What is masking in autism?

Autistic masking is a behavioral pattern commonly observed in individuals with autism spectrum disorder (ASD). It is a strategy that autistic individuals use to hide their symptoms and better “fit in” with their peers.

ASD masking behaviors can manifest in many ways, including rehearsing or preparing scripted responses to comments, mirroring the facial expressions of others, and more.

Masking can help individuals with autism function in social situations that would otherwise be challenging. However, masking can also be a tiring and stressful process, leading to burnout and mental health issues.[i]

The Drake Institute offers non-drug treatment for autism, which include brain map-guided neurofeedback. These treatments aim to help individuals with autism reduce symptoms and improve their quality of life. For more information about how we treat patients on the autism spectrum, call 800-700-4233 or fill out the contact form.

What is autism?

Autism Spectrum Disorder, or ASD, is a neurodevelopmental disorder that ranges from mild to severe and includes repetitive behaviors, impaired social communication, restricted interests, and rigidity.

It is typically diagnosed in early childhood, and the severity of symptoms can vary widely from person to person. The exact causes of autism are believed to be due to a combination of genetic and environmental factors.

Autistic individuals may have difficulty with social interaction and communication, including maintaining eye contact, understanding social cues, and engaging in reciprocal conversation. They may also exhibit repetitive behaviors or restricted interests, such as fixations on specific topics.

What are the signs & symptoms of autism?

Autism Spectrum Disorder (ASD) typically manifests in early childhood, with signs and symptoms usually appearing by age three. Although the presentation of ASD can vary from individual to individual, some common symptoms in children include a lack of social reciprocity, avoidance of eye contact, engagement in repetitive behaviors, and a narrow range of interests or activities.

Some common signs and symptoms associated with autism include: [ii]

  • Avoids eye contact
  • Doesn’t respond to name by 9 months of age
  • Lack of facial expressions (e.g., happy, sad, angry, etc.) by 9 months of age
  • Doesn’t play simple interactive games (e.g., pat-e-cake) by 12 months of age
  • Uses few or no hand gestures (e.g., doesn’t wave hello or goodbye) by 12 months of age
  • Doesn’t share interests with others (e.g., doesn’t show you their favorite toy) by 15 months of age
  • Doesn’t point to show you something interesting by 18 months of age
  • Doesn’t notice when others are hurt or upset by 24 months of age
  • Doesn’t notice other children and play with them by 36 months of age
  • Doesn’t pretend to be someone else (e.g., teacher, superhero, etc.) by 48 months of age
  • Doesn’t sing, act, or dance for you by 60 months of age

What is masking or camouflaging in autism?

So, just what does masking mean in autism?

Masking in autism refers to the process of suppressing autistic behaviors and characteristics in social situations. It is a coping mechanism that many autistic individuals use to fit into social situations that would be challenging for them. Masking can involve mimicking neurotypical social behavior, including initiating eye contact even if uncomfortable, avoiding stimming behaviors, and using rehearsed responses to conversation.

Autism and masking are compensatory behaviors that are used by autistic individuals to hide their disorder, but it can also be tiring and stressful. Autistic individuals who mask their differences may experience burnout and mental health issues, such as anxiety and depression.

Autism Masking Examples

Autistic masking is used in social situations, and involves concealing or suppressing one's autistic behaviors to fit in with neurotypical individuals. Here are some autism masking examples:

  • Mirroring the facial expressions or social behaviors of others: Autistic individuals may consciously or unconsciously mimic the facial expressions, gestures, and body language of the people around them to appear more socially adept. For example, if someone smiles, the individual may smile back even if they don't understand why the other person is smiling. [iii]
  • Using rehearsed responses in everyday conversation: Autistic individuals may have difficulty with spontaneous conversation and small talk. To compensate for this, they may prepare scripted responses to common questions or situations ahead of time. This can help them appear more socially skilled, but it can also come across as robotic or insincere. [iv]
  • Difficulty controlling autistic behaviors in unfamiliar situations: In new or overwhelming situations, autistic individuals may struggle to maintain their typical masking behaviors so their autistic behaviors may resurface.[v]
  • Feeling like they’re “shutting down” after prolonged social activity: ASD masking requires a great deal of mental and emotional effort and energy, which can be draining over time. Some autistic individuals may experience sensory overload or emotional exhaustion after prolonged social activity, leading to a sense of shutdown or withdrawal. [vi]
  • Forcing themselves to maintain eye contact: Eye contact is an important aspect of social communication, but it can be difficult for autistic individuals. Some may find it uncomfortable or overwhelming but may feel pressure to make eye contact in social situations. This can lead to anxiety, avoidance, or forced eye contact that may be perceived as awkward or insincere.
  • Stimming behaviors (rocking back and forth vs. fidgeting): Many individuals with autism may exhibit stimming, or self-stimulatory behavior. It can include repetitive movements such as rocking, hand flapping, or tapping.

