging may be be e
unde s ood h ough he analogy o passing, as i has been p oposed in
some ecen con ibu ions (Pea son & Rose, 2021; Ai e al., 2022; Lib-
sack e al., 2021). Al hough he analogy wi h passing allows us o
desc ibe camou laging as a complex and he e ogeneous phenomenon,
we a gue ha we should be wa y o o e s e ching i . In ac , he analogy
is unlikely o be applicable o cu en ly unde s udied g oups ac oss he
au is ic spec um (see §3 and §4).
2. Camou laging as passing
Some ecen accoun s ha e sugges ed unde s anding au is ic
camou laging as a o m o passing as neu o ypical (Libsack e al., 2021;
Pea son & Rose, 2021; Pe y e al., 2022; Radulski, 2022). The no ion o
passing has been explo ed in sociology as well as gende and ace
s udies, and e e s o a pe son’s abili y o be ega ded as a membe o an
iden i y g oup o ca ego y di e en om hei own (Go man,
1959/2002).
5
Speci ically, wha is usually known as “ ull- ledged pass-
ing” (Ren ow, 2004) is connec ed o he no ion o s igma and in ol es
membe s o disad an aged g oups who a e pe cei ed and ea ed as
membe s o an ad an aged g oup. One co e aspec o his phenomenon
consis s in hiding impo an aspec s o one’s iden i y (known as “mas e
s a uses” - see Go man, 1963/2009), such as one’s e hnici y, gende ,
disabili y, e c. Full- ledged cases o passing also end o be desc ibed as
cogni i ely and emo ionally cos ly. While some ins ances o passing may
include elemen s o decep ion, o he s may be seen as ac s o
sel -p ese a ion, especially in he con ex o un ai demands abou
e ealing in ima e aspec s o one’s iden i y (Samuels, 2003).
The analogy be ween passing and camou laging is undoub edly
illumina ing in some espec s. Bo h passing and camou laging in ol e
di e en aims and gi e ise o signi ican ade-o s in e ms o well-
being. Exis ing accoun s o camou laging qua passing end o emphasize
i s nega i e consequences in e ms o men al heal h – e.g. exhaus ion,
bu nou – while occasionally men ioning i s “ex e nal” ad an ages – e.
g., a oiding bullying (Pea son & Rose, 2021, p. 8). This iew is con-
nec ed o he idea ha camou laging would be p ima ily a esponse o
au ism- ela ed s igma (Cage e al., 2022; Pe y e al., 2022; see also
Lawson, 2020 on adap i e mo phing), and hus some hing ha could be
amelio a ed by adically changing he socio-cul u al as well as ma e ial
condi ions ha o ce people o adop passing beha io s in he i s place
(Radulski, 2022).
Ye , o he a ailable accoun s o passing – such as he one p oposed
by Sil e min (2018) – o e a mo e nuanced iew o he phenomenon.
Fa om being uniquely posi i e o nega i e, pe missible o impe mis-
sible, passing may be cha ac e ized as a coping s a egy wi h upsides and
downsides, and hus as a si ua ional and con ex -dependen esponse o
challenging ci cums ances. Gi en his complexi y, di e en ins ances o
passing may gi e ise o signi ican ade-o s among mul iple cons i -
uen s o wellbeing (Sil e min , 2018, p. 38). Simila ly, he e ec s o
camou laging a e likely o a y signi ican ly depending on he si ua ion.
Passing as neu o ypical, o ins ance, may p o ide someone wi h sig-
ni ican ad an ages in educa ional o p o essional se ings. Despi e
being e o ul and po en ially inc easing isk o expe iencing anxie y
and bu nou , camou laging may also allow someone o c ea e signi ican
social bonds and o ge meaning ul ela ionships. In hese cases, i is
pa icula ly ha d o d aw a sha p dis inc ion be ween “in e nal” and
“ex e nal” ad an ages, as eedback loops a e likely o occu . Fo
ins ance, gi en ha lack o social con ac plays an impo an ole in he
de elopmen o anxie y and dep ession in he au is ic popula ion
(Schil z e al., 2021), some ins ances o camou laging may con ibu e o
alle ia ing loneliness and o imp o ing o e all wellbeing as a esul .
Ye , we should be wa y o o e s e ching he analogy be ween
4
One issue wi h he e m “compensa ion” is ha i appea s o endo se a
de ici model o au ism, whe e some alleged dys unc ion – e.g., in heo y o
mind abili ies – has o be bypassed h ough di e en means – e.g., memo y,
in e en ial abili ies, e c. This iew addi ionally be ays he p oblema ic
assump ion ha he neu o ypical social wo ld should wo k as he no ma i e
s anda d o which e e yone has o con o m.
5
Following ano he s and o Go man’s wo k (1959 & 1963), some ecen
p oposals a emp o connec camou laging wi h imp ession managemen (o IM)
– ha is, a mo e gene al human endency o os e a o able imp essions o he
sel in o he s du ing social in e ac ions (Ai e al., 2022; Schneid & Raz, 2020).
We canno discuss such p oposals in de ail in his pape , al hough we plan o
ake his up in u u e wo k. One key ques ion su ounding he ela ionship
be ween IM and camou laging conce ns whe he we should unde s and hese
beha io s as being on a spec um, o whe he au is ic camou laging would
a he p esen some quali a i ely di e en aspec s. Some exis ing accoun s
p opose o see he wo phenomena as di e ing in e ms o deg ee o e o ,
in ensi y, and scope (Ai e al., 2022; Lai e al., 2021). O he s push back agains
he idea o s ong con inui y by s essing ha camou laging – as opposed o IM
– implies “hiding one’s ue sel ” in a s onge and mo e de imen al sense
(Pea son & Rose, 2021, p. 10). No ably, his is pa ly an empi ical ques ion ha
canno be se led wi h a ailable da a, gi en ha e y ew s udies o da e ha e
compa ed au is ic and neu o ypical popula ions ac oss IM o camou laging
measu es (see Mille e al., 2021; Li ings on e al., 2020 o some excep ions).
V. Pe olini e al.
New Ideas in Psychology 68 (2023) 100992
4
camou laging and passing. In ou iew, expe iencing camou laging as
passing es s on wo condi ions. Fi s , as we men ion abo e, ull- ledged
passing is usually aken o imply ha one is concealing a mas e s a us,
ha is a cen al aspec o one’s iden i y. This implies ha – o camou-
laging o coun as a o m o passing – one has o ega d “being au is ic”
as some hing in eg al o one’s iden i y. Al hough his is undoub edly he
iew pu o wa d by se e al esea che s and ac i is s, especially wi hin
he neu odi e si y pa adigm (Bo ha e al., 2020; Radulski, 2022), he
claim may no be equally applicable ac oss he au is ic spec um. In
o he wo ds, camou laging would no be expe ienced as passing by
people who – o one eason o ano he – ail o ega d “being au is ic” as
a co e aspec o hei iden i y.
6
Second, passing as neu o ypical implies
he possibili y o hiding one’s au is ic s a us in he i s place. Such a
possibili y - simila ly o wha happens in cases o passing along e hnic o
gende bounda ies - would be p ima ily a ailable o some subg oups o
indi iduals, such as non-s e eo ypical membe s whose beha io does
no immedia ely signal hei s a us (Sil e min , 2018). I his is co ec ,
many au is ic people p obably do no expe ience camou laging as
passing. Some membe s will be mo e isible and hus no in he posi ion
o hide o engage in deep compensa ion mo es (see also Mil on 2013 on
his poin ). Inciden ally, hese indi iduals a e also mo e likely o be
unde ep esen ed in he cu en li e a u e.
