Scientific background: CAT-Q (Masking)
About this test
The CAT-Q was developed in 2019 by Laura Hull and colleagues at University College London, after clinical observations showed that many autistic people -- particularly women and adults diagnosed later in life -- camouflage their traits so successfully that classic screening instruments like the AQ don't reliably capture them. Camouflaging is associated with increased mental exhaustion, anxiety and depression, and delayed diagnosis. The questionnaire shows good internal consistency for all three subscales in validation studies and reliably distinguishes between autistic and non-autistic samples. Important context: a 2026 critical review of 389 studies (Arnold, Bitsika & Sharpley, 2026, Autism) credits the CAT-Q with excellent reliability but finds mixed evidence for its validity -- total scores correlated more strongly with social anxiety than with autistic traits already in Hull's own 2019 validation study, and more strongly with ADHD traits than autistic traits in a separate study (Ai et al., 2023). This limits the instrument's specificity to autism, which is why the review explicitly cautions against using it as a screening tool. Several non-English translations (including Dutch, Japanese, Swedish, and Traditional Chinese) also failed to replicate the original three-factor structure, and the Dutch and French versions failed to show measurement invariance between autistic and non-autistic groups -- a sign that results aren't automatically comparable across languages and cultures. The CAT-Q's own authors now explicitly caution against diagnostic use as well: a 2026 Perspective article (Hannon, Hull, Lai, Magiati & Mandy, 2026, Autism in Adulthood) -- with CAT-Q co-creator Laura Hull as a co-author -- recommends against using CAT-Q scores in diagnostic decision-making or as a treatment-outcome measure.
Dimensions
Compensation
Strategies to actively offset difficulties in social situations -- e.g. learning social rules, imitating others, or developing fixed "scripts" for interactions.
Masking
Strategies to hide autistic traits or control the impression you make -- e.g. consciously controlling facial expressions, body language, or eye contact.
Assimilation
Strategies and experiences around trying to fit into social situations -- e.g. "performing" interest, or forcing yourself through interactions.
Sources & license
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.
The CAT-Q is published under the CC BY 4.0 license and may be used, modified, and redistributed freely with attribution. Item wording, subscale assignment, and reverse-scored items were verified verbatim against Table 4 of the original article.
https://cat-q.org/Arnold, W. M., Bitsika, V., & Sharpley, C. F. (2026). Camouflaging and autism: Conceptualisation and methodological issues. Autism, 30(5), 1131–1146.
Open-access article under CC BY 4.0. A critical review of 389 studies on camouflaging concepts and measurement tools (including the CAT-Q); used here only as background context on the instrument's validity and limits, not as a basis for the items or bands used on this page (see scientific background).
https://doi.org/10.1177/13623613261420085Hannon, B. R., Hull, L., Lai, M.-C., Magiati, I., & Mandy, W. (2026). The Use and Misuse of the Camouflaging Autistic Traits Questionnaire in Autism Research and Clinical Practice: Issues, Considerations, and Suggestions. Autism in Adulthood.
A Perspective article by CAT-Q co-creator Laura Hull and colleagues, explicitly recommending against using CAT-Q scores in diagnostic decision-making or as a treatment-outcome measure. Used here only as background context; it directly reinforces this page's existing disclaimer.
https://doi.org/10.1177/25739581261435868