It may be difficult to recognize when an autistic individual is masking. For example, girls on the spectrum may more frequently use this behavioral strategy to hide the disorder, and as a result, it may delay diagnosis and treatment.

Autistic individuals may seem perfectly at ease in a social situation, making eye contact and engaging in conversation, but could be struggling internally to maintain this façade, which can be exhausting.

Effects of masking in autism

The negative effects of masking can be significant. Masking requires a great deal of mental and emotional energy, which can lead to problems like exhaustion, burnout, and even mental health symptoms such as anxiety and depression. Masking can also lead to feelings of isolation and disconnection from one's true self, as individuals with autism may feel like they are constantly putting on a façade to fit in. Additionally, masking can make it difficult for individuals with autism to receive appropriate support and accommodations, as their symptoms may be less visible to others.

The long-term effects of masking are not yet fully understood, as research on the topic is ongoing. It is possible that prolonged masking can lead to a delay in autism diagnosis or misdiagnosis, as well as a lack of access to appropriate interventions and support. Additionally, autistic masking may contribute to an increased sense of being abnormal and not fitting in, as individuals with autism may feel like they are constantly failing to live up to societal expectations of "normal" behavior.[vii]

Do girls “mask” more than boys?

ASD masking doesn’t look the same for everyone. Recent research has suggested that girls with autism may be more likely to mask their symptoms than boys with the disorder. One theory is that girls with ASD may be more inclined or adept than boys with ASD at masking their symptoms. However, the act of masking can still bring on increased tension or stress.

These findings are based on relatively small sample sizes and may not be true for all girls and boys with autism. However, they do suggest that gender differences may play a role in how individuals with autism mask their symptoms and cope with social stress.

Overall, it’s important for clinicians and caregivers to be aware of potential gender differences in masking behaviors so that they can provide appropriate support and interventions for individuals with autism.[viii]

Can you grow out of autism?

Autism is a neurodevelopmental disorder characterized by impairments in social communication, repetitive behaviors, and sensory sensitivities. While there is no known cure for autism, some individuals may experience a reduction in symptoms over time, while others may continue to experience significant challenges throughout their lives.

Some individuals may appear to have “grown out” of their disorder but could simply be hiding the symptoms via ASD masking behavior.[ix] However, while masking can be a coping mechanism in some situations, it can also be exhausting.

Can Autism Be Cured?

Autism is a neurodevelopmental disorder that affects individuals in various ways, making it a complex condition that may require lifelong support in some individuals. While there is no known cure for autism, it is possible to help individuals with autism reduce their symptoms and improve their life. In fact, at the Drake Institute, we have treated some patients that no longer meet the criteria for an ASD diagnosis by the end of treatment.

How The Drake Institute Treats Autism

Over the last 40 years, the Drake Institute has clinically pioneered the use of advanced treatment technologies to treat a variety of brain-based medical disorders such as ADHD, Autism Spectrum Disorder, PTSD, anxiety, panic disorder, depression, insomnia, and more. Using a combination of brain map-guided neurofeedback and sometimes neurostimulation, our Medical Director creates customized treatment protocols to address each patient's needs.

Brain Mapping

To develop our individualized treatment plans, we first complete a qEEG brain map analysis for each patient. Brain mapping helps us identify which specific regions or networks of the brain are dysregulated linked to symptoms.

To collect this data, 19 sensors are placed around the scalp in areas of the brain responsible for language, focus, memory, executive functioning, social/emotional understanding and behavioral/emotional regulation. The 19 sensors measure and record brainwave activity that is processed through a normative database of neurotypical individuals.

When we compare the patient's results with those of neurotypical individuals, we can identify regions or networks of the brain that are dysregulated and causing symptoms. This information also allows us to determine how these areas are dysregulated so that we can develop specific treatment protocols that help improve brain functioning and reduce symptoms.


During neurofeedback training/treatment, sensors are once again placed on the scalp. The sensors record and display instantaneous brainwave activity visually in real-time on a computer screen with simultaneous auditory feedback as well.

During neurofeedback sessions, the patient is seeing the results of how their brain is working and with this information, they learn to improve their brainwave activity by guiding it toward healthier, more appropriately functional brainwave patterns.

We do not administer any drugs or perform invasive procedures during this process. Instead, the patient is improving their own brain functioning, guided by visual and auditory feedback.


As an adjunct to neurofeedback, we may also use neurostimulation guided by qEEG brain map findings to gently stimulate the brain into healthier functional patterns. In our experience, some patients may benefit even more from neurofeedback if we also use neurostimulation. We have found this particularly helpful for lower-functioning children on the Autism Spectrum.

Contact The Drake Institute Today!

In the last forty years, Drake has helped thousands of patients with various disorders such as autism, ADHD, PTSD, anxiety, panic disorder, depression, insomnia, migraine headaches, irritable bowel syndrome, and hypertension reduce or resolve their symptoms and thereby achieve a better quality of life. Call us at 1-800-700-4233 or fill out the free consultation form to get started.


[i] https://psychcentral.com/autism/autism-masking-why

[ii] https://www.cdc.gov/ncbddd/autism/signs.html

[iii] https://psychcentral.com/autism/autism-masking-why#symptoms

[iv] https://www.autismparentingmagazine.com/autism-masking/

[v] https://www.autismparentingmagazine.com/autism-masking/

[vi] https://www.autismparentingmagazine.com/autism-masking/

[vii] https://psychcentral.com/autism/autism-masking-why#effects

[viii] https://www.psychologytoday.com/us/blog/women-autism-spectrum-disorder/202104/masking-and-mental-health-in-women-autism

[ix] https://psychcentral.com/autism/can-you-grow-out-of-autism


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dr david velkoff headshot

“David F. Velkoff, M.D., our Medical Director and co-founder, supervises all evaluation procedures and treatment programs. He is recognized as a physician pioneer in using biofeedback, qEEG brain mapping, neurofeedback, and neuromodulation in the treatment of ADHD, Autism Spectrum Disorders, and stress related illnesses including anxiety, depression, insomnia, and high blood pressure. Dr. David Velkoff earned his Master’s degree in Psychology from the California State University at Los Angeles in 1975, and his Doctor of Medicine degree from Emory University School of Medicine in Atlanta in 1976. This was followed by Dr. Velkoff completing his internship in Obstetrics and Gynecology with an elective in Neurology at the University of California Medical Center in Irvine. He then shifted his specialty to Neurophysical Medicine and received his initial training in biofeedback/neurofeedback in Neurophysical Medicine from the leading doctors in the world in biofeedback at the renown Menninger Clinic in Topeka, Kansas. In 1980, he co-founded the Drake Institute of Neurophysical Medicine. Seeking to better understand the link between illness and the mind, Dr. Velkoff served as the clinical director of an international research study on psychoneuroimmunology with the UCLA School of Medicine, Department of Microbiology and Immunology, and the Pasteur Institute in Paris. This was a follow-up study to an earlier clinical collaborative effort with UCLA School of Medicine demonstrating how the Drake Institute's stress treatment resulted in improved immune functioning of natural killer cell activity. Dr. Velkoff served as one of the founding associate editors of the scientific publication, Journal of Neurotherapy. He has been an invited guest lecturer at Los Angeles Children's Hospital, UCLA, Cedars Sinai Medical Center-Thalians Mental Health Center, St. John's Hospital in Santa Monica, California, and CHADD. He has been a medical consultant in Neurophysical Medicine to CNN, National Geographic Channel, Discovery Channel, Univision, and PBS.”

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