In he nex sec ion we explo e a b oade no ion o camou laging, one
ha ocuses on au is ic people who expe ience camou laging in di e en
ways wi h espec o he passing analogy jus desc ibed. We a gue ha
such a b oade iew is needed bo h o me hodological easons – i.e., o
make he esea ch on camou laging mo e inclusi e – and o heo e ical
ones. Indeed, by cha ac e izing all ins ances o camou laging as a o m
o passing, we isk adop ing oo na ow o a ocus on he phenomenon
and unduly limi ing ou concep ions o wha camou laging looks like as
a consequence. I is possible o objec ha he cases o people whose
beha io does no p ima acie all unde he no ion o passing, a e
none heless cases o people ying o pass as neu o ypicals wi hou suc-
ceeding (see also Belche e al., 2022). While his migh be he case, we
ha e o be cau ious abou a ibu ing such in en ion o people whose
goals appea o be na owe , such as being able o enjoy mo e ci cum-
sc ibed social si ua ions. In p inciple, cha ac e izing such cases as a -
emp s o pass as neu o ypical does no seem o be he mos na u al way
o desc ibe hem.
3. Towa ds a mo e inclusi e iew
3.1. Limi a ions o cu en s udies
In his sec ion we discuss some limi a ions exhibi ed by he me h-
odologies and measu emen ools employed o s udy au is ic camou-
laging. As we men ion in §1, esea ch on his phenomenon is mos ly
app oached by means o scales o ques ionnai es ha ocus on speci ic
s a egies, aims, con ex s, and impac on men al heal h (Hull e al.,
2019; Cage & T oxell-Whi man, 2019; Li ings on e al., 2019). Al hough
o he measu es o camou laging a e employed - such as disc epancy
measu es - mos published s udies ely on ei he quali a i e desc ip ions
o li ed expe iences, o on a combina ion o quali a i e and quan i a i e
measu es ha o en includes he adminis a ion o he abo emen ioned
ques ionnai es (see Libsack e al., 2021 o a e iew o exis ing
me hodologies).
Measu emen ools based on sel - epo a e undoub edly impo an ,
bu hey lea e ou a high p opo ion o people on he spec um,
including people who camou lage unconsciously, child en, and people
wi h di e en in ellec ual and/o linguis ic abili ies – e.g., people wi h a
concomi an in ellec ual disabili y o language impai men . Se ing
aside unconscious camou lage s,
7
a ailable da a on age and in ellec ual
abili y con i m ha cu en s udies a e including only a small po ion o
au is ic indi iduals. Fo ins ance, al hough a numbe o s udies ha e
included au is ic you hs and child en, he a e age age o pa icipan s is
a ound 12 yea s old,
8
making young child en one o he mos unde -
explo ed g oups wi hin he spec um. Da a on in ellec ual abili ies a e
e en mo e s iking, gi en ha nea ly all s udies analyzed in sys ema ic
e iews o mally o in o mally exclude pa icipan s wi h in ellec ual
disabili y, and many e en ail o epo in o ma ion abou in ellec ual
abili ies o hei pa icipan s (Libsack e al., 2021, pp. 803–804. See also
Cook e al., 2021; Appendix C). Simila ly, linguis ic abili ies a e a ely
conside ed among he ac o s wo h explo ing, al hough hey a e likely
o ha e a signi ican impac on he camou laging s a egies ha one can
adop . Al hough au is ic indi iduals wi h co-occu ing in ellec ual
and/o linguis ic disabili ies a e sys ema ically unde ep esen ed, hey
do make up a signi ican p opo ion o indi iduals on he spec um. Fo
ins ance, Tage -Flusbe g and Kasa i (2013)Tage -Flusbe g and Kasa i
(2013) epo an es ima e o 20–30% o non- e bal o minimally e bal
au is ic people. Da a on in ellec ual disabili y widely oscilla e be ween
16,7%–84% (Pos o ino e al., 2016), wi h global es ima es sugges ing a
p opo ion o app oxima ely 50% (Russell e al., 2019).
9
These limi a ions ha e a me hodological as well as heo e ical
impac on camou laging as a cons uc . One ob ious issue conce ns he
gene alizabili y o he esul s, as a ailable conclusions canno be eason-
ably applied o a signi ican po ion o he au is ic popula ion (Fom-
bonne, 2020). As long as we do no know how camou laging is
expe ienced by mo e di e se g oups o people on he spec um, any
exis ing conclusion should be in e p e ed wi h cau ion. We a e awa e
ha his e lec s b oade inclusi i y issues in au ism esea ch (Pellicano
e al., 2014), bu ailu e o acknowledge he e ogenei y seems o ha e
pa icula ly un o una e consequences in he case o camou laging.
Indeed, as opposed o esea ch ocused on one aspec o au ism as a
condi ion – e.g., whe he au ism ‘as such’ is cha ac e ized by di e ences
in heo y o mind abili ies – s udies on camou laging a e in e es ed in
how au is ic indi iduals y o na iga e he neu o ypical social wo ld. I
he ocus is on he indi iduals’ expe ience in a pa icula domain, lack o
inclusi i y is bound o be e en mo e p oblema ic.
One signi ican example conce ns he ela ionship be ween camou-
laging and men al heal h. As we men ion abo e, se e al s udies epo a
co ela ion be ween camou laging and ad e se men al heal h ou comes
6
Bo de line cases a e also possible: ake a pe son who is awa e o exhibi ing
au is ic ai s o beha io s (e.g., special in e es s) bu who has no ye been
diagnosed wi h au ism. Al hough his pe son migh e y well enac camou-
laging s a egies (e.g., p e ending o be in e es ed in opics ha o he people
ind in e es ing), hey would p obably no conside being au is ic as a co e
aspec o hei iden i y. I is unclea whe he his would quali y as a case o ull-
ledged passing, o a he as a mo e sub le o m o imp ession managemen ha
migh be con inuous wi h nonclinical expe iences.
7
Al hough i is plausible o assume ha a good deal o camou laging happens
unconsciously, he cons uc o unconscious camou laging is pa icula ly di icul
o in es iga e, bo h me hodologically (e.g., i is no accessible h ough in o-
spec ion) and heo e ically - e.g., one could a gue ha comple ely success ul
camou laging should simply no be iden i ied as such, o ha camou laging
always equi es a gap be ween obse ed beha io and inne awa eness. Despi e
his complexi y, people a imes ealize ha hey ha e been camou laging in
hindsigh (e.g., h ough he diagnosis o hei child – see Holliday-Willey, 1999)
o hey become able o label hei expe ience mo e accu a ely now ha he
cons uc o camou laging is a ailable (simila ly o wha happened wi h o he
cons uc s, such as ‘sexual ha assmen ’ o ‘s alking’).
8
This has been ob ained by a e aging he wo esul s epo ed by he mos
comp ehensi e sys ema ic e iews o da e: Cook e al. (2021) epo a sample
anged om 5 o 18 yea s wi h a mean age o 11.9 in s udies on child en, while
Libsack e al. (2021) epo an a e age age o 11.8 yea s in s udies on you h
be ween 2 and 17 yea s o age.
