Researchers from our Department of Psychology have developed a potential new tool to help clinicians detect hidden signs of autism in adults.

Autism is usually diagnosed in childhood but a growing number of adults are being diagnosed with the condition, even in mid-to-late adulthood.

Many adults develop compensatory psychological strategies to hide their symptoms from clinicians, employers and even their own families.

These strategies make the developmental condition much harder to diagnose and “performing” to fit into society can place a huge mental strain on the autistic person.

Eloise Stark, 30, a postgraduate student at Oxford University diagnosed with autism three years ago, said the hardest part of being autistic was trying to “hide it”, and likened it to wearing a “mask”. Read more on her story

Researchers from Cardiff University, King’s College London and the University of Bath have now devised the first potential tool to help detect psychological strategies that disguise signs of autism.

In a new study, published in Molecular Autism, the researchers outline a checklist of 31 compensatory strategies that doctors, psychiatrists and psychologists could look for or ask their clients about.

They developed the checklist by asking autistic people about their experiences of using psychological strategies in everyday social situations.

Dr Lucy Livingston, who led the research, said: “This allowed us to come up with a checklist of the most frequently-reported ‘social scripts’, including things like copying gestures and facial expressions of others, learning when to laugh at a joke without understanding why it is funny and deliberately making eye contact, even when it might be really uncomfortable.”

“At the moment, professionals know very little about these strategies and what to look for. The new tool, if found to be effective, could help clinicians assessing adults for autism who appear to be non-autistic or ‘neurotypical’ on the surface, particularly those who are highly intelligent,” she said.

“Being aware of these strategies should help clinicians to understand how hard the individual could potentially be working to keep up this appearance.

“Ultimately, this could mean that autistic people receive a more accurate and timely diagnosis.”

About 700,000 people in the UK are living with autism and it is under-diagnosed in females; three times as many males as females are diagnosed.

Dr Punit Shah from Bath's Department of Psychology who co-authored the research, added: “This is an important practical step in translating recent work on compensatory strategies in autism towards clinical practice. Equally, it is important to note that it isn’t just autistic people who use these strategies and it isn’t merely a clinically relevant phenomenon.

"Many people in society don’t ‘fit in’ and use psychological strategies to do so. We could do a lot more to question this and being truly accepting of differences in society, not just because it feels or sounds good, but it leads to more inclusive, innovative, and productive societies.”