Tuesday, 21 November 2017

Autism and Camouflage - how girls with ASD can keep it hidden from sight

This week I have been learning about the concept of 'camouflaging' as a technique used by autistic people to get by in the world of neurotypicals.  It has been a real eye-opener, not least because it's blatantly obvious that this is the very method I have used to get through my life to date.

Also known as 'compensation', camouflaging is the term for how autistic individuals manage to hide or disguise their autistic traits, allowing them to come across to the casual acquantaince as entirely neurotypical, often to the point that no-one would ever suspect that the individual is on the spectrum.  It is a real hot topic currently, and it seems that long-overdue research is finally being undertaken into its mechanics and its effect on autistic people who employ it.  At its most basic, camouflaging appears to rely on intense effort and stress on the part of the individual as they utilise their excellent memory of social cues to 'artificially' fit into social conversation and situations - essentially making their social life an endless act in order to prevent showing behaviours that they would be embarrassed or even ashamed of.  The range of skills involved is pretty daunting - the individual will have learned in minute detail how to react appropriately to the actions, speech and expressions of others, often using memorised details from their own life and even the media (films, TV shows) to help them 'say and do the right thing.'  As Meng-Chuan Lai notes in the introduction to the article 'Quantifying and exploring camouflaging in men and women with autism':

"One such coping strategy is that they may ‘camouflage’ difficulties during social situations by either hiding behaviour that might be viewed as socially unacceptable or artificially ‘performing’ social behaviour deemed to be more neurotypical – they Pretend to be Normal".

Forced eye contact, moderation of voice volume, even jokes and types of laughter can be examples of this camouflaging, all of which can usually serve to allow the autistic individual to 'fly under the radar', as Lai puts it, never getting diagnosed as there is never any concern from their teachers, parents or doctors.  The turmoil is all on the inside and is invisible to others.

Several clear patterns are beginning to emerge from the studies that continue to be published.  Firstly, successful camoflaging seems to be more prevalent in female autistic people for reasons that are still unclear; the ability to hide one's autistic traits (especially social ones) seems to be more readily within the purview of females, and female children in particular seem to have far more success in establishing friendships, for example (though maintaining them is often far less successful).  It appears that girls are more adroit at performing the expected social cues, and presumably more able to identify them in the first place.  Boys, in contrast, are far less capable of this, meaning that their autistic traits and behaviour may be more visible and obvious.

This, I think, has significant ramifications in the school environment.  The overwhelming 'maleness' of autism and aspergers in schools is well noted, and I think SEN departments, teachers and other stakeholders would benefit from being aware of the fact that female students who are on the spectrum are very good at hiding the fact, and therefore more care and time should be taken when trying to identify a students extra needs.  From my reading, I would suggest that the following considerations be taken when working with female students who may be on the spectrum:

1. Do not dismiss the possibility of ASD if they seem to have a social life - closer examination may be needed to establish the nature of the social interaction and whether friendships are maintained or falling out is commonplace.

2. Do not dismiss the possibility of ASD if eye contact is maintained, conversation with known adults is easy and a sense of humour is apparent!  Firstly, a sense of humour is often finely developed in people with autism (I, for example, am hilarious); secondly, it tends to be that conversation and interaction with other children and adults known to the student will be fine, flowing naturally - the student knows the rules and cues for those people.  They will, however, struggle with strangers for whom they have no record or knowledge.

3. Consider the other traits of ASD more carefully.  Obsessive behaviours, limited and intense interests, dislike of physical contact are all quite noticeable if you know what to look for.

It goes without saying that male children can be adept at camouflaging their symptoms, right up to adulthood.  I was only diagnosed at 34 because I had felt for years something wasn't quite right; at school it was never even considered as far as I am aware.  With male camouflaging, autistic traits can be hidden by a desire to not appear unusual, to avoid bullying, or just to avoid stressful situations getting worse.  This compensation is draining - it seems that males with autism that has been well-hidden are far more likely to suffer with anxiety and depression, mostly (it seems) due to sheer constant effort such camouflaging requires.

Finally, this phenomenon seems to be one of the reasons for some autistic children showing less severe traits as they grow older - they simply learn to cover them up.  All of this brings us to the rather uncomfortable conclusion that people with autism, girls and boys, have to expend considerable energy and mental strength to appear normal, for fear of being bullied, ostracized or treated unfairly.  This leaves them drained, depressed and even at times suicidal.  Surely this is no way for society to handle such a potentially talented and bright segment of the population?

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