9
P ecise es ima es on he co-occu ence o au ism and in ellec ual disabili y
a e pa icula ly ha d o come by, exac ly because o he widesp ead selec ion
bias and sys ema ic unde - ec ui ing ha we desc ibe in he case o camou-
laging (see Russell e al., 2019 o a gene al o e iew).
V. Pe olini e al.
New Ideas in Psychology 68 (2023) 100992
5
such as anxie y, dep ession, and bu nou . Take Hull e al.‘s ecen s udy
on camou laging and anxie y (2021), whose pa icipan s a e au is ic
adul s wi hou in ellec ual disabili y who a e awa e o hei own
camou laging (N =305; age ange: 18–75). This s udy ound a linea
co ela ion be ween sel - epo ed camou laging and anxie y: indi iduals
who sco ed ≥125 on he CAT-Q also showed he highes sco es on
measu es o gene alized anxie y and dep ession, while indi iduals who
sco ed ≥75 exhibi ed highe sco es on a measu e o social anxie y. Gi en
he cha ac e is ics o he sample in ol ed, which ails o be ep esen-
a i e o he he e ogenei y o au ism as a condi ion, he e is a clea issue
wi h gene alizabili y. As a consequence, i is unclea whe he au is ic
people who a e excluded by cu en esea ch would expe ience
camou laging in simila ways, also in connec ion wi h anxie y.
Mo eo e , s udies in es iga ing he ela ionship be ween camou-
laging and men al heal h end o be c oss-sec ional in na u e and hus
unable o es ablish causal ela ionships be ween he cons uc s in ol ed
(Cage e al., 2022; Cage & T oxell-Whi man, 2019; Hull e al., 2021).
The a ailable da a a e hus insu icien o de e mine whe he camou-
laging would cause anxie y o a he p e-exis ing highe le els o anx-
ie y may cause inc eased camou laging beha io (see Hull e al., 2021, p.
6). In ac , gi en he linea co ela ion unco e ed, one may also hy-
po hesize ha anxie y migh be connec ed o one being sel -awa e o
one’s camou laging, being sel -awa e o one’s own social anxie y, o
being sel -awa e o one’s own social di icul ies pe se (see Williams,
2021 o a simila poin ). This issue is e en mo e p essing conside ing
ha high le els o anxie y and dep ession a e no unique o he
camou laging po ion o he au is ic popula ion, bu a he widesp ead
in au ism ac oss he boa d (Hollocks e al., 2019). Addi ionally, some
mani es a ions o social anxie y in nonau is ic popula ions, such as
educed eye con ac o ehea sing con e sa ions be o e hey occu , a e
likely o o e lap wi h camou laging beha io (Fombonne, 2020; Picci-
illo e al., 2016).
We u ge addi ional cau ion on his poin because – despi e hese is-
sues being acknowledged by esea che s – he ela ionship be ween
camou laging and men al heal h is o en in e p e ed as a one-way s ee
– i.e., as camou laging being conduci e o poo e men al heal h ou -
comes. No ably, his endency esul s – again – om he in e p e a ion o
quali a i e s udies, which su e om he lack o inclusi i y ha we ha e
al eady s essed.
To summa ize, esea ch on camou laging and i s p e e ed me hod-
ologies cu en ly ocus on a e y limi ed sample o au is ic indi iduals,
usually adul s who can delibe a ely sel - epo abou hei expe ience.
The way in which cu en esea ch is conduc ed aises me hodological as
well as concep ual issues. Me hodologically speaking, esul s a e ha dly
gene alizable due o lack o inclusi i y, while c oss-sec ional associa-
ions p e en us om es ablishing causal associa ions. This has impo -
an consequences o he concep ual cha ac e iza ion o camou laging,
as cu en esea ch ends up wi h an unduly es ic ed concep ion o he
phenomenon, which migh in u n obscu e impo an aspec s o al e -
na i es. Fo ins ance, cu en s udies migh encou age he iew ha
camou laging should be unde s ood as a o m o passing as neu o ypical
(see §2), o as au oma ically exace ba ing anxie y (see abo e). In he
nex subsec ion we s eng hen he case o a mo e inclusi e esea ch
p og am, by poin ing o ele an ins ances o camou laging enac ed by
g oups ha a e cu en ly excluded by exis ing s udies. This would help
us o b oaden he ocus o esea ch by looking a camou laging om a
de elopmen al pe spec i e, a how i is expe ienced by a b oade ange
o indi iduals, and so on.
3.2. Camou laging in o he g oups
As we discuss abo e, camou laging is cu en ly s udied as a p ima ily
adul phenomenon enac ed by indi iduals wi hou in ellec ual disabil-
i ies who a e also pa ially awa e o he s a egies hey adop . To sys-
ema ize u u e esea ch, Lai e al. (2021) ha e ecen ly p oposed he
ollowing classi ica ion: a) people who (delibe a ely) wan o
camou lage and success ully employ hese s a egies; b) people who
(delibe a ely) wan o camou lage bu a e only pa ially success ul in
doing so (po en ially due o cogni i e di icul ies); c) people who do no
wan o camou lage; d) people who a e obli ious o he no ion o
camou laging. While esea ch a he cu en s age is ocused on (a) cases,
(b)-(d) ha e no been su icien ly explo ed.
We now discuss young child en and indi iduals wi h in ellec ual
disabili ies as ele an g oups ha may be included in (b) and/o (d).
This p elimina y – and a imes specula i e – discussion would also se e
o expand he cu en concep ion o camou laging o include some cases
o (seemingly) shallow compensa ion ha depa om he usual
desc ip ion, i.e., one ocused on hiding beha io and i s po en ially
nega i e consequences on men al heal h.
Le us s a by ou lining how camou laging migh look like in young
child en. I is plausible o hink ha many au is ic child en s a
camou laging a an ea ly age, ei he spon aneously o as soon as hey
s a pa icipa ing in in e en ion p og ams. Indeed, many exis ing
p og ams a ge a ange o skills – such as join a en ion, eye con ac ,
poin ing, e c. – ha o e lap wi h he ones desc ibed by sel - epo ed
camou lage s (Li ings on & Happ´
e, 2017). Take eye con ac as an
example. I a child is s uggling wi h making and main aining eye con-
ac , a he apis migh employ a a ie y o s a egies o inc ease he
numbe o occasions in which hey look in he eyes o o he s. I he
in e en ion is success ul, he child will s a by ixing hei gaze on he
eyes o he he apis , and hen on he eyes o o he people as well. As a
esul , om an obse e ’s iewpoin he au is ic child’s eye con ac
migh come o be indis inguishable om he one exhibi ed by a neu o-
ypical child, al hough he wo ac ions we e qui e dis inc in hei p e-
limina y s ages. While he la e engage in eye con ac spon aneously o
check in wi h o he s, he o me migh come o pe o m he same o e
beha io as an e o ully lea ned esponse. Simila ly, many he apis s
spend qui e a long ime eaching how o use poin ing ges u es o chil-
d en who would no o he wise poin a hings spon aneously o make
eques s. They y o eplace he endency o use ano he pe son’s body,
o o simply pick up he hings hey a e in e es ed in, wi h a endency o
poin a he ele an objec s o people. In he i s s ages o such in-
e en ions, poin ing is a om spon aneous. O e ime, howe e ,
poin ing becomes pa o he communica i e epe oi e o he child,
likely eaching a poin when i becomes bo h spon aneous and signi i-
can . Some hing along he same lines can be said wi h espec o in-
e en ions aimed a playing and playing oge he , a p e ense play, a
ask-swi ching, e c.
