CAT-Q: Complete Guide to Measuring Autism Camouflaging (2026)

Written by Dror Arbel, a parent, not a clinician. Last updated October 2026. This page explains a research questionnaire; it is not a diagnostic test.

What Is Autistic Camouflaging?

Camouflaging (often called masking) is the set of strategies some autistic people use to hide autistic traits or appear non-autistic in social situations. In interviews with autistic adults, Hull and colleagues (2017) described people forcing eye contact, rehearsing conversations, copying other people's facial expressions and humour, and suppressing stimming — often at a high cost in exhaustion. Our longer guide to autistic masking covers the everyday side; this page focuses on how the CAT-Q measures it.

Common examples of camouflaging include:

• Forcing or faking eye contact
• Using memorised scripts, phrases or jokes
• Copying other people's body language, tone or facial expressions
• Hiding or redirecting stimming
• Studying social rules (from TV, books or watching others) and applying them deliberately
• Pretending to follow or enjoy a conversation to fit in

Camouflaging is one reason autism is often recognised later in women and girls — see our guide to late autism diagnosis in women.

The CAT-Q at a Glance

Feature	Details
Full name	Camouflaging Autistic Traits Questionnaire
Developed by	Laura Hull, William Mandy, Meng-Chuan Lai, Simon Baron-Cohen, Carrie Allison, Paula Smith and K. V. Petrides
Published	2019, Journal of Autism and Developmental Disorders 49(3): 819–833
Format	25 statements, self-report, rated from 1 (strongly disagree) to 7 (strongly agree)
Subscales	Compensation (9 items), Masking (8 items), Assimilation (8 items)
Score range	Total 25–175 (higher = more camouflaging)
Age	Adults and adolescents aged 16+
Time	About 5 minutes
Cost	Free; the questionnaire was published open access and is shared under a Creative Commons licence
Diagnostic?	No. It measures camouflaging, not autism

The Three CAT-Q Subscales

Subscale	Items	Score range	What it captures
Compensation	9	9–63	Strategies used to make up for social difficulties, such as learning social rules from books or TV, copying others, or using scripts
Masking	8	8–56	Monitoring and adjusting your own face, body language and voice so you come across as relaxed or "normal"
Assimilation	8	8–56	Putting on an act to blend in: feeling you have to pretend, forcing yourself to interact, avoiding being noticed

Interestingly, the subscales do not behave the same way. In the large 2020 study by Hull and colleagues, autistic adults scored clearly higher than non-autistic adults on Compensation and Assimilation, but Masking scores were similar across groups (see the table below). That is one reason to look at the subscales, not just the total.

How CAT-Q Scoring Works

• Each of the 25 statements is rated from 1 to 7.
• A few items are worded in the opposite direction and are reverse-scored before adding up.
• Item scores are added to give the three subscale scores and the total (25–175).
• Higher scores mean more self-reported camouflaging.

If you take the CAT-Q online (for example on Embrace Autism's free version), the reverse-scoring is done for you. If you score it by hand from the original paper, check which items are reversed first.

What Your CAT-Q Score Means (and Doesn't)

There is no official diagnostic cutoff for the CAT-Q. The original authors did not publish one, and the questionnaire was designed for research and for understanding a person's experience, not for diagnosing autism. Some websites use a total of about 100 as a rough reference point for "elevated" camouflaging, but the average scores below show why that number should be read with care:

Group (Hull et al., 2020)	Total	Compensation	Masking	Assimilation
Autistic women	124.4	41.9	37.9	44.6
Autistic men	109.6	36.8	32.9	39.9
Non-autistic men	96.9	30.1	36.3	30.5
Non-autistic women	90.9	27.2	34.7	29.0

Mean scores reported in Hull et al. (2020), Autism 24(2), as summarised in NovoPsych's CAT-Q review. Score spreads were wide (standard deviations of roughly 23–28 points on the total), so the groups overlap a lot.

What this means in practice:

• A score around 100 is close to the non-autistic average. It tells you that you camouflage about as much as many people do, not that you are autistic.
• Scores well above 120 are more typical of autistic women in research samples, but plenty of non-autistic people with social anxiety also score high.
• A low score does not rule out autism. Some autistic people camouflage very little, and some do it so automatically that they don't notice it.
• Clinical scoring services such as NovoPsych compare your total to percentiles of a non-autistic sample (for example, "extremely high" is a total of 137 or more, the top 5% of that sample). That is a description, not a diagnosis.

How Well Was the CAT-Q Validated?

The development study (Hull et al., 2019) tested the questionnaire online with 354 autistic and 478 non-autistic adults. Key findings:

• Factor analysis supported three factors (Compensation, Masking, Assimilation) across 25 items.
• Internal consistency was high (α = 0.94).
• Preliminary test–retest reliability was acceptable (r = 0.77).
• The factor structure was equivalent across gender and across autistic and non-autistic groups, so scores can be compared between them.

Limitations worth knowing:

• It is self-report. It measures what you notice and remember about your own behaviour, which is exactly what camouflaging can make hard to see.
• It measures effort, not success. A high score means you try hard to camouflage, not that other people can't tell.
• It overlaps with social anxiety. People with social anxiety also monitor and adjust themselves in social situations, which raises scores.
• The concept is still debated. Some researchers (e.g. Fombonne, 2020) have argued that camouflaging is not yet well defined or measured, and that it should not be used to explain away a lack of observable autistic traits during assessment.
• Mostly studied in adults online. It is not validated for children under 16, and translated versions are still being studied in different countries.

