What Does “High-Masking” Mean in ADHD and Autism? Understanding the Signs and Prevalence
If you seem to “blend in” despite facing challenges with attention, social interaction, or sensory sensitivities, you might have heard the term high-masking. But what does high-masking mean when it comes to ADHD and autism? And how common is it?
What Is High-Masking?
High-masking refers to the ability of some individuals with ADHD or autism to hide or “mask” their symptoms in social, school, or work settings. People who are high-masking work hard to imitate typical behaviors, suppress their natural responses, and “fit in” with peers, even when it’s exhausting or stressful.
Masking can involve:
Copying social cues or facial expressions
Holding back stimming or fidgeting behaviors
Preparing scripts for conversations
Hiding difficulties with attention, organization, or sensory overload
High-masking is especially common among girls and women, as well as people who are highly intelligent or motivated to avoid standing out (Hull et al., 2020). Many high-masking individuals are not diagnosed until adolescence or adulthood because their challenges are less obvious to teachers, parents, or clinicians.
High-Masking in Autism
In autism, high-masking is often called camouflaging. Research shows that many autistic people—especially girls and women—learn to mimic social behaviors, even if it feels unnatural or draining. According to a 2020 study, camouflaging is linked to higher rates of anxiety and depression, and can delay diagnosis (Hull et al., 2020).
High-Masking in ADHD
People with ADHD may mask their symptoms by overcompensating—working extra hard to stay organized, suppressing restlessness, or hiding impulsive behaviors. High-masking individuals with ADHD often struggle silently, and their challenges may be mistaken for anxiety or perfectionism.
How Common Is High-Masking?
While exact numbers are hard to determine, studies suggest that a significant percentage of autistic people mask their symptoms at least some of the time. One survey found that over 70% of autistic adults reported camouflaging their difficulties in social situations (Hull et al., 2017). In ADHD, masking is less studied, but clinical experience shows it is frequent—especially among women and high-achievers.
Why Is High-Masking Important to Recognize?
High-masking can delay diagnosis and access to support. People who mask their symptoms often experience:
Increased stress, anxiety, and burnout
Difficulty maintaining relationships
Feeling misunderstood or “fake.
Late or missed diagnosis
Recognizing high-masking can help clinicians, parents, and adults themselves seek more accurate assessments and tailored support.
What Should You Do If You Suspect High-Masking?
If you relate to the experience of masking your symptoms, consider seeking a professional evaluation. A compassionate clinician can help you explore your strengths and challenges, even if they’re not always visible to others.
Ready to learn more? Contact Grey Matter to schedule an ADHD or autism assessment in Santa Monica, California. Virtual assessments available for residents of California.
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