These o ms o in e en ions a e widesp ead and usually modeled on
a cogni i e-beha io al app oach, whe e he main aim is o eplace some
pa e ns o beha io s wi h o he s.
10
Many o hese a ge social abili ies
h ough ime-speci ic and con en -speci ic uni s o in e en ion. Fo
ins ance, he Social Compe ence In e en ion p og am (S ich e e al.,
2010) ocuses on de eloping a ange o abili ies h ough he ollowing
s uc u e: (a) e iewing a p e iously lea ned skill and in oducing a new
skill in an ins uc ional and g oup discussion o ma , (b) skill modeling,
(c) oppo uni ies o p ac ice he skill in s uc u ed and na u alis ic ac-
i i ies, and (e) closing ac i i y o e iew. Mos o hese app oaches a e
s uc u ed a ound ules (“Look in he o he pe son’s eyes”) and s a e-
gies o app oxima e he desi ed beha io (“T y o ix you gaze on o he
pa s o he pe son’s ace o s a ”).
In ou opinion, hese cases ha in ol e explici lea ning o social
skills a e su icien ly simila o camou laging, as au is ic child en
10
As we b ie ly discuss in he nex sec ion, we a e awa e ha hese app oaches
o in e en ion ha e been widely c i icized bo h in e ms o design and e ec-
i eness (see Bo ema-Beu el e al., 2018). I is impo an o s udy whe he such
app oaches, which, in ou iew, in ol e camou laging (a leas empo a ily),
ha e long las ing e ec s wi h espec o using o no using camou laging s a-
egies o e ime. On he o he hand, i is also impo an o s udy how o he , less
sc ip ed, app oaches a e wi h espec o camou laging beha io .
V. Pe olini e al.
New Ideas in Psychology 68 (2023) 100992
6
pe o m a some le el jus as neu o ypical child en, bu come o pe o m
he same ac ion h ough a mo e di ec and s uc u ed in e en ion
p ocess. We hus sugges ha some in e en ion p og ams make he
child camou lage as a esul , wi h he expec a ion ha a some poin he
camou laging componen will disappea o gi e way o mo e o ganic
and spon aneous beha io .
The e a e wo main easons o seeing hese cases as essen ially
con inuous wi h he ypically s udied ones:
(i) I he child esponds well o he apy and, e.g., ends up e ec i ely
making and main aining eye con ac wi h o he s, his is likely o
happen h ough di e en s ages. In he ini ial phase, as we
men ion abo e, he he apis in oduces new ules o s a egies
wi hin he limi ed con ex o he session, e o ully ying o
ins ill a gi en ac ion. In la e phases, he child inco po a es he
ac ion o di e en deg ees and applies i ou side o he he a-
peu ic se ing. A ha poin , ou sugges ion is ha he child’s
beha io should coun as an ins ance o camou laging, as i would
be simila o he one enac ed by people who espond o ques-
ionnai es. Fo ins ance, some o hem epo ha pa o hei
camou laging consis s in looking in he eyes o o he people e en
when hey a e eluc an o do i (Hull e al., 2017).
(ii) Al hough his pe ains o issues in philosophy o ac ion (see
Da idson, 1963 o he seminal discussion), i can be a gued ha i
someone enac s some hing ha we call A, hen we a e co ec in saying
ha hey a e enac ing A ( ega dless o whe he hey ha e he in en ion
o enac ing A as such). In ou example abo e, e en i child en do no
make eye con ac in o de o camou lage, hei looking in he eyes o
o he people is a guably a camou laging beha io . Tha is, he beha io
displayed by some au is ic child en a e he apy should coun as
camou laging o he ex en ha , om he poin o iew o he obse e o
he ele an in e ac ion(s), i is no eadily dis inguishable om he one
enac ed by neu o ypical child en o a simila age.
We p opose o call his kind o camou laging “socially-d i en”. In he
example abo e, one would say, he child unde aking he in e en ion is
no ini ially a camou lage himsel . Ra he , o he people, in his case
he apis s, should be seen as he agen s a ge ing he child’s unusual
beha io and p omp ing some o m o camou laging. No ably, in hese
cases camou laging beha io is induced unde he di ec supe ision o
ano he social agen , unlike he s anda d examples discussed in he
li e a u e whe e camou laging is p esen ed as sel - augh o sel -
de eloped. Ye , his does no make i essen ially di e en om such
examples, especially when we conside he s ages in which he child has
lea ned o sel - egula e and eminds himsel o look in he eyes o o he s.
Indeed, e en he cases cu en ly being discussed in he li e a u e may be
unde s ood as socially-d i en o some ex en . As we ha e shown abo e,
people who camou lage do so mainly o con o m o he ex e nal social
wo ld and o ailo hei beha io o he people a ound hem, who ac
acco ding o no ms, habi s, and i uals ha a e deeply social in na u e.
The only ele an di e ence conce ns he way in which a gi en beha io
has o igina ed - ha is, i s ajec o y and de elopmen .
Child en also seem o exhibi mo e spon aneous o ms o camou-
laging beha io . Fo example, young child en ou inely p e end o
unde s and ques ions hey do no eally unde s and. Neu o ypical 2-
yea -olds almos sys ema ically p o ide “yes” esponses o pola (i.e.,
yes-o -no) ques ions (Hea he F i zley & Lee, 2003). This is also he case
o hea ing impai ed people and second-language lea ne s, as well as o
many au is ic child en who also expe ience language di icul ies. In all
hese cases, ques ions ha a e no p ope ly unde s ood a e none heless
o en answe ed in he a i ma i e. The main pu pose behind his
beha io appea s o be camou laging a lack o unde s anding. Inciden-
ally, his is no dissimila o he way some au is ic people app oach
i ony: hey s uggle o eac in he app op ia e way and o en look o
clues (e.g., p osody, ace exp ession, e c.) so ha he in e locu o s do no
no ice hei di icul y. A simila eac ion is again obse ed in hea ing
impai ed indi iduals and second-language lea ne s, and plausibly pa -
e ns oge he wi h he a i ma i e bias owa ds pola ques ions.
