The Camouflaging Autistic Traits Questionnaire (CAT-Q): A Guide

Masking is often credited for missed autism diagnoses, especially among autistic women and girls. Popular self-assessment tools like the Autism Spectrum Quotient (AQ) have been criticized for not taking camouflaging behaviors into account, and on average, autistic women and nonbinary people score lