[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"assessment-cat-q":3,"all-assessments-nav":355,"related-assessments-query":1002},{"id":4,"title":5,"body":6,"category":337,"categoryTitle":338,"clinicalCitations":339,"copyright":337,"description":343,"disclaimer":337,"downloadLink":337,"extension":344,"faqs":337,"featured":345,"i18nReady":346,"icon":337,"interpreter":337,"lastReviewed":347,"meta":348,"navigation":345,"path":349,"permissionsNote":337,"published":345,"recommendedFrequency":337,"relatedCodes":337,"relatedConditions":337,"reviewedBy":337,"seo":350,"slug":351,"stem":352,"summary":343,"takeaways":337,"timeline":337,"type":353,"usedToDiagnose":337,"__hash__":354},"assessments\u002Fassessments\u002Fcat-q.md","CAT-Q",{"type":7,"value":8,"toc":314},"minimark",[9,14,18,21,25,28,51,54,58,61,75,80,101,106,124,128,133,141,145,159,163,180,186,190,204,209,213,216,219,222,225,229,232,236,239,242,245,248,251,255,258,261,265,268,272,278,284,290,294,297,301,304,307,311],[10,11,13],"h3",{"id":12},"foundational-context","Foundational Context",[15,16,17],"p",{},"Camouflaging describes the strategies autistic individuals use (consciously or unconsciously) to fit into social environments. Examples include rehearsing social scripts, copying facial expressions, suppressing stimming, imitating peers, or actively concealing distress or confusion. Hull et al. (2019) highlighted that camouflaging is not inherently adaptive; while it can help individuals navigate social demands, it is also associated with anxiety, exhaustion, identity confusion, and autistic burnout.",[15,19,20],{},"The CAT-Q was developed through extensive qualitative interviews and psychometric modeling across autistic and non-autistic adult samples. Its design captures both surface-level behaviors (Masking) and deeper compensatory cognitive strategies (Compensation), as well as efforts to blend into social groups (Assimilation). Because camouflaging varies by gender, cultural expectations, and social context, the CAT-Q offers insight into lived experiences often overlooked by traditional autism measures.",[10,22,24],{"id":23},"what-the-assessment-measures","What the Assessment Measures",[15,26,27],{},"The CAT-Q assesses three distinct dimensions of camouflaging:",[29,30,31,39,45],"ul",{},[32,33,34,38],"li",{},[35,36,37],"strong",{},"Compensation (8 items):"," Cognitive strategies used to compensate for perceived social or communication difficulties (e.g., preparing scripts, analyzing interactions).",[32,40,41,44],{},[35,42,43],{},"Masking (10 items):"," Behaviors aimed at concealing autistic traits, including hiding stimming, controlling facial expressions, or suppressing natural responses.",[32,46,47,50],{},[35,48,49],{},"Assimilation (7 items):"," Efforts to blend into social environments by adapting appearance, behavior, or interests to match peers.",[15,52,53],{},"Together, these domains offer a comprehensive picture of how an individual navigates social expectations and the mental effort required to do so.",[10,55,57],{"id":56},"interpretation-guidelines","Interpretation Guidelines",[15,59,60],{},"The CAT-Q yields:",[29,62,63,69],{},[32,64,65,68],{},[35,66,67],{},"Total score:"," 25–175",[32,70,71,74],{},[35,72,73],{},"Three subscale scores:"," Compensation, Masking, Assimilation",[15,76,77],{},[35,78,79],{},"Interpretation principles:",[29,81,82,88,91,98],{},[32,83,84,85],{},"Higher scores indicate ",[35,86,87],{},"more frequent or intense use of camouflaging behaviors",[32,89,90],{},"Subscale patterns are often more informative than the total score",[32,92,93,94,97],{},"There are ",[35,95,96],{},"no diagnostic thresholds"," or clinical cutoffs",[32,99,100],{},"Normative group means (Hull et al., 2019) can support comparative interpretation",[15,102,103],{},[35,104,105],{},"Interpretation Notes:",[29,107,108,111,118,121],{},[32,109,110],{},"Elevated camouflaging is associated with anxiety, stress, exhaustion, identity strain, and autistic burnout",[32,112,113,114,117],{},"High scores do ",[35,115,116],{},"not"," confirm autism; non-autistic individuals may camouflage for different reasons (e.g., social anxiety)",[32,119,120],{},"Camouflaging may vary across gender, culture, social contexts, and life stages",[32,122,123],{},"The CAT-Q should not be used in isolation to make diagnostic or treatment decisions",[10,125,127],{"id":126},"psychometric-properties","Psychometric Properties",[129,130,132],"h4",{"id":131},"reliability","Reliability",[29,134,135,138],{},[32,136,137],{},"Excellent internal consistency for total and subscale scores",[32,139,140],{},"Strong test–retest reliability reported across adult samples",[129,142,144],{"id":143},"validity","Validity",[29,146,147,150,153,156],{},[32,148,149],{},"Strong