GPs would miss fewer diagnoses if ‘camouflaging’ was better understood, say researchers
Womenmay not be diagnosed with autism as frequently as men because they are better at hiding the common signs of the condition, according to new research.
Some autistic people use strategies to hide traits associated with the condition during social interactions, a phenomenon called social camouflaging. Scientists involved in the study say raising awareness of camouflaging among doctors could help reduce the number of missed autism diagnoses.
Scientists studied the results of an online survey designed to measure gender differences in camouflaging in autistic and non-autistic adults. They found autistic women exhibited more camouflaging behaviors than men, which supported previous observations from self-reported studies. No gender camouflaging differences were reported in non-autistic groups.
“The effect wasn’t as big as we were expecting,” said Dr Will Mandy, from University College London, one of the authors of the study, published in the journal (Autism) and presented at the British Science Festival.
“What I’m finding interesting is how ubiquitous camouflaging is. When you start to dig into why, it’s quite alarming; for starters it’s experienced as an obligation rather than a choice. It’s very often about self-preservation, avoiding bullying or attack. ”
Common camouflaging behaviors include learning how to make eye contact, or suppressing urges to move in physical ways which some autistic people would find comforting, called stimming, for example rocking of the body or flapping of hands .
Data from non-binary people and other genders was also studied and no behavioral differences were found, although the sample sizes of these groups were small.
“In its most complex form, [social camouflaging] involves the adoption of a persona. In women particularly, this might involve observing other women or girls who appear to be popular, and copying their gestures or clothing, ”continued Mandy.
“Anyone who is alert to autism won’t be surprised by these findings,” said Hannah Hayward, a researcher on autism in women at King’s College London. “We find that for a lot of females, their autistic traits are not being picked up or recognized in the same way that males have been at school. This is because we’re trying to fit their diagnosis through the same molds as males, but often they don’t fit that criteria because their presentation is slightly different.
“I’ve spoken to a lot of [autistic] women who say they presented to their GP, but because they used these social camouflaging strategies like using eye contact and communicating well, they have missed an autism diagnosis.
“[Social camouflaging] is not a common diagnostic criterion at the moment, but if it was then I think more females would be diagnosed. We need to be doing better as a society in picking this up, and shifting our perspectives of what autism is. ”
Laura Hull, from University College London and also an author on the study, hopes the work will lead to positive change. “If we can get awareness of social camouflaging into the NHS or Nice guidelines, and get it known how common it is in both men and women, that would be so important.”