Spotting Autism Spectrum Disorder: The Challenge of Social Camouflaging
At Philadelphia Integrative Psychiatry, Dr. Danish and Chris Smith, head of the Autism Services Team, are adept at identifying Autism Spectrum Disorder (ASD) in patients. A significant challenge in diagnosing ASD is the phenomenon of social camouflaging, where individuals with ASD adopt compensatory behaviors to mask their social difficulties. This can lead to missed or delayed diagnoses, particularly in females, who tend to use these behaviors more frequently. Dr. Danish and his team are aware of these subtleties and incorporate this understanding into their comprehensive assessment and treatment plans, ensuring that each patient receives the personalized care they need.
Social camouflaging involves a range of behaviors that individuals with ASD use to blend in with neurotypical peers. These behaviors can include masking one’s true self, engaging innocuously, modeling neurotypical communication, and actively presenting oneself in a certain way. While these strategies can help individuals navigate social situations, they often come at the cost of increased stress and mental health challenges. Understanding and identifying these behaviors is crucial for accurate diagnosis and effective treatment.
Masking
Masking involves concealing one's true self to fit in socially. Individuals may avoid talking about themselves or sharing personal information. This behavior can make it difficult for clinicians to identify ASD, as patients may appear more socially adept than they feel internally.
Innocuous Engagement
This strategy includes behaviors like maintaining eye contact or creating the illusion of eye contact by looking at a person's forehead or nose. Individuals might also laugh inappropriately to fit in with social cues. These behaviors can be misleading, making it appear as though the individual is more socially engaged than they are.
Modeling Neurotypical Communication
Some individuals with ASD may mimic the body language, facial expressions, or speech patterns of those around them. They might also adopt behaviors from media sources, such as movies or books, to appear more socially typical. This modeling can mask their social challenges, complicating the diagnostic process.
Active Self-Presentation
In this form of camouflaging, individuals use rehearsed phrases or anecdotes to navigate social interactions. This pre-planned communication can give the impression of spontaneity and ease, further concealing underlying social difficulties.
Why Social Camouflaging is a Problem
Social camouflaging can lead to significant challenges for individuals with ASD. The constant effort to maintain these behaviors can result in feelings of inauthenticity and stress. Over time, this can contribute to mental health issues such as anxiety and depression. Furthermore, social camouflaging can hinder accurate diagnosis, delaying access to appropriate support and interventions.
Getting in Touch with Dr. Danish, Chris Smith, and the Rest of the Team
At Philadelphia Integrative Psychiatry, we pride ourselves on our nuanced approach to psychiatry, a field often fraught with misdiagnoses and superficial assessments. We strive to provide the level of care we would want for our own family members. Our holistic and integrative approach ensures that we consider all aspects of our patients' well-being in developing personalized treatment plans. If you or a loved one are seeking support for ASD or similar conditions, please text or call 610-999-6414 to learn how we can help.
For more on this topic and related subjects, check out these blogs by Dr. Danish:
This blog looks at the role sensory processing concerns play in many patients with ADHD.
This blog looks at ARFID, which is a subtype of sensory processing disorder.
This blog looks at PDA, or Pathological Demand Avoidance, which can lead to rage and regular outbursts in patients who do not fit criteria for ASD.
This blog dives further into sensory processing disorder including research that backs up both diagnosing and treating it.
Sources:
Dean, M., Harwood, R., & Kasari, C. (2017). The art of camouflage: Gender differences in the social behaviors of girls and boys with autism spectrum disorder. Autism, 21(6), 678-689.
Parish-Morris, J., Liberman, M. Y., Cieri, C., Herrington, J. D., Yerys, B. E., & Schultz, R. T. (2017). Linguistic camouflage in girls with autism spectrum disorder. Molecular Autism, 8, 48.
Cook, J., Hull, L., Crane, L., & Mandy, W. (2022). Camouflaging in autism: A systematic review. Autism, 26(3), 643-656.
Cremone, A., & Cook, J. (2023). The mental health impact of camouflaging in autism: A review. Journal of Autism and Developmental Disorders, 53(2), 789-803.
