Masking in Neurodiversity

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Masking in Neurodiversity

What is masking?

Masking (sometimes called camouflaging) is when a child hides or compensates for their natural processing style in order to appear “typical” in a demanding environment such as school.

Masking is not deliberate deception. It is an adaptive response — often automatic — that helps the child avoid overload, negative attention, or being singled out as different.

Masking may protect the child in the short term, but it comes at a cost: exhaustion, anxiety, or behavioural collapse at home. The absence of visible difficulties in school should not be taken as proof that difficulties do not exist — the effort and hidden cost of masking are themselves important diagnostic evidence. The potential consequences for wellbeing are explored further in the section Masking and Mental Health Risks below.

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Masking in Autism and ADHD

Aspect	Autism	ADHD
Natural processing style	Broad and detailed – takes in too much sensory and social data at once. Filtering is harder, so overload builds quickly.	Wide-angle and divergent – brain notices multiple streams at once. Attention is interest-driven rather than teacher-directed.
Why masking happens	To suppress sensory overload, hide processing delays, and appear “typical” in class.	To suppress natural curiosity, restlessness, or impulsivity to appear focused and compliant.
Typical masking behaviours	Staying quiet; copying peers; avoiding questions; forcing eye contact; suppressing stims; rigid rule-following.	Sitting unnaturally still; copying notes without processing; avoiding help; rehearsing answers; appearing “busy.”
How school may perceive it	“Quiet, shy, perfectionist,” sometimes “exceptionally able” or “obsessive about rules.”	“Daydreamer, lazy, disorganised,” or conversely “very capable when they try.”
Hidden cost	Mental overload → shutdowns, meltdowns, exhaustion after school; anxiety; reduced authentic learning.	Burnout from self-control; rebound hyperactivity at home; poor self-esteem; anxiety.
Educational potential	Detail focus can support precision, creativity, pattern recognition.	Divergent thinking can support innovation, big-picture links, problem-solving.
Why this matters diagnostically	No visible difficulties at school does not mean no difficulties. The effort of masking and the after-school impact are key evidence.	Same — “good behaviour” at school may only be sustained through extraordinary hidden effort.

Other Neurodivergent Conditions

Masking or compensatory strategies are also seen in other conditions, though the research is less developed:

• Dyslexia: memorising text, guessing words, avoiding reading aloud; hidden cost is fatigue and low self-esteem.
• Dyspraxia / DCD: avoiding sports, staying close to peers, disguising clumsiness; hidden cost is social exclusion and fatigue.
• Auditory Processing Disorder (APD): nodding along, copying peers, vague answers; hidden cost is frustration, missed learning, and isolation.
• Visual Stress / Irlen’s Syndrome: avoiding books, slowing tasks, memorising instead of reading; hidden cost is headaches, fatigue, and anxiety about literacy.

The unifying point is that children often mask to protect themselves from exposure, overload, or distress. Outward “normality” in school must be interpreted with caution — the real picture emerges from the effort involved and the child’s behaviour outside school.

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Masking and Mental Health Risks

Masking may allow a child to get through the school day, but it is not a healthy or protective behaviour. It comes at a significant emotional and psychological cost. Over time, the effort of suppressing natural behaviours and compensating for processing differences can cause serious harm.

Immediate costs of masking

• Chronic fatigue – children may appear “fine” at school but are exhausted or irritable afterwards.
• Increased anxiety – constant fear of being “found out” or making mistakes.
• Low self-esteem – feeling that their true self is unacceptable.
• Reduced learning – energy goes into hiding difficulties rather than engaging fully in class.

Long-term risks

• Depression – arising from years of invalidation or pressure to perform as “normal.”
• Autistic/ADHD burnout – episodes of severe withdrawal, loss of function, and loss of confidence.
• Self-harm and suicidality – research shows a worrying link between prolonged masking and suicidal thoughts or behaviours, particularly in autistic young people.

Why this matters

• Masking should never be seen as a protective behaviour in itself.
• If a child appears “fine at school” but shows collapse, distress, or severe fatigue at home, this is a red flag.
• Dismissing parental concerns because the child is coping in class is unsafe, and risks missing serious mental health deterioration.

Key point: The absence of visible problems in school should not reassure teachers or clinicians if there is credible evidence of distress elsewhere. Masking is itself evidence of difficulty and potential harm, not of resilience.

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References / Evidence Note

• Hull, L., Mandy, W., Lai, M.-C., Baron-Cohen, S., Allison, C., Smith, P., & Petrides, K. V. (2017). “Camouflaging” in Autism Spectrum Disorder: Examining Sex-Based and Diagnosis-Based Differences. Journal of Autism and Developmental Disorders, 47(8), 2519–2534.
• Pearson, A., & Rose, K. (2021). A Conceptual Analysis of Autistic Camouflaging: Implications for Research and Practice. Autism, 25(8), 2305–2316.
• Livingston, L. A., Shah, P., & Happé, F. (2019). Compensation in Autism: Evidence from Brain and Behaviour. Trends in Cognitive Sciences, 23(1), 1–11.
• Cage, E., & Troxell-Whitman, Z. (2019). Understanding the Reasons, Contexts and Costs of Camouflaging for Autistic Adults. Journal of Autism and Developmental Disorders, 49, 1899–1911.
• NICE Clinical Guideline [CG72] (2009, updated). Recognition, referral and diagnosis of autism in children and young people.
• NICE Clinical Guideline [NG87] (2018). Attention deficit hyperactivity disorder: diagnosis and management.