convergent validity with autistic trait measures (e.g., AQ, RAADS-R)",[32,151,152],{},"Distinguishes between autistic and non-autistic populations",[32,154,155],{},"Correlated with measures of anxiety, depression, and autistic burnout in research",[32,157,158],{},"Factor structure consistently replicated",[10,160,162],{"id":161},"administration-considerations","Administration Considerations",[29,164,165,168,171,174,177],{},[32,166,167],{},"Particularly relevant in populations where masking is common: women, AFAB individuals, late-diagnosed autistic adults, and those who report social exhaustion",[32,169,170],{},"Should be administered in environments where respondents feel safe to be candid",[32,172,173],{},"Works well as part of autism assessment batteries or identity\u002Fmental health support contexts",[32,175,176],{},"Not recommended as a standalone diagnostic tool",[32,178,179],{},"Useful in guiding treatment discussions about masking, burnout, boundaries, and self-acceptance",[15,181,182,185],{},[35,183,184],{},"Documenting CAT-Q scores in clinical notes:"," CAT-Q scores belong in the Objective section of your note. See our SOAP notes guide and Intake Notes guide for templates and examples.",[10,187,189],{"id":188},"limitations","Limitations",[29,191,192,195,198,201],{},[32,193,194],{},"Does not measure autistic traits themselves, only camouflaging behaviors",[32,196,197],{},"High scores may reflect social anxiety, trauma, or cultural pressures rather than autism",[32,199,200],{},"Self-report accuracy may vary depending on insight and emotional readiness",[32,202,203],{},"Not validated extensively outside Western cultural contexts",[205,206,208],"h2",{"id":207},"cat-q-overview","CAT-Q Overview",[10,210,212],{"id":211},"what-is-the-cat-q","What is the CAT-Q?",[15,214,215],{},"The Camouflaging Autistic Traits Questionnaire (CAT-Q) is a validated 25-item self-report\ntool that measures social camouflaging behaviors in autistic adults. Used to identify masking,\nunderstand diagnostic barriers, and assess burnout risk in neurodivergent individuals.",[15,217,218],{},"Camouflaging (also called masking) refers to the conscious and unconscious strategies\nautistic individuals use to appear neurotypical in social situations: mimicking others, suppressing\nnatural behaviors, and developing scripts for social interactions.",[15,220,221],{},"The CAT-Q is particularly important because high levels of camouflaging can mask autism traits\nfrom standardized assessments, leading to missed or delayed diagnoses, especially in women,\ngirls, and AFAB (assigned female at birth) individuals who are socialized to conform. A person\ncan score below the autism threshold on screening tools like the RAADS-R or AQ while\nsimultaneously spending enormous energy hiding their autistic characteristics.",[15,223,224],{},"Research consistently links high CAT-Q scores with increased rates of depression, anxiety, and\nautistic burnout. Understanding a patient's camouflaging profile provides critical clinical\ncontext: a moderate RAADS-R score paired with high CAT-Q scores suggests the patient may be\nmore significantly autistic than the screening score indicates.",[10,226,228],{"id":227},"why-camouflaging-matters-for-diagnosis","Why Camouflaging Matters for Diagnosis",[15,230,231],{},"Autistic individuals who camouflage heavily may score below diagnostic thresholds on standard\nautism assessments. The CAT-Q helps clinicians identify when masking behavior is obscuring\nthe clinical picture, reducing missed diagnoses, particularly in women and AFAB individuals.",[10,233,235],{"id":234},"camouflaging-and-burnout-risk","Camouflaging and Burnout Risk",[15,237,238],{},"Sustained camouflaging is energetically costly and is strongly associated with autistic\nburnout: a state of chronic exhaustion, loss of skills, and increased sensory sensitivity\nthat can persist for months or years. High CAT-Q scores should prompt discussion of\nsustainable coping strategies and reduced masking demand.",[15,240,241],{},"Rate each statement based on how much it applies to you generally.\nSubscale scores (Assimilation, Compensation, Masking) are calculated automatically.",[15,243,244],{},"Response scale: 1 = Strongly Disagree  ·  4 = Neutral  ·  7 = Strongly Agree",[15,246,247],{},"Higher scores indicate more frequent camouflaging behavior. Total score range: 25–175.",[15,249,250],{},"Total CAT-Q Score",[10,252,254],{"id":253},"cat-q-score-interpretation","CAT-Q Score Interpretation",[15,256,257],{},"The CAT-Q uses a 7-point Likert scale (1 = Strongly Disagree to 7 = Strongly Agree).