Consolidating a framework of autistic camouflaging strategies

Masking autism involves hiding traits to blend into social environments—like forcing eye contact, mimicking others’ speech, or suppressing stimming. But it’s more than just “pretending to fit in.”

Research shows autistic people use a range of strategies—like scripting, imitation, or creating personas—that vary by situation.

These strategies can be deliberate, complex, and mentally exhausting, revealing that masking is more nuanced than previously understood.

Nel, J., Spedding, M., & Malcolm-Smith, S. (2025). Consolidating a framework of autistic camouflaging strategies: An integrative systematic review. Autism, 13623613251335472. https://doi.org/10.1177_13623613251335472

Key Points

• Main Focus: This systematic review explores autistic camouflaging—a process by which autistic individuals hide or compensate for their autistic traits in social situations.
• Research Aims: The study aims to consolidate and organize the wide range of camouflaging strategies used by autistic adults into a single, conceptual framework. It also investigates the contextual factors that affect the use and success of these strategies.
• Method: A qualitative meta-synthesis was conducted using 28 studies that involved 2669 adults (16+ years) with either a confirmed or self-identified autism diagnosis. Studies were selected using the SPIDER framework, with data drawn from multiple databases and analyzed thematically.
• Key Findings:
  • Six types of camouflaging strategies were identified: masking, tools for a growing repertoire (e.g., imitation), cognitive strategies, use of others, unhealthy practices, and selective settings.
  • Four contextual moderators were found to affect camouflaging: unclear cues, group size, stress/overwhelm, and duration of social interaction.
• Implications: The framework advances understanding of camouflaging beyond existing fragmented definitions. It provides clinicians and researchers with clearer markers for recognizing camouflaging behaviors and highlights the significant mental health impacts associated with camouflaging.

Rationale

Autistic camouflaging refers to behaviors used to obscure one’s autistic traits in order to blend into neurotypical environments.

Though a growing area of research, the concept is inconsistently defined and poorly operationalized across studies (Fombonne, 2020; Lai et al., 2021).

Previous reviews have often focused narrowly, such as on camouflaging in women (Allely, 2019) or its impact on mental health (Zhuang et al., 2023).

No study, until this one, has systematically synthesized all camouflaging strategy types into a unified framework.

Camouflaging is widely reported by autistic individuals and has been linked to serious mental health consequences including anxiety, burnout, and suicidality (Cassidy et al., 2022; Cook, Hull, et al., 2021).

The complexity of camouflaging—ranging from momentary masking to long-term identity suppression—suggests that a single cohesive framework is necessary to guide assessment and support interventions.

This study addresses critical gaps in the literature by consolidating qualitative findings into a structured typology of strategies and identifying environmental moderators that affect their use and outcomes.

Method

• Review Type: Integrative systematic review and thematic meta-synthesis of qualitative data.
• Guidelines Followed: PRISMA (2022) standards.
• Databases Searched:
  • EBSCOhost (Academic Search Premier, CINAHL, APA PsycINFO, APA PsycArticles)
  • PubMed
  • Web of Science
  • Scopus (including Embase)
  • Connected Papers and citation searching
• Search Terms: Combined free-text and controlled vocabulary terms related to “autism,” “camouflaging,” “masking,” and “qualitative research” (see Supplementary Materials in the article).
• Search Time Frame: Final database search conducted April 26, 2022.
• Inclusion/Exclusion Criteria:
  • Adults (16+) with confirmed or self-identified autism.
  • Studies focusing on camouflaging strategy types, motivations, or contextual factors.
  • Empirical, peer-reviewed, qualitative research in English.
  • Studies had to include at least three examples of camouflaging strategies.
  • Excluded studies: low reporting quality, insufficient focus, or not enough factors.
• Final Sample:
  • 28 studies included.
  • Total participant base: up to 2669 individuals.
  • Skewed toward White, British, female, and educated participants.
• Data Extraction & Coding:
  • Line-by-line coding of results sections.
  • Semi-inductive thematic analysis using QDA Miner Lite, based on Braun and Clarke’s framework.
  • Codes were revised iteratively and grouped into hierarchical themes.

Statistical Measures

• Type of Analysis: No meta-quantitative statistical tests were applied; this was a meta-synthesis of qualitative data.
• CERQual Confidence: Moderate confidence in findings was rated using GRADE-CERQual due to high consistency but limited demographic diversity.
• Inter-rater Reliability: Cohen’s Kappa = 0.77 during initial screening—a strong level of agreement between reviewers.

