Unusual social behaviour can be attributed to a girl being more introverted and shyer when boys with ASD present with more overt behaviors that are socially unacceptable and more obvious; if there is separation from the group, it is usually due to and seemingly more socially impaired when there is isolation. This ability to mask increases the likelihood of appearing like others socially (assimilation) without having differences social. A negative consequence of camouflaging is the toll one’s self-perception endures because the core authenticity of the individual and the rigid thinking of ASD creates tensions in oneself because the individual is inauthentic or living behind a façade (Hull et al. 2017).
The research of Lai et al. (2011), highlight the importance of not only including direct interview and observation (commonly used in the ADOS and the ADI-R) but also gathering historical reporting of childhood behaviors which also includes a comprehensive neuropsychological assessment to discern how an individual’s brain functions, revealing the connection between an individual’s behaviour and cognitive abilities. However, the work of Lai et al. (2017) impresses a need to utilize self-reporting methods in the comprehensive assessment. This comprehensive approach to assessment reduces the potential for camouflage bias because one gains a more thorough understanding of the individual, along with their coping mechanisms to garner a holistic understanding of how they experience social life (Lai et al., 2011).
Other researchers have also emphasized the importance of self-reporting because it exposes how an individual experiences a social situation and further illuminates the perceived challenges that the individual faces in day-to-day social communication demands. This perspective not only gives insight into an individual’s personal experience, but it bolsters the information obtained from the observations made by carers and clinicians. Additionally, Kreiser and White (2014) emphasize that females with a history of multiple diagnoses and who present with ongoing social difficulties should have their symptoms carefully analyzed, especially when considering the influences of social-cultural and interpersonal differences. Females with autism face unique challenges socially, and comorbid internalized behaviors may be inadequately addressed through the current ASD protocol (Kreiser & White, 2014).
Lastly, diagnosing females with ASD should include understanding qualitative differences that
Furthermore, surreptitious behaviour and communication mean that females with high-functioning autism go undetected because they do not raise enough concern. Subsequently, these females are exposed to developing other mental health conditions (e.g., stress, anxiety, degraded self-esteem, and other mental illness) that end up the prevailing condition of a diagnosis, instead of their autism spectrum disorder (Hull et al. 2017; Tierney, Burns, & Kilbey, 2016; Auger, 2013).