Can Diagnostic Manuals Overlook Camouflaging in Autism? 

Yes, diagnostic manuals can sometimes overlook camouflaging in autism, particularly when individuals have developed coping mechanisms to mask their symptoms. Masking involves consciously or unconsciously hiding social difficulties, repetitive behaviours, or sensory sensitivities in order to fit in or avoid stigma. This can make it difficult for clinicians to identify autism, especially in individuals who are able to “pass” as neurotypical in social situations, leading to potential delays in diagnosis or missed diagnoses entirely. These diagnosis challenges can be particularly evident in those who camouflage their traits effectively.  

How Camouflaging Impacts Autism Diagnosis 

Camouflaging behaviours can influence the accuracy and timing of an autism diagnosis: 

Subtle Signs Masked by Social Adaptations 

For individuals who camouflage, social interactions may appear typical, as they mimic social behaviours, make eye contact, or follow social scripts. These traits can mask underlying difficulties that are integral to an autism diagnosis. 

Gender Differences in Masking 

Females, in particular, are more likely to engage in masking strategies, as societal expectations place greater emphasis on social conformity. This can lead to underrecognition in women and girls, whose autism may not align with traditional diagnostic profiles. 

The Challenge of Detecting Camouflaging 

Clinicians may struggle to distinguish between genuine neurotypical behaviour and camouflaging when individuals consciously adapt to social environments. This can lead to diagnosis challenges, making it difficult to assess if the person truly lacks certain social skills or if they are simply masking them effectively.   

Impact on Diagnosis at Later Stages 

Masking can delay the diagnosis of autism, especially in adolescence or adulthood when the demands of social situations increase, and camouflaging becomes harder to maintain. 

Summary 

Camouflaging in autism is a significant challenge for accurate diagnosis, particularly when the individual’s coping mechanisms hide the more typical signs of autism. Diagnostic manuals like DSM-5 and ICD-11 are not always equipped to address this complexity, leading to potential diagnostic delays. 

For personalised advice and guidance on autism assessments, visit providers like Autism Detect for personal consultations. 

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to Autism Diagnostic Criteria (DSM-5, ICD-11).