Au is ic child en he e o e seem o exhibi bo h socially-d i en and
spon aneous o ms o camou laging o di e en deg ees. In he o me ,
he main camou laging agen is no (ini ially) he child himsel , al hough
a a la e momen - as a Vygo skyan would pu i (Vygo sky, 1978) -
social egula ions become sel - egula ions. A his la e s age i would be
di icul o dis inguish he child’s beha io om he one exhibi ed by a
s anda d camou lage , excep ha he child would p obably be unawa e
o he complexi ies in ol ed in he ele an ac ion. By con as , mo e
spon aneous o ms o camou laging de elop o ganically as a way o
mask social di icul ies, o i in a social se ing, e c. Some o hese in-
s ances may be mo e sel - e lec i e (e.g., o cing onesel o laugh a
jokes), while o he s may be mo e implici and au oma ic (e.g., a i -
ma i e answe s o pola ques ions). While we do no ega d hese in-
s ances as di e en ypes o camou laging pe se, we ega d hem as
use ul o illus a e ha camou laging in young child en may ha e
di e en sou ces. In his sense, we do no wan o sugges ha camou-
laging in young child en only esul s om he apeu ic in e en ion. As
a ma e o ac , he same kind o beha io s ha many child en de elop
as a esul o in e en ion may de elop wi hou in e en ion in o he s
(wi h di e en aims in di e en cases). I would be in e es ing o be able
o s udy how mo e spon aneous as well as mo e socially-d i en
camou laging may ela e o he di e en dimensions o camou laging
ha a e being explo ed (e.g., anxie y, wellbeing, success, di e si y o
con ex s, e c.). Finally, in e en ions may impac di e en child en in a
a ie y o ways: some in e en ions may u n ou o be edundan ,
child en unde going a simila p og am may end up exhibi ing camou-
laging beha io o e y di e en deg ees, and so on. Tha said, mo e
esea ch is needed be o e we can es ablish whe he he social skills
lea ned by au is ic child en ( h ough in e en ion o mo e spon ane-
ously) conside ably o e lap wi h camou laging s a egies epo ed by
adul s. Al hough we sugges ha his migh be he case, and ha simila
mechanisms may unde lie he de elopmen o hese beha io s, mo e
e idence should be collec ed om a wide ange o popula ions.
Al hough we ha e sugges ed ha au is ic child en plausibly camou lage,
we ha e no ackled he ques ion o how adul , sel -conscious, o ms o
camou laging de elop, and whe he o no hese a e ela ed o how o he
g oups on he spec um expe ience hei own camou laging.
Au is ic people who ha e a concomi an in ellec ual o linguis ic
disabili y a e simila ly le ou by cu en esea ch on camou laging.
Gene ally speaking, in e en ion p og ams aimed a au is ic people wi h
linguis ic o cogni i e di icul ies do no di e subs an ially om he
p og ams a ge ing young child en. The Social Compe ence In e en ion
p og am desc ibed abo e, o ins ance, p o ides a he apeu ic se ing
whe e child en and you h ha e he oppo uni y o in e ac in o a
s uc u ed en i onmen and lea n new skills (S ich e e al., 2010). A
simila in e en ion s udied o adul s is G oup Cogni i e Beha io al
The apy, which p io i izes s uc u e, social aining (e.g. skill building
such as p ac icing phone calls and asking o help), and
cogni i e-beha io al echniques – e.g. ole-playing and exposu e exe -
cises (see Hesselma k e al., 2014 o an example).
Simila ly o wha happens wi h child en, he e may be di e en ways
in which he ele an ac ion comes o be lea ned. Some indi iduals may
ini ially be induced o camou lage h ough in e en ion and hen u n
he ele an ac ions in o a habi , while o he s may de elop camou-
laging beha io in a mo e indi idual and spon aneous ashion. Fo
ins ance, an au is ic pe son who has g own up wi h neu o ypical iends
wi hin an in eg a ed school sys em may pa icipa e in sha ed ways o
add essing each o he , use unning jokes, ou ines and con e sa ions
wi hou ully g asping he meaning o such p ac ices, nei he enjoying
hem no inding hem “easy”. In o he cases, hey may be able o adjus
o he dynamics o a na ow social en i onmen wi h speci ic ules, such
as a baske ball eam, while expe iencing p oblems adjus ing o wide o
mo e unp edic able en i onmen s. In such cases, he pe son may no
ecei e any explici ins uc ion conce ning how o in e ac wi h o he s,
V. Pe olini e al.
New Ideas in Psychology 68 (2023) 100992
7
bu will lea n how o adjus hei own ac ions o he ones pe o med by
o he s by imi a ing, being sensi i e o eedback, and modula ing hei
esponses.
People who pa icipa e in quali a i e s udies in ol ing sel - epo
measu es, as well as he majo i y o esea che s, end o ocus on a i-
e ies o camou laging ha de elop as he esul o indi idual e o s o
imi a ion and mo e o less explici sel -ins uc ion. Howe e , as we
s ess abo e, we should also look a how camou laging may eme ge in
childhood and in o he popula ions o ully unde s and he phenome-
non. In his sense, i would be in e es ing o in es iga e how camou-
laging comes abou , o wha ex en socially-induced camou laging
de elops in o habi ual beha io , whe he and a which s age people
become sel -conscious o wha hey do, and whe he sel -awa eness has
an impac on how camou laging is expe ienced. In he inal sec ion we
explo e some p elimina y ideas on how o mo e esea ch o wa d along
hese lines.
4. Implica ions and conclusions
A ew ecen con ibu ions o e some sugges ions on how o explo e
he cons uc o camou laging mo e inclusi ely. One common ecom-
menda ion conce ns he need o mo e beyond sel - epo measu es o-
wa ds mo e obse a ional me hods (Libsack e al., 2022, p. 806). Fo
ins ance, Lai e al. (2021) p opose o e ine exis ing disc epancy mea-
su es by looking a he ools used o assess o he condi ions – such as
dyslexia – whe e obse ed pe o mance and unde lying unde s anding
may come apa .
11
Williams (2021) sugges s looking a beha io al
measu es widely used in social psychology – such as he Con e sa ion
P obe Role-play Tes (Mo ison e al., 2020) – o de elop an expe imen al
disc epancy app oach. These me hods a e based on expe imen al
manipula ion, so ha pa icipan s a e eco ded while in e ac ing unde
di e en condi ions ha a e designed o inc ease o dec ease camou-
laging beha io . Manipula ions may include ins uc ing pa icipan s o
conceal hei diagnosis om a con e sa ional pa ne , o being
encou aged o “show hei ue sel ” (Williams, 2021, p. 3).
Camou laging as enac ed by he g oups conside ed in §3.2
s eng hens he idea ha we a e looking a a complex phenomenon
whose mo i a ions a e mixed and a y o di e en people ac oss con-
ex s. Some o ms o camou laging aim a ull-blown in eg a ion in he
neu o ypical social wo ld. Mos exis en esea ch is ocused on such
cases. Ye , o he ins ances may be a he di ec ed owa ds mo e minimal
o ms o in eg a ion, such as pa icipa ing in a sha ed game o ac i i y,
ca ying ou a sho con e sa ion, being pa o a social e en , o jus
dealing wi h mo e ci cumsc ibed aspec s o he social wo ld. De eloping
new expe imen al disc epancy app oaches seems o be a p omising way
o explo e a ia ions o camou laging beha io in child en and in people
wi h concomi an linguis ic o in ellec ual disabili ies. In hese cases, we
hypo hesize ha he con ex pa ame e can be pa icula ly impo an , as
e y o en beha io s enac ed in one con ex a e no gene alized o o he
con ex s (e.g., use o al e na i e sys ems o communica ion a school
while e using o use hem a home). By manipula ing he con ex
pa ame e , esea che s migh ge an app oxima e idea as o wha ex en
a ce ain pe son who pa icipa es in some social sc ip has a deep o
shallow unde s anding o ha sc ip (e.g., o wha ex en child en who
“do well” on he ADOS-2 bi hday pa y sub es unde s and ha kind o
social si ua ion). Expe imen al disc epancy measu es would also allow
us o obse e whe he di e en s a egies a e being employed in
di e en si ua ions (o whe he some s a egies a e es ic ed o some
si ua ions), o wi h di e en con e sa ional and social pa ne s.
