Camouflaging Autistic Traits Questionnaire (CAT-Q)

Coby Tucker | Aug 14, 2022 | 4 min read

BHCS is very lucky to have Coby share his work on our blog. Coby is seeking his master's in counseling at Montana State University and helping BHCS out with data analytics. The CAT-Q is an excellent assessment and BHCS clinicians use it frequently to support our patients.


The Camouflaging Autistic Traits Questionnaire (CAT-Q) Is an assessment created to determine if a person is using strategies to mask their autistic characteristics. The 25 items were created by compiling answers from a previous study that asked adults with autism what their experiences were with camouflaging and asked to describe these behaviors (Hull et al. 2017). The assessment measures three identified factors for camouflaging, compensation, masking and assimilation.

Psychometric Qualities

Mentioned before, the CAT-Q consist of 25 questions and uses a 7-point Likert scale ranging from strongly agree to strongly disagree with neither in the middle. There are nine statements on compensation, eight for masking and eight for assimilation. The CAT-Q has been shown to be valid with a Cronbach's a equaling .94. A longitudinal study was done in order to determine the reliability of the CAT-Q. There were 30 individuals with autism that took the CAT-Q three months after originally taking it and had no significant difference (Hull et al. 2018).

Scoring and interpretation

The CAT-Q has a score range of 25 to 175. To meet criteria of camouflaging a score of 100 or above is required. To score the assessment you first need to reverse the scores of statements 3, 12, 19, 22, and 24. Now add all the answers 1 - 25. The higher the score, the more a person is trying to hide non-socially conforming behaviors from others and self.

Strengths and Limitations

There has long been a skew in the autism diagnosis resulting in males being diagnosed much more than females. It is harder to reach diagnosis with female clients due to their better ability to mask symptoms (Tint & Weiss, 2017). Some individuals do not meet criteria for the diagnosis yet have a high score on the CAT-Q. Since these people are masking, clinicians are better able to compare autism assessments like the AQ-10 or the AQ-50 with the CAT-Q and have criteria now met for diagnosis. The questions are derived from those on the autism spectrum which indicates real lived statements for common symptoms.

A few limitations to this assessment. Autism looks different and is experienced differently for every individual which means the assessment is unable to capture all symptoms. There were no measures of social skills, those with higher social skills will feel less need to camouflage (Hull et al. 2018). Those who experience language barriers would be less able to accurately complete the assessment unless there were a measurement with behavioral or informant report measures (Hull et al. 2018).

Application in Practice

The CAT-Q can be useful in other ways as well. I have a client that does not meet criteria for ASD or ADHD. They experience intense anxiety and depression. Trauma has been assessed and is a factor. The CAT-Q will allow me to assess their masking, assimilation, and compensation. If the scores are high, then lowering the need to camouflage may also lower the anxiety and depression. Lower anxiety and depression can make the trauma healing process more bearable.


Hull, L., Mandy, W., Lai, M.-C., Baron-Cohen, S., Allison, C., Smith, P., & Petrides, K. V. (2018). Development and Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q). Journal of Autism and Developmental Disorders. doi:10.1007/s10803-018-3792-6

Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M.-C., & Mandy, W. (2017). “Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions. Journal of Autism and Developmental Disorders, 47(8), 2519–2534. doi:10.1007/s10803-017-3166-5

Tint, A., & Weiss, J. A. (2017). A qualitative study of the service experiences of women with autism spectrum disorder. Autism, 136236131770256. doi:10.1177/1362361317702561

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