SLPSystematic ReviewAutism research : official journal of the International Society for Autism Research2023

A comparison of methods for measuring camouflaging in autism.

Benjamin Hannon, William Mandy, Laura Hull

PMID 36424824

WHAT IT FOUND

Self-report, parent-report, and discrepancy measures of camouflaging correlate moderately but are not interchangeable.

Self-report captures internal effort; parent-report and discrepancy methods capture observable behavioral changes. Choose the method based on whether you need to assess subjective experience or external presentation.

Key findings

01Self-reported and parent-reported camouflaging scores were strongly correlated, suggesting similar perceptions between adolescents and parents, but the correlation was not high enough to treat the measures as interchangeable.

02Parent-reported camouflaging correlated strongly with discrepancy scores (which measure the gap between internal traits and observable behavior), whereas self-reported camouflaging showed only a weak correlation with discrepancy scores.

03Camouflaging measures were largely independent of social skills deficits, indicating that camouflaging is distinct from simply having good social abilities.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The study focused on verbally fluent adolescents; results may not generalize to autistic individuals with minimal spoken language. The parent-report CAT-Q is a novel adaptation and has not yet been fully psychometrically validated. Discrepancy scores are calculated from other measures (AQ and ADOS) and may inherit their measurement errors. The sample size for the empirical validation (Study 2) was small (59 participants).

Declared interests

Two authors (Laura Hull and Will Mandy) were part of the original team that developed the CAT-Q, which was evaluated in the review. They receive no financial gains from this resource. The research was funded by various bodies including Autistica and the National Institute for Health Research.

The easy way to misread this

Do not assume that self-reported camouflaging accurately reflects how much an autistic person masks their traits in observable social interactions. The study found that self-report correlates weakly with discrepancy scores (which measure observable masking), while parent-report correlates strongly. Relying solely on self-report may miss the behavioral impact of camouflaging.

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