Ex ending he s udy o camou laging o cu en ly o e looked g oups
also has impo an implica ions in e ms o e aming how we hink
abou impac . As we show in §1, he cu en li e a u e ends o p esen
camou laging (a leas , “shallow” camou laging) as mos ly de imen al
wi h some local excep ions. This is co obo a ed by i s -pe son epo s
and ques ionnai es in which camou laging is desc ibed as d aining and
e o ul, and as p o oundly impac ing anxie y and wellbeing (Cage &
T oxell-Whi man, 2019; Mille e al., 2021; Milne e al., 2022).
12
Howe e , hese esul s a e once again limi ed by o e ly es ic ed
sample sizes and me hodological ools ha exclude a signi ican po ion
o people on he spec um. S udying camou laging in di e en g oups
may p omp us o signi ican ly econside his poin . As we a gue abo e,
impac should go beyond he ocus on men al heal h because camou-
laging beha io – in all i s a ie ies – is likely o b ing abou complex
adeo s be ween di e en wellbeing componen s. Any e alua ion
abou camou laging and i s impac on wellbeing should ake in o ac-
coun camou laging beha io enac ed by he e ogeneous g oups o peo-
ple wi h di e en abili ies and deg ees o awa eness. One poin ha
eme ges om ou discussion is ha camou laging may p esen i sel
di e en ly – and ha e a di e en impac – depending on he people who
enac i .
Ano he implica ion o ou discussion conce ns he connec ion be-
ween camou laging and di e en he apeu ic app oaches. In §3 we ha e
mos ly conside ed cogni i e-beha io al p og ams ha go h ough a
phase whe e child en camou lage. Howe e , many he apeu ic in-
e en ions nowadays end o depa om op-down cogni i e-beha -
io al app oaches in a o o a mo e ela ional and bo om-up
de elopmen o social compe ences (see Bo ema-Beu el e al. (2018) o
some examples). Fo ins ance, social-p agma ic in e en ions use he
de elopmen al s age o he pe son as a s a ing poin o build skills
h ough a holis ic app oach ha does no ocus on speci ic beha io s.
These p og ams include indi idual-di e ence, ela ionship-based
models whe e di e en capaci ies, such wo-way, pu pose ul communi-
ca ion, a e de eloped in eal-li e con ex s and used in a ious ypes o
social in e ac ions ha occu in daily li e, h ough he sca olding and
con inuous suppo o e ed o he child en o go h ough di e en
unc ional and de elopmen al le els (see Mok & Chung, 2014 o an
example). This kind o app oach is widely used in childhood, and aims a
de eloping skills o ganically and lexibly om expe ience. O he
bo om-up in e en ions – such as he Con e sa ion Analy ic Roleplay
Me hod (CARM) ecommended by Bo ema-Beu el e al. (2018) –
equi e signi ican language epe oi es in o de o be accessed. Pa ic-
ipan s obse e hemsel es in con e sa ions, while iden i ying di icul ies
and looking o possible solu ions oge he wi h a ained acili a o .
This way, pa icipan s d i e he change in he in e ac ion wi h o he s.
Howe e , o he easons jus men ioned, his ype o in e en ion migh
no be sui able o popula ions wi h linguis ic o in ellec ual disabili ies.
One in e es ing esea ch de elopmen in his espec would be o
assess how di e en he apeu ic app oaches a e wi h espec o
camou laging e ec s ac oss di e en ime ames – i.e., du ing in e -
en ion as well as in la e s ages o de elopmen . In pa icula , i would
be in e es ing o assess whe he cogni i e-beha io al p og ams would
gi e ise o camou laging s a egies mo e di ec ly, o whe he bo om-up
app oaches – despi e he emphasis on de elopmen and lexibili y –
could also p omo e some o ms o camou laging. Wi h espec o longe
ime ames, i would be impo an o de e mine whe he wha we ha e
called socially-d i en camou laging lea es some “ma k” o “ ace” as he
pe son g ows in o adul hood, which may ha e some de imen al e ec s.
By con as , he e migh be si ua ions in which beha io s ha began as
camou laging become mo e in eg al o he pe son’s habi ual ac ions and
11
Lai and colleagues acknowledge ha disc epancy measu es a e po en ially
p oblema ic in he case o au ism, gi en ha unequi ocal measu es o psy-
chia ic diagnoses a e ha d o come by. They p opose o o e come he issue by
combining se e al measu es o obse able beha io and cogni i e es s in a
ne wo k-like s uc u e ha would ideally bypass he need o g ound u h
measu es (Lai e al., 2021, p. 2).
12
As a consequence, some ecen publica ions a e explici ly amed in e ms o
educing o minimizing he nega i e e ec s associa ed wi h masking (see o
ins ance Cage e al., 2022; Belche , 2022).
V. Pe olini e al.
New Ideas in Psychology 68 (2023) 100992
8
disposi ions ( he eby making camou laging po en ially indis inguish-
able om social lea ning o imi a ion). In his sense, we migh wan o
obse e whe he people who ha e gone h ough a mo e global he a-
peu ic app oach exhibi mo e in eg a ed and spon aneous in e ac ions
la e in li e. Longi udinal s udies on long- e m ou comes o au is ic in-
di iduals who ha e expe ienced di e en he apeu ic app oaches would
be a p omising way o collec da a in his espec (see he ASD Long Te m
Ou comes S udy (ALTOS) s udy o an example). Fo ins ance, we could
obse e how people unde going di e en in e en ion p og ams a e
wi h espec o anxie y le els as well as o he ele an men al heal h
measu es. This way i would be possible o de e mine whe he
socially-induced camou laging would inc ease anxie y, o whe he
anxie y le els would dec ease upon de eloping no el means o in e ac
and communica e.
In his pape we s a by discussing he ecen body o esea ch on
au is ic camou laging, which mos ly ocuses on adul and e bal in-
di iduals. In sec ion §1 we ocus on how di e en esea che s desc ibe
he cons uc and we show ha di e en accoun s emphasize di e en –
a imes alue-laden – aspec s o he phenomenon. In §2 we explo e he
analogy be ween camou laging and passing, which we ake o be illu-
mina ing al hough we a e cau ious abou some ecen a emp s a
o e s e ching i . Sec ion §3 is de o ed o g oups o indi iduals who
a guably camou lage bu who ha e no been he ocus o cu en
esea ch: among hem, we p ima ily discuss child en and adul s wi h
concu en in ellec ual o linguis ic disabili ies. We a gue ha by look-
ing a hese indi iduals we can ga ne impo an insigh s on he na u e
o camou laging and on how o s udy i . Theo e ically speaking, hese
cases p omp us o see ha no all o ms o camou laging a e sel -d i en
and sel -moni o ed. Ra he , some o ms o camou laging a e socially-
d i en in o igin, and some a e also spon aneous, in he sense o
a ising om a he unmoni o ed esponses. A mo e inclusi e iew hus
aises an impo an ques ion abou how camou laging de elops, an issue
ha has no ecei ed he a en ion i equi es.
Decla a ion o compe ing in e es
The au ho s decla e ha hey ha e no known compe ing inancial
in e es s o pe sonal ela ionships ha could ha e appea ed o in luence
he wo k epo ed in his pape .
Da a a ailabili y
No da a was used o he esea ch desc ibed in he a icle.
