(PS3-B29) Factors Influencing Camouflaging Behavior in Children and Adolescents with Autism Spectrum Disorder

            Autism Spectrum Disorder (ASD) is a behaviorally defined condition characterized by social-communication differences and the presence of restricted, repetitive behaviors and interests. A burgeoning body of research has identified a subgroup of autistic individuals who exhibit context-dependent variation in their behavior to such a degree that they present as non-autistic. This subgroup employs various strategies, such as intentionally suppressing self-stimulatory behavior or engaging in performative behaviors such as eye contact, all of which fall under the umbrella term “camouflaging.” In the qualitative literature, autistic individuals have consistently described this experience as emotionally exhausting and negatively impacting their mental health. The direct association between camouflaging and internalizing problems in autistic adults has recently received increasing empirical attention and is supported. Although the existing literature on camouflaging has focused mainly on autistic adults, this construct is of particular relevance in adolescents given that concerns regarding social acceptance, which emerge in early childhood, tend to intensify during the developmental period of adolescence. In addition to internalizing problems, previous research suggests that gender, age of diagnosis with ASD, and autism symptom severity influence camouflaging behavior. The current study examined the combined influence of these factors on self-reported camouflaging behavior in a sample of 82 children and adolescents, aged 11-20 (M = 13.81, SD = 1.96).

            A multiple linear regression revealed greater levels of camouflaging in children and adolescents with higher levels of depression (β = 1.18, SE = 0.42, p > .01) and who identified as female (β = 14.17, SE = 6.38, p > .05). Lower levels of camouflaging were found for those diagnosed with ASD at a later age (β = -1.71, SE = 0.84, p = .05). Autism symptom severity did not emerge as a significant correlate with camouflaging.

            The current study found that camouflaging is associated with higher levels of depression in autistic children and adolescents, consistent with previous findings in autistic adults. Therefore, the degree to which autistic children and adolescents engage in camouflaging behaviors should be considered by clinicians during assessment and treatment planning when an autistic individual presents with symptoms of depression. This finding raises concerns regarding the cost-benefit of social skills interventions that emphasize conformity to neurotypical social standards. Given the repeatedly supported link between camouflaging and internalizing problems, as well as the impact of social isolation, stigmatization, and bullying, careful examination of competing priorities with all parties is required. Findings also replicate literature highlighting the importance of better understanding the unique phenotype of autistic females and how camouflaging may play a role in the underdiagnosis of ASD among females. Lastly, the finding that older age of diagnosis is associated with less camouflaging may reflect that individuals diagnosed with ASD later in life experience less internalized stigma and therefore do not feel pressured to act in ways incongruent with autism.