Sometimes it can be fun to hide who you are and pretend you’re someone else. For people with autism spectrum disorder (ASD), masking is a life skill they develop to blend in with their peers—to ensure their autistic characteristics go unnoticed.
Unfortunately, when masking becomes part of the daily routine—something people with autism feel they have to sustain—it can come with significant drawbacks, says Tisa Johnson-Hooper, M.D., a pediatrician and autism specialist at Henry Ford Health.
What Is Autism Masking?
Autism Care at Henry Ford
The term “autism masking” is used to describe behaviors used by people with ASD to suppress or hide the signature characteristics of the disorder. It can also mean mirroring the behavior of neurotypical people and developing “scripts” that work in social situations.
A few examples:
- An adult who is sound-sensitive might try to avoid reacting to loud noises.
- A child who usually engages in stimming behaviors like licking their hands or rocking back and forth might try harder to squash those movements.
- A person who struggles to understand language might pretend they’re following a conversation.
- A teen who is nervous around the opposite sex might come up with a short script to use in social situations.
In each case, the goal of masking is to avoid being judged by others as “different” and to fit in. Masking may be a natural result of therapeutic approaches, such as applied behavioral analysis (ABA), which aims to help kids improve their function.
Who Is Most Likely To Mask Autism Traits?
At one time or another, nearly everyone strives to gain acceptance and meet social expectations. For people with ASD, that pressure can be even more intense because they already feel they have a deficit.
Masking ASD is most common among the following groups:
- People who fall on the mild end of the spectrum and require little support
- Females
- Adolescents and young adults
- People who have been bullied or experienced social rejection
- People who are striving for a particular goal, such as a job or a prom date
The Drawbacks Of Autism Masking
Autism masking can help kids and adults with ASD fit in with their peers at school and at work. In the short term, it can help individuals with ASD gain greater social acceptance and boost self-confidence.
Unfortunately, if masking becomes part of the person’s daily routine, it can create new problems, including:
- Delayed diagnosis: Suppressing certain behaviors that aren’t socially acceptable can lead to delayed diagnosis for a subset of children, particularly those who only have mild autism—and that means they won’t receive needed care.
- Burnout: “Hiding autistic traits can be emotionally, mentally and physically exhausting,” Dr. Johnson-Hooper says. “When kids with autism use all of their energy to suppress and to hide their authentic selves, there’s nothing left for making social connections, learning and creative thinking.” Over time, that intensity of focus can lead to stress, irritability, anger and burnout.
- Mental health challenges: Studies suggest that adults who camouflage autistic traits are more likely to suffer from mental health issues, such as depression. It’s important for people with ASD to feel accepted by the external world and to find community.
How To Help People Who Are Hiding Autism
It can be difficult to know how to support someone who is cracking under the strain of trying to adapt to a world that isn’t set up for their way of thinking. Even people who haven’t been diagnosed with ASD may find themselves trying to mask differences like attention deficit hyperactivity disorder (ADHD), sensory processing disorder and learning disabilities.
“Autism is a complex diagnosis and there are many other diagnoses that have similar features,” Dr. Johnson-Hooper says. “So even people who haven’t been diagnosed with autism may engage in masking behaviors.”
Whether someone you care about has been diagnosed with ASD or some other neurological difference, you can use the following strategies to help them better navigate the world:
- Show acceptance. Make sure the person knows that they don’t have to hide their true selves with you. No matter where a person falls on the ASD spectrum, it’s important to assure them they are worthy of love and acceptance.
- Don’t take outbursts personally. If your child (or spouse) comes home and becomes irritable, volatile or anxious, remember that it’s not necessarily about you. “Meeting social demands all day long is hard work,” Dr. Johnson-Hooper says. “They may just need a release after holding it together all day long.”
- Prepare a simple script. Help your loved one find ways to minimize the energy required for masking. “Some adolescents prepare a social script so they have something to say in different social settings,” Dr. Johnson-Hooper says. “That way, they don’t have to work so hard when a situation arises.”
- Come up with workarounds. Kids who use stimming behaviors to calm down may benefit from adopting a socially acceptable workaround. So children who lick their hands might do well with a fidget spinner, those who rock back and forth can try a wobble chair. “One of my young adult patients took up knitting to keep her hands busy and minimize bullying,” Dr. Johnson-Hooper says.
Unsure whether someone you love is masking their neurodiversity? Consider consulting with a psychologist, neurodevelopmental specialist or mental health professional who specializes in ASD.
Reviewed by Dr. Tisa Johnson-Hooper, a board-certified pediatrician and serves as the medical director of the Henry Ford Center for Autism and Developmental Disabilities. She sees patients at Henry Ford Medical Center—New Center One in Detroit.
