The Camouflaging Autistic Traits Questionnaire (CAT-Q) is a valuable self-report tool designed to measure social camouflaging behaviors in adults. This questionnaire is particularly useful in identifying autistic individuals who may not meet standard diagnostic criteria due to their ability to consciously or unconsciously mask their autistic traits. If you suspect you might be on the autism spectrum, or if you’ve been told you don’t fit the typical profile, the CAT-Q test could provide important insights.
Understanding the CAT-Q (Camouflaging Autistic Traits Questionnaire)
The CAT-Q, short for Camouflaging Autistic Traits Questionnaire, is a screening tool consisting of 25 statements. Developed by Laura Hull and colleagues in 2018, this questionnaire is designed to quantify the extent to which adults employ camouflaging strategies in social situations. Camouflaging, also known as masking, refers to the conscious or unconscious suppression of autistic traits and the adoption of neurotypical social behaviors. The CAT-Q helps to shed light on this often-overlooked aspect of autism.
For further details on the development and validation of this tool, you can refer to the seminal research paper: “Development and Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q) (Hull et al., 2018)“.
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CAT-Q
| Basic information | |
| Statements: | 25 |
| Duration: | 5–10 minutes |
| Type: | Screening tool |
| Authors: | Laura Hull et al. |
| Publishing year: | 2018 |
| Seminal paper: | Hull et al., 2018 |
Who is the CAT-Q Test Designed For?
The CAT-Q test is specifically designed for adults. It is particularly relevant for individuals who:
- Suspect they may be autistic but have not received a formal diagnosis.
- Feel they consciously or unconsciously mask their autistic traits in social situations.
- Have scored low on other autism spectrum quotient tests, yet still strongly identify with autistic characteristics.
Camouflaging can lead to individuals, especially women and marginalized groups, being overlooked in traditional autism assessments. The CAT-Q helps bridge this gap by directly addressing the phenomenon of masking. It acknowledges that some autistic individuals develop sophisticated strategies to navigate social situations, which can obscure their autistic traits from clinicians and even themselves.
What Does the CAT-Q Test Measure?
The primary purpose of the CAT-Q test is to measure the degree of camouflaging an individual employs. It assesses how frequently you utilize strategies to suppress autistic traits and present a neurotypical persona. A high score on the CAT-Q suggests a significant use of camouflaging techniques.
Importantly, a high camouflaging score can provide context for lower scores on other autism assessments. If you suspect you are autistic but have received ambiguous or negative results from other autism tests, a high CAT-Q score might indicate that your camouflaging abilities are influencing those results.
The CAT-Q further breaks down camouflaging into three distinct subcategories, providing a more nuanced understanding of masking behaviors:
Compensation
Compensation refers to strategies used to actively counteract difficulties in social situations. These are conscious efforts to manage social interactions and minimize challenges arising from autistic traits.
- Examples of compensation strategies include:
- Preparing conversation topics in advance.
- Learning and practicing social scripts.
- Actively monitoring and adjusting body language to appear more neurotypical.
Masking
Masking encompasses strategies employed to hide autistic characteristics or portray a non-autistic persona. This subcategory focuses on concealing traits that might be perceived as “different” or socially unacceptable.
- Examples of masking strategies include:
- Forcing eye contact, even when uncomfortable.
- Mimicking facial expressions and gestures observed in neurotypical individuals.
- Suppressing stimming behaviors (self-stimulatory behaviors).
- Adjusting tone of voice and speech patterns to sound more socially conventional.
Assimilation
Assimilation involves strategies used to fit in with others in social situations and to appear as part of the social group. This aspect of camouflaging is driven by a desire to belong and avoid social exclusion.
- Examples of assimilation strategies include:
- “Putting on an act” or adopting a social facade to blend in.
- Forcing or avoiding social interactions depending on what is perceived as socially appropriate in a given context.
- Mirroring the interests and behaviors of peers to gain acceptance.
- Overwhelming oneself with social activities to appear socially engaged, even if it leads to burnout.
Taking the CAT-Q Test: Structure and Format
The CAT-Q test is straightforward and user-friendly. It consists of 25 statements related to social interactions and behaviors. For each statement, you are asked to choose from 7 response options that best reflect your experiences:
- Strongly Disagree
- Disagree
- Somewhat Disagree
- Neither Agree Nor Disagree
- Somewhat Agree
- Agree
- Strongly Agree
These 25 statements are distributed across the three subcategories of camouflaging:
- 9 statements relate to Compensation.
- 8 statements relate to Masking.
- 8 statements relate to Assimilation.
CAT-Q Scoring and Interpretation
The scoring range for the CAT-Q test is 25–175. A threshold score of 100 or higher is generally indicative of significant camouflaging behaviors.
- Higher scores reflect greater camouflaging. The higher your total score, the more likely you are to employ camouflaging strategies in social situations.
While self-scoring is possible, an auto-scoring feature is often provided with online versions of the CAT-Q to simplify the process and reduce potential errors. This automated scoring addresses the reverse-scoring complexity inherent in some items of the test.
To gain a deeper understanding of how autistic individuals and neurotypical individuals typically score on the CAT-Q, further resources on average scores and detailed guidance on interpreting your CAT-Q scores are available (links provided in the original article or on the test website). These resources can help you contextualize your score and understand its implications.
Validity and Reliability of the CAT-Q
The CAT-Q is a relatively new but rigorously developed tool. Its validity and reliability are supported by research, including the seminal paper by Hull et al. (2018).
Expert reviews, such as that from Dr. Natalie Engelbrecht, highlight the CAT-Q’s strengths in addressing limitations within older autism research. Dr. Engelbrecht notes that the CAT-Q is valuable because:
- It addresses outdated definitions of autism prevalent in some research literature.
- It can identify autistic individuals who might score below the diagnostic threshold on other autism tests due to masking.
Expert and User Perspectives on the CAT-Q
The CAT-Q has been reviewed and taken by various individuals, offering diverse perspectives on its utility and design. Here are some key takeaways from user feedback:
Dr. Natalie Engelbrecht:
Dr. Engelbrecht, who identifies as autistic and scored 143 on the CAT-Q, found the test to be insightful and reflective of her own experiences with masking. Her score was significantly higher than the average for autistic females, which she attributed to her extensive history of camouflaging, leading to a delayed autism diagnosis until age 47. She highlighted that the CAT-Q effectively captured her “impression management” skills – behaviors used in front of others. Her subscale scores were:
- Compensation: 49 (higher than the average of 42 for autistic females)
- Masking: 52 (higher than the average of 38 for autistic females)
- Assimilation: 45 (average for autistic females)
Kendall:
Kendall, another individual who took the CAT-Q, found some aspects of the test design slightly challenging. She noted that the “Strongly Agree” and “Strongly Disagree” options felt somewhat redundant, and she sometimes struggled to differentiate between “agreeing” and “strongly agreeing.” She also pointed out the presence of very similar statements with minor wording changes, which she found “puzzling and distracting.” Despite these minor criticisms, Kendall found her score of 131 surprisingly high, indicating she camouflages more than she consciously realizes. Her subscale scores were:
- Compensation: 41
- Masking: 42
- Assimilation: 48
Martin:
Martin appreciated the subtle repetitions in the CAT-Q statements, particularly for individuals with alexithymia (difficulties identifying and describing emotions), a condition often co-occurring with autism. He suggested that rephrasing questions could encourage deeper self-reflection. However, he questioned whether respondents would meaningfully differentiate between very similar statements and whether replacing some with more distinct items might improve the metric. Martin also questioned the slight imbalance in the number of items per subscale (Compensation having 9 items while Masking and Assimilation have 8). Despite these questions, Martin found his scores consistent across multiple test administrations and intuitively reflective of his social behaviors. His scores ranged from 121 to 125 across two tests. He also highlighted the potential difficulty of self-scoring, especially for individuals with dyscalculia (difficulty with math). He experienced discrepancies when manually calculating his scores, underscoring the value of auto-scoring features. His subscale scores on one test were:
- Compensation: 38
- Masking: 34
- Assimilation: 49
Access the CAT-Q Test
To assess your own camouflaging traits, you can take the CAT-Q test online. Remember to consider your experiences during social interactions when responding to each statement.
Take the CAT-Q Test Here
Conclusion
The CAT-Q test is a valuable tool for understanding social camouflaging in autistic adults. It offers a unique perspective on autism by measuring the often-hidden strategies individuals use to navigate the social world. While not a diagnostic tool in itself, the CAT-Q can provide crucial insights for individuals who suspect they may be autistic, particularly if they feel they mask their traits or have received inconclusive results from other assessments. If you score high on the CAT-Q, it may be beneficial to explore further resources on autism and camouflaging and consider seeking a comprehensive autism assessment from a qualified professional.
