Camouflaging in Autism: Examining Sex-Based and Compensatory Models in Social Cognition and Communication.
Blythe A Corbett, Jessica M Schwartzman, Erin J Libsack and 4 others
PMID 33220170WHAT IT FOUND
Adolescent girls with autism showed fewer repetitive behaviors and more varied vocal tone during social tasks than boys.
However, boys and girls had similar social affect scores. Clinicians should not assume girls are less impaired based on standard diagnostic observations alone.
Key findings
01Females with ASD showed significantly fewer restricted and repetitive behaviors than males, but no significant difference in social affect.
02Females demonstrated more vocal expressiveness than males during a peer interaction task, though other social behaviors did not differ significantly.
03Youth classified as 'High Compensation' (good observed social affect but poor theory of mind) showed better vocal expression and rapport than 'Low Compensation' peers, despite similar IQs.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was uneven by sex (115 males vs 46 females), reducing power to detect small differences in females. Participants all had average to above-average IQ, so findings do not apply to those with intellectual disability. The compensation groups were created using median splits, resulting in smaller subgroups and preliminary findings. Anxiety was measured only immediately after a single social interaction, which may not capture chronic mental health costs associated with camouflaging. The study used a cross-sectional design, so it cannot determine how these behaviors change over time.
Declared interests
Blythe Corbett is the founder of SENSE Theatre but derives no financial compensation from the non-profit entity. The study was supported by the NIH.
The easy way to misread this
Do not interpret fewer repetitive behaviors in girls as evidence of milder autism. The study suggests this difference may reflect camouflaging or measurement bias in male-centric diagnostic tools, and social affect scores were similar between sexes.