A comparison of methods for measuring camouflaging in autism.

Researchers looked at different ways to measure 'camouflaging' - when autistic people hide their autistic traits in social situations. They found 16 different tools but noted that most need more testing. They created a parent version of one questionnaire and found it worked reasonably well compared to the young person's own answers. The tools seemed to measure something different from general social skills.

This two-part study examined methods for measuring camouflaging in autism. Part 1 was a systematic review identifying 16 distinct measurement tools, all in preliminary psychometric evaluation phases. The review revealed gaps including lack of parent-report tools and limited validation studies comparing different methods. Part 2 addressed these gaps by creating a parent-report version of the Camouflaging Autistic Traits Questionnaire (CAT-Q) and testing its validity in autistic young people.

The parent and self-report versions showed moderate correlation (r=0.47), and neither measure was associated with social skills, suggesting they assess a distinct construct from social ability.

Clinicians currently lack well-validated tools for measuring camouflaging. The parent-report CAT-Q shows promise as a clinical assessment tool. Camouflaging appears to be a distinct construct from social skills, requiring specific assessment approaches rather than relying on general social ability measures.

All identified measurement tools are in preliminary validation phases. Sample size not reported for the validation study. Limited generalizability due to focus on young people. Concurrent validity testing was limited to three measurement approaches.

Interest in social camouflaging has led to a multiplicity of measurement methods of uncertain validity. This two-part investigation first used a systematic review ("Study 1") to identify and appraise methods used to quantify camouflaging of autistic traits, using the Consensus-based Standards for the Selection of Health Status Measurement Instruments checklist. A total of 16 distinct measurement tools were identified; all are in the preliminary phases of psychometric evaluation. The systematic review highlighted: (1) the need for parent-report tools which specifically measure camouflaging; and (2) a lack of studies looking at associations between different methods of camouflaging, which limits understanding of their validity. "Study 2" aimed to begin to address these gaps in knowledge.

We created a parent-report version of the Camouflaging Autistic Traits Questionnaire (CAT-Q) and evaluated its concurrent validity in autistic young people by examining associations with the self-report CAT-Q and a discrepancy measure. Discriminant validity was investigated by comparing all three methods of measuring camouflaging to a measure of social skills, to test whether they assess a construct distinct from social ability. The self- and parent-report CAT-Q were significantly related (r = 0.47, 95% CI = 0.24-0.65), and were related weakly (r = 0.20, 95% CI = -0.06 to 0.43) and strongly (r = 0.46, 95% CI = 0.23-0.64), respectively, to the discrepancy approach. No measure was associated with social skills.

Improving the psychometric properties of these methods, and introducing a novel parent-report measure, may help selection of appropriate methods in future research and integration into clinical practice.