\nHigher scores indicate more camouflaging behavior.",[15,259,260],{},"Note: These ranges are based on published research means (~97 for non-autistic adults;\n~124 for autistic adults). The CAT-Q does not have a single published diagnostic cutoff; scores\nshould be interpreted alongside clinical assessment, RAADS-R, or other autism-specific evaluations.",[10,262,264],{"id":263},"add-cat-q-to-your-assessment-workflow","Add CAT-Q to Your Assessment Workflow",[15,266,267],{},"HiBoop's digital platform makes it easy to administer the CAT-Q alongside RAADS-R and\nother autism assessments, with automated subscale scoring, longitudinal tracking, and\nintegration into your clinical workflow.",[10,269,271],{"id":270},"cat-q-subscales","CAT-Q Subscales",[15,273,274,277],{},[35,275,276],{},"Assimilation",": Fitting in and mimicking others: Measures behaviors like studying how others interact to copy their mannerisms, adjusting body language, and actively working to blend into social groups.",[15,279,280,283],{},[35,281,282],{},"Compensation",": Developing compensatory strategies: Assesses developing scripts for social situations, memorizing social rules, and using deliberate techniques to navigate interactions that feel unnatural.",[15,285,286,289],{},[35,287,288],{},"Masking",": Hiding autistic traits: Evaluates active suppression of autistic behaviors such as stimming, avoiding eye contact, and the effort to appear relaxed and neurotypical.",[205,291,293],{"id":292},"cat-q-vs-other-autism-assessment-tools","CAT-Q vs Other Autism Assessment Tools",[15,295,296],{},"The CAT-Q serves a unique role in the autism assessment toolkit by measuring\nhow autistic traits are hidden, not just whether they exist.",[10,298,300],{"id":299},"cat-q-vs-raads-r-camouflaging-vs-autism-traits","CAT-Q vs RAADS-R: Camouflaging vs Autism Traits",[15,302,303],{},"Clinical Guidance: Use RAADS-R for initial\nautism screening. Add CAT-Q when: (1) RAADS-R is borderline but clinical suspicion\nis high, (2) patient reports exhaustion from \"acting normal,\" or (3) patient is\nfemale\u002FAFAB or was diagnosed late in life. High CAT-Q + moderate RAADS-R is a\nstrong signal for masked autism that deserves full evaluation.",[15,305,306],{},"RAADS-R at HiBoop: See the RAADS-R assessment.",[10,308,310],{"id":309},"cat-q-vs-aq-masking-vs-autism-quotient","CAT-Q vs AQ: Masking vs Autism Quotient",[15,312,313],{},"Clinical Guidance: The AQ and CAT-Q answer\ndifferent questions. AQ asks \"does this person have autism traits?\"; CAT-Q asks \"how\nmuch is this person hiding those traits?\" High AQ + high CAT-Q = classic presentation\nwith masking on top. Low-moderate AQ + high CAT-Q = possible masked autism that standard\nscreens are missing entirely.",{"title":315,"searchDepth":316,"depth":316,"links":317},"",2,[318,320,321,322,323,324,325,333],{"id":12,"depth":319,"text":13},3,{"id":23,"depth":319,"text":24},{"id":56,"depth":319,"text":57},{"id":126,"depth":319,"text":127},{"id":161,"depth":319,"text":162},{"id":188,"depth":319,"text":189},{"id":207,"depth":316,"text":208,"children":326},[327,328,329,330,331,332],{"id":211,"depth":319,"text":212},{"id":227,"depth":319,"text":228},{"id":234,"depth":319,"text":235},{"id":253,"depth":319,"text":254},{"id":263,"depth":319,"text":264},{"id":270,"depth":319,"text":271},{"id":292,"depth":316,"text":293,"children":334},[335,336],{"id":299,"depth":319,"text":300},{"id":309,"depth":319,"text":310},null,"Neurodivergence & Autism",[340],{"text":341,"link":342},"Hull L, Mandy W, Lai MC, Baron-Cohen S, Allison C, Smith P, Petrides KV. Development and Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q). J Autism Dev Disord. 2019;49(3):819-833.","https:\u002F\u002Fdoi.org\u002F10.1007\u002Fs10803-018-3792-6","25-item autism masking scale. Learn how the CAT-Q identifies camouflaging behaviors, subscale scoring, and why high scores indicate burnout risk.","md",true,false,"2026-02-21",{},"\u002Fassessments\u002Fcat-q",{"title":5,"description":343},"cat-q","assessments\u002Fcat-q","assessment","tnbDAXH2sBWDvqbp95NUOBlBWDSAP0QYd4jWtxt0F78",[356,361,366,370,374,379,384,388,393,398,403,408,413,417,421,426,430,435,440,445,449,453,458,463,467,471,475,480,484,489,494,499,504,509,513,517,522,526,530,531,535,539,544,548,553,558,563,568,573,578,582,587,591,596,600,605,609,614,619,623,627,631,636,641,645,650,655,659,663,667,671,676,680,684,688,692,696,701,705,709,713,717,721,726,730,734,738,743,748,753,757,761,765,769,774,779,783,787,791,795,799,803,807,811,815,819,823,827,831,836,840,845,849,853,857,862,866,870,875,879,883,887,892,896,900,904,908,912,916,921,926,931,936,940,944,948,952,956,960,964,968,972,977,981,985,989,993,998],{"title":357,"slug":358,"path":359,"categoryTitle":360},"ACE 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