Work

Clinical characteristics and camouflaging behaviors in children and adolescents with late-diagnosed autism spectrum disorder: a retrospective descriptive study

Year: 2026

Type: article

Abstract: Purpose Autism is a heterogeneous neurodevelopmental condition characterized by persistent difficulties in social communication and interaction, together with restricted and repetitive patterns of behavior, interests, or activities. Camouflaging-related behaviors and co-occurring psychiatric disorders may make autistic features less visible and contribute to delayed recognition. This study aimed to examine clinical characteristics and camouflaging-related behaviors among children and adolescents with late-diagnosed autism. Methods This retrospective chart review included 46 children and adolescents aged 6–21 years who received an ASD diagnosis after the age of six. Autism diagnoses had been confirmed using a standardized observational assessment. Data were retrospectively extracted using structured case report forms based on clinical records, parental reports, and literature-informed camouflaging-related clinical features. Results Attention-Deficit/Hyperactivity Disorder was the most common co-occurring psychiatric condition. Masking-related social adaptation behaviors were more common among girls. Giftedness and easy temperament were also observed more frequently in girls and were identified among factors associated with delayed recognition. Boys showed greater behavioral difficulties than girls. Clinician-rated camouflaging scores demonstrated a moderate positive correlation with post-diagnosis Global Assessment Scale scores ( r = 0.38). Conclusions The findings describe a clinically heterogeneous group of late-diagnosed children and adolescents and suggest that camouflaging-related behaviors, co-occurring psychiatric conditions, and contextual factors may reduce the visibility of autistic features. Given the retrospective design, small sample size, and use of a clinician-developed measure of camouflaging-related features, the findings should be interpreted as exploratory.

Source: Frontiers in Child and Adolescent Psychiatry

DOI: 10.3389/frcha.2026.1910194

Authors: Nazlı Burcu Özbaran, Zeynep İrem Şener, Seda Sarı, Gülenay Korkmaz Şahin

Institution: Ege University

Language: English

Topic: Autism Spectrum Disorder Research

Subfield: Cognitive Neuroscience

Field: Neuroscience

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,353