Quantifying compensatory strategies in adults with and without diagnosed autism.

The sample was a convenience sample recruited through an advert, so it may not represent the wider autistic or non-autistic adult population. The study relied on self-reported written descriptions and did not observe whether these strategies produced neurotypical social behaviour or were used successfully. The Compensation Checklist was newly created from qualitative responses, and its effect on diagnostic accuracy or clinical support has not been tested. There were too few males, 22, to rule out sex differences, although the observed effect sizes were small. The results do not necessarily apply to autistic people with additional intellectual disability, because participants had to describe strategies verbally. Individual strategy subtypes had low internal consistency, so the checklist should be used as a whole rather than as separate validated subscales. Autism diagnosis was not associated with compensation after autistic traits and education level were accounted for, so the group differences do not show that diagnosis itself drives compensation. The expected link between compensation and later age at diagnosis was not found. The diagnosed group included 48 of 58 people diagnosed in adulthood, which restricts the range of diagnosis ages.

The work was funded by the Medical Research Council, the Economic and Social Research Council, and the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust. The supplied text does not report author conflict-of-interest declarations.

Do not read the higher scores in diagnosed adults as proof that autism diagnosis causes more compensation, or the checklist as a validated diagnostic tool. Diagnosis was not associated with compensation after autistic traits and education were accounted for, and the paper states that the tool's efficacy for improving diagnostic accuracy and clinical support requires thorough investigation.