Acknowledgmen s (including unding)
We a e g a e ul o Elena Cas o iejo, Inge-Ma ie Eigs i, Ma a Jo ba,
and Te esa Ro e si o hei aluable eedback on ea lie e sions o his
pape . Con e sa ions wi h I zia A bina and Oiane Musi u om he
Landabe de Dayca e Cen e we e impo an in he de elopmen o ou
ideas conce ning camou laging in adul s wi h e bal and in ellec ual
di icul ies. Ea lie e sions o his ma e ial we e discussed a he Phi-
losophy o Psychia y Wo k in P og ess a Lancas e Uni e si y and a
Lindy Lab semina s a he Uni e si y o he Basque Coun y (UPV/EHU).
We would also like o hank wo anonymous e e ees o his jou nal o
hei cons uc i e, encou aging, and engaging sugges ions h oughou
he e ision p ocess.
Re e ences
Ai, W., Cunningham, W. A., & Lai, M. C. (2022). Reconside ing au is ic ‘camou laging’ as
ansac ional imp ession managemen . T ends in Cogni i e Sciences, 26(8), 631–645.
Ame ican Psychia ic Associa ion. (2022). Diagnos ic and s a is ical manual o men al
diso de s, ex e ision (5 h ed.). DSM-5-TR.
ASD Long Te m Ou comes S udy (ALTOS). Uni e si y o Connec icu . h ps://al os.
uconn.edu/.
Baldwin, S., & Cos ley, D. (2016). The expe iences and needs o emale adul s wi h high-
unc ioning au ism spec um diso de . Au ism, 20(4), 483–495.
Ba giela, S., S ewa d, R., & Mandy, W. (2016). The expe iences o la e-diagnosed women
wi h au ism spec um condi ions: An in es iga ion o he emale au ism pheno ype.
Jou nal o Au ism and De elopmen al Diso de s, 46(10), 3281–3294.
Belche , H. L. (2022). Taking o he mask: P ac ical exe cises o help unde s and and
minimise he e ec s o au is ic camou laging. Jessica Kingsley Publishe s.
Belche , H. L., Mo ein-Zami , S., Mandy, W., & Fo d, R. M. (2022). Camou laging in en ,
i s imp essions, and age o ASC diagnosis in au is ic men and women. Jou nal o
Au ism and De elopmen al Diso de s, 52(8), 3413–3426.
Bo ha, M., Dibb, B., & F os , D. M. (2020). Au ism is me": An in es iga ion o how au is ic
indi iduals make sense o au ism and s igma (pp. 1–27). Disabili y & Socie y.
Bo ema-Beu el, K., Pa k, H., & Kim, S. Y. (2018). Commen a y on social skills aining
cu icula o indi iduals wi h ASD: Social in e ac ion, au hen ici y, and s igma.
Jou nal o Au ism and De elopmen al Diso de s, 48(3), 953–964.
B adley, L., Shaw, R., Ba on-Cohen, S., & Cassidy, S. (2021). Au is ic adul s’ expe iences
o camou laging and i s pe cei ed impac on men al heal h. Au ism in Adul hood, 3
(4), 320–329.
Cage, E., C anney, R., & Bo ha, M. (2022). B ie epo : Does au is ic communi y
connec edness mode a e he ela ionship be ween masking and wellbeing? Au ism in
Adul hood, 4(3), 247–253.
Cage, E., & T oxell-Whi man, Z. (2019). Unde s anding he easons, con ex s and cos s o
camou laging o au is ic adul s. Jou nal o Au ism and De elopmen al Diso de s, 49
(5), 1899–1911.
Cage, E., & T oxell-Whi man, Z. (2020). Unde s anding he ela ionships be ween au is ic
iden i y, disclosu e, and camou laging. Au ism in Adul hood, 2(4), 334–338.
Cook, J., Hull, L., C ane, L., & Mandy, W. (2021). Camou laging in au ism: A sys ema ic
e iew. Clinical Psychology Re iew, 89, A icle 102080.
Fombonne, E. (2020). Camou lage and au ism. Jou nal o Child Psychology and Psychia y,
61(7), 735–738.
Foss-Feig, J. H., McPa land, J. C., An ice ic, A., & Wol , J. (2016). Re-concep ualizing
ASD wi hin a dimensional amewo k: Posi i e, nega i e, and cogni i e ea u e
clus e s. Jou nal o Au ism and De elopmen al Diso de s, 46(1), 342–351.
Go man, E. (1959/2002). The p esen a ion o sel in e e yday li e. Ga den Ci y.
Go man, E. (1963/2009). S igma: No es on he managemen o spoiled iden i y. Simon and
Schus e .
Hea he F i zley, V., & Lee, K. (2003). Do young child en always say yes o yes–no
ques ions? A me ade elopmen al s udy o he a i ma ion bias. Child De elopmen , 74
(5), 1297–1313.
Hesselma k, E., Plen y, S., & Beje o , S. (2014). G oup cogni i e beha iou al he apy and
g oup ec ea ional ac i i y o adul s wi h au ism spec um diso de s: A p elimina y
andomized con olled ial. Au ism: The In e na ional Jou nal o Resea ch and
P ac ice, 18(6), 672–683.
Hille , R. M., Young, R. L., & Webe , N. (2016). Sex di e ences in p e-diagnosis conce ns
o child en la e diagnosed wi h au ism spec um diso de . Au ism, 20(1), 75–84.
Holliday-Willey, L. (1999). P e ending o be no mal: Li ing wi h Aspe ge ’s synd ome.
London: Jessica Kingsley.
Hollocks, M. J., Le h, J. W., Magia i, I., Meise -S edman, R., & B ugha, T. S. (2019).
Anxie y and dep ession in adul s wi h au ism spec um diso de : A sys ema ic e iew
and me a-analysis. Psychological Medicine, 49(4), 559–572.
Hull, L., Le y, L., Lai, M. C., Pe ides, K. V., Ba on-Cohen, S., Allison, C., … Mandy, W.
(2021). Is social camou laging associa ed wi h anxie y and dep ession in au is ic
adul s? Molecula Au ism, 12(1), 1–13.
Hull, L., Mandy, W., Lai, M. C., Ba on-Cohen, S., Allison, C., Smi h, P., & Pe ides, K. V.
(2019). De elopmen and alida ion o he camou laging au is ic ai s ques ionnai e
(CAT-Q). Jou nal o Au ism and De elopmen al Diso de s, 49(3), 819–833.
Hull, L., Pe ides, K. V., Allison, C., Smi h, P., Ba on-Cohen, S., Lai, M. C., & Mandy, W.
(2017). Pu ing on my bes no mal”: Social camou laging in adul s wi h au ism
spec um condi ions. Jou nal o Au ism and De elopmen al Diso de s, 47(8),
2519–2534.
Lai, M. C., Hull, L., Mandy, W., Chak aba i, B., No dahl, C. W., Lomba do, M. V., …
Li ings on, L. A. (2021). Commen a y: ‘Camou laging’ in au is ic people– e lec ion
on ombonne (2020). Jou nal o Child Psychology and Psychia y, 62(8).
Lai, M. C., Lomba do, M. V., Ruig ok, A. N., Chak aba i, B., Auyeung, B., Sza ma i, P., …
MRC AIMS Conso ium. (2017). Quan i ying and explo ing camou laging in men and
women wi h au ism. Au ism, 21(6), 690–702.
Lawson, W. B. (2020). Adap i e mo phing and coping wi h social h ea in au ism: An
au is ic pe spec i e. Jou nal o In ellec ual Disabili y-Diagnosis and T ea men , 8(3),
519–526.
Libsack, E. J., Keenan, E. G., F eden, C. E., Mi mina, J., Iskhako , N., K ishna hasan, D.,
& Le ne , M. D. (2021). A sys ema ic e iew o passing as non-au is ic in au ism
spec um diso de . Clinical Child and Family Psychology Re iew, 24(4), 783–812.
Li ings on, L. A., & Happ´
e, F. (2017). Concep ualising compensa ion in
neu ode elopmen al diso de s: Re lec ions om au ism spec um diso de .
Neu oscience & Biobeha io al Re iews, 80, 729–742.
Li ings on, L. A., Shah, P., & Happ´
e, F. (2019). Compensa o y s a egies below he
beha iou al su ace in au ism: A quali a i e s udy. The Lance Psychia y, 6(9),
766–777.
Li ings on, L. A., Shah, P., Milne , V., & Happ´
e, F. (2020). Quan i ying compensa o y
s a egies in adul s wi h and wi hou diagnosed au ism. Molecula Au ism, 11(1),
1–10.
McC acken, C. (2021). Au is ic iden i y and language lea ning: Response o Kissine.
Language, 97(3), e211–e217.
Mille , D., Rees, J., & Pea son, A. (2021). Masking is li e”: Expe iences o masking in
au is ic and nonau is ic adul s. Au ism in Adul hood, 3(4), 330–338.
V. Pe olini e al.
New Ideas in Psychology 68 (2023) 100992
9
Milne , V., Mandy, W., Happ´
e, F., & Col e , E. (2022). Sex di e ences in p edic o s and
ou comes o camou laging: Compa ing diagnosed au is ic, high au is ic ai and low
au is ic ai young adul s. Au ism, 13623613221098240.
Mok, J. W., & Chung, K. H. (2014). Applica ion o DIR/Floo ime model in he
psychia ic se ice o e y young child en wi h au ism in Hong Kong. Hong Kong
Jou nal o Men al Heal h, 40(1), 23–30.
Mo ison, K. E., DeB abande , K. M., Jones, D. R., Acke man, R. A., & Sasson, N. J.
(2020). Social cogni ion, social skill, and social mo i a ion minimally p edic social
in e ac ion ou comes o au is ic and non-au is ic adul s. F on ie s in Psychology, 11.
Ni ode, V. (2019). ‘Why I ake being ‘no mal’ — and o he women wi h au ism do. Too’
h ps://www.heal hline. com/heal h/au ism/how-women-camou lage-au ism#1.
Pea son, A., & Rose, K. (2021). A concep ual analysis o au is ic masking: Unde s anding
he na a i e o s igma and he illusion o choice. Au ism in Adul hood, 3(1), 52–60.
Pellicano, E., Dinsmo e, A., & Cha man, T. (2014). Wha should au ism esea ch ocus
upon? Communi y iews and p io i ies om he Uni ed Kingdom. Au ism, 18(7),
756–770.
Pe y, E., Mandy, W., Hull, L., & Cage, E. (2022). Unde s anding camou laging as a
esponse o au ism- ela ed s igma: A social iden i y heo y app oach. Jou nal o
Au ism and De elopmen al Diso de s, 52(2), 800–810.
Picci illo, M. L., D yman, M. T., & Heimbe g, R. G. (2016). Sa e y beha io s in adul s
wi h social anxie y: Re iew and u u e di ec ions. Beha io The apy, 47(5), 675–687.
Pos o ino, V., Fa a, L. M., Sanges, V., Gio agnoli, G., De Peppo, L., Vica i, S., &
Mazzone, L. (2016). In ellec ual disabili y in au ism spec um diso de : In es iga ion o
p e alence in an I alian sample o child en and adolescen s.
Radulski, E. M. (2022). Concep ualising au is ic masking, camou laging, and
neu o ypical p i ilege: Towa ds a mino i y g oup model o neu odi e si y. Human
De elopmen , 66(2), 113–127.
Raymake , D. M., Teo, A. R., S eckle , N. A., Len z, B., Scha e , M., Delos San os, A., …
Nicolaidis, C. (2020). Ha ing all o you in e nal esou ces exhaus ed beyond
measu e and being le wi h no clean-up c ew”: De ining au is ic bu nou . Au ism in
adul hood, 2(2), 132–143.
Ren ow, D. G. (2004). A ca og aphy o passing in e e yday li e. Symbolic In e ac ion, 27
(4), 485–506.
Rose, K. (2017). The inside o au ism: You should see he wo ld inside my head. h
ps:// heau is icad oca e.com/2017/11/ he-inside-o -au ism-you-should-see- he-wo
ld-inside-my-head/.
Russell, G., Mandy, W., Ellio , D., Whi e, R., Pi wood, T., & Fo d, T. (2019). Selec ion
bias on in ellec ual abili y in au ism esea ch: A c oss-sec ional e iew and me a-
analysis. Molecula Au ism, 10(1), 1–10.
Samuels, E. J. (2003). My body, my close : In isible disabili y and he limi s o coming-
ou discou se. GLQ: A Jou nal o Lesbian and Gay S udies, 9(1), 233–255.
Schil z, H. K., McVey, A. J., Dolan Wozniak, B., Haendel, A. D., S anley, R., A ias, A., …
Van Hecke, A. V. (2021). The ole o loneliness as a media o be ween au ism
ea u es and men al heal h among au is ic young adul s. Au ism, 25(2), 545–555.
Schneid, I., & Raz, A. E. (2020). The mask o au ism: Social camou laging and imp ession
managemen as coping/no maliza ion om he pe spec i es o au is ic adul s. Social
Science & Medicine, 248, A icle 112826.
Sedgewick, F., Hull, L., & Ellis, H. (2021). Au ism and masking: How and why people do i ,
and he impac i can ha e. Jessica Kingsley Publishe s.
Sil e min , D. (2018). Passing as p i ileged. E go, an Open Access Jou nal o Philosophy, 5.
S ich e , J. P., He zog, M. J., Viso sky, K., Schmid , C., Randolph, J., Schul z, T., &
Gage, N. (2010). Social compe ence in e en ion o you h wi h Aspe ge synd ome
and high- unc ioning au ism: An ini ial in es iga ion. Jou nal o Au ism and
De elopmen al Diso de s, 40(9), 1067–1079.
Tage -Flusbe g, H., & Kasa i, C. (2013). Minimally e bal school-aged child en wi h
au ism spec um diso de : The neglec ed end o he spec um. Au ism Resea ch, 6(6),
468–478.
Vygo sky, L. S. (1978). Mind in socie y. In M. Cole, V. John-S eine , S. Sc ibne ,
E. Soube man, eds, & ans (Eds.), The de elopmen o highe men al p ocesses.
Camb idge, MA: Ha a d Uni e si y P ess (O iginal wo k published 1930–1935).
Williams, Z. J. (2021). Commen a y: The cons uc alidi y o ‘camou laging’ in au ism:
Psychome ic conside a ions and ecommenda ions o u u e esea ch- e lec ion on
Lai e al. Jou nal o Child Psychology and Psychia y, 63(1), 118–121.
V. Pe olini e al.