Results

Six types of camouflaging strategies were identified:

1. Masking:
   • Divided into suppression (hiding distress, stimming, or preferences) and performativity (adopting personas or feigning interest).
   • Often linked to avoiding stigma or rejection.
2. Tools for a Growing Repertoire:
   • Includes imitation (mirroring behaviors or learning from media) and active social training (reading social guides or being coached).
   • Seen as foundational to developing more sophisticated strategies.
3. Cognitive Strategies:
   • Subtypes include:
     • Scripting: Pre-planned phrases and responses.
     • Modulation: Adjusting behavior to appear likable or competent.
     • Mental Equations: Using learned heuristics to predict others’ mental states (Theory of Mind).
4. Use of Others:
   • Supportive friends or partners are used to explain social cues or initiate interactions.
   • Sometimes this support is enlisted without the other’s awareness.
5. Unhealthy Practices:
   • Using alcohol or restrictive eating to ease social anxiety or appear more socially acceptable.
6. Selective Settings:
   • Choosing environments (e.g., structured groups, quieter cultures) that make camouflaging easier or unnecessary.

Four contextual moderators were found to affect camouflaging:

1. Unclear or Unexpected Cues:
   • Camouflaging strategies often fail in unpredictable situations, e.g., fast-paced conversations or vague social signals.
2. Number of People:
   • Larger groups increase cognitive load and anxiety, making it harder to maintain camouflage.
3. Distress and Overwhelm:
   • Sensory stress or emotional strain (e.g., from prolonged masking) disrupts strategy use and increases burnout risk.
4. Duration of Camouflaging:
   • Extended camouflaging leads to exhaustion and a disconnection from one’s authentic self.
   • Some report never being able to unmask, even at home.

Insight

This review provides a conceptual map of how autistic adults camouflage in social settings.

The typology clarifies that camouflaging is not a single act but a flexible, learned, and often taxing process that can be shaped by environmental and social demands.

The role of imitation as both a strategy and a developmental tool was especially novel.

Rather than merely mimicking others, autistic individuals build and refine “social templates” over time through iterative trial and error.

This aligns with Bayesian learning models, where people accumulate and generalize predictive patterns to navigate uncertainty.

Importantly, not all strategies are equally taxing or maladaptive. Some (e.g., modulation) may align with authentic self-presentation, while others (e.g., unhealthy practices) are more distressing.

Comparatively, this review extends prior work by researchers such as Hull et al. (2017) by moving beyond surface behaviors to examine internal cognitive processes and motivations, offering a more holistic understanding of camouflaging in adult autism.

Clinical Implications

Strengths

This study had several methodological strengths, including:

• The review adheres to PRISMA guidelines and is registered with PROSPERO (CRD42022324957).
• High-quality qualitative meta-synthesis method used.
• Novel integration of Bayesian theory to explain social learning and strategy development.
• Clearly defined strategy framework with practical examples (see Table 3, p. 6).
• Comprehensive inclusion across a range of camouflaging behaviors and settings.

Limitations

This study also had several limitations, including:

• Most participants were White, British, and female, limiting generalizability.
• Lack of community involvement from autistic individuals in the review process.
• Relied on self-reported data, which may miss unconscious camouflaging.
• Inclusion of self-identified (rather than formally diagnosed) participants may affect diagnostic clarity.
• Focused only on studies discussing camouflaging explicitly, possibly excluding relevant data from broader autism research.

Socratic Questions

1. What are the ethical implications of encouraging or discouraging camouflaging in autistic individuals?
2. How might cultural norms shape which camouflaging strategies are considered effective or necessary?
3. Can we develop better screening tools that detect camouflaging without relying on self-report?
4. How should clinicians balance supporting identity expression with helping clients navigate neurotypical environments?
5. In what ways might camouflaging lead to misdiagnosis or delayed diagnosis of autism?
6. How might these findings change public policy around autism accommodations in education and employment?
7. What strategies could be used to reduce the need for camouflaging in everyday social settings?
8. Could camouflaging ever be beneficial, or is it always psychologically harmful?
9. How might the strategies outlined in this framework differ between youth and adults, or across cultures?
10. What further research would be needed to capture unconscious or automatic camouflaging behaviors?