Camouflaging and Mental Health

Across many studies, higher self-reported camouflaging is linked with more anxiety, depression and stress, and with exhaustion that many autistic adults describe as burnout (Cook et al., 2021 review). One study of autistic adults found that camouflaging was associated with suicidal thoughts and behaviours (Cassidy et al., 2018). These are associations: they do not prove that camouflaging causes poor mental health, and people often camouflage for understandable reasons such as safety, work or avoiding bullying.

If camouflaging leaves you drained, our free autism burnout self-check may help you put words to it. If you are struggling or thinking about suicide, in the US you can call or text 988 (Suicide & Crisis Lifeline) at any time; elsewhere, contact your local emergency number or crisis line.

CAT-Q vs AQ and RAADS-R

Questionnaire	What it measures	Items	Commonly cited reference score
AQ-50	Autistic traits in everyday life	50	32+ (screening threshold, not a diagnosis)
AQ-10	Short screen used by NHS/NICE referrals	10	6+
RAADS-R	Autistic traits across the lifespan, including childhood	80	65+
CAT-Q	How much you hide or compensate for autistic traits	25	No official cutoff (about 100 sometimes used as a rough reference)

Because the CAT-Q measures something different, it is most useful alongside trait measures. Someone with a modest AQ score and a very high CAT-Q score may be worth a careful assessment by a clinician who understands camouflaging. Embrace Autism offers the CAT-Q and many other free questionnaires — see our Embrace Autism tests guide.

What to Do With Your CAT-Q Score

• Write down examples. A score alone says little. Specific examples ("I rehearse phone calls", "I copy my coworker's laugh") are what clinicians find useful.
• Look at the subscales. High Compensation and Assimilation scores are more typical of autistic adults than a high Masking score alone.
• Take a trait measure too, such as the AQ-50 or RAADS-R, and bring all results to an assessment.
• Tell your assessor that you camouflage. Ask whether they have experience assessing adults, especially women, who mask. Our guide on how to get tested for autism as an adult explains the process.
• Notice the cost. If camouflaging is exhausting you, reducing it in safe places (home, autistic friends, online communities) is worth exploring with a therapist who is autism-informed.

Frequently Asked Questions

What is the CAT-Q test?

The CAT-Q (Camouflaging Autistic Traits Questionnaire) is a free 25-item self-report questionnaire, published by Hull and colleagues in 2019, that measures how much a person aged 16 or older hides or compensates for autistic traits in social situations. It has three subscales: Compensation, Masking and Assimilation.

What is a high score on the CAT-Q?

Total scores range from 25 to 175. There is no official cutoff. In research, non-autistic adults averaged about 91 to 97 and autistic adults about 110 (men) to 124 (women), with a lot of overlap. A score of about 100 is sometimes used as a rough reference point for elevated camouflaging, but it is not diagnostic.

Can the CAT-Q diagnose autism?

No. The CAT-Q measures camouflaging behaviour, which non-autistic people also show. Only a qualified clinician can diagnose autism, usually using interviews, developmental history and tools such as the ADOS-2.

Is the CAT-Q free?

Yes. The original paper was published open access and the questionnaire is shared under a Creative Commons licence. You can take it free online, for example through Embrace Autism.

How long does the CAT-Q take?

About 5 minutes. It has 25 statements, each rated from 1 (strongly disagree) to 7 (strongly agree).

Sources

• Hull, L., Mandy, W., Lai, M.-C., Baron-Cohen, S., Allison, C., Smith, P., & Petrides, K. V. (2019). Development and validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q). Journal of Autism and Developmental Disorders, 49(3), 819–833. doi:10.1007/s10803-018-3792-6
• Hull, L., Lai, M.-C., Baron-Cohen, S., Allison, C., Smith, P., Petrides, K. V., & Mandy, W. (2020). Gender differences in self-reported camouflaging in autistic and non-autistic adults. Autism, 24(2), 352–363. doi:10.1177/1362361319864804
• 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
• Cook, J., Hull, L., Crane, L., & Mandy, W. (2021). Camouflaging in autism: A systematic review. Clinical Psychology Review, 89, 102080. doi:10.1016/j.cpr.2021.102080
• Cage, E., & Troxell-Whitman, Z. (2019). Understanding the reasons, contexts and costs of camouflaging for autistic adults. Journal of Autism and Developmental Disorders, 49(5), 1899–1911. doi:10.1007/s10803-018-03878-x
• Cassidy, S., Bradley, L., Shaw, R., & Baron-Cohen, S. (2018). Risk markers for suicidality in autistic adults. Molecular Autism, 9, 42. doi:10.1186/s13229-018-0226-4
• Fombonne, E. (2020). Camouflage and autism. Journal of Child Psychology and Psychiatry, 61(7), 735–738. doi:10.1111/jcpp.13296
• NovoPsych. Camouflaging Autistic Traits Questionnaire (CAT-Q) review paper (subscale items, percentile bands and group means).
• Embrace Autism. Camouflaging Autistic Traits Questionnaire (CAT-Q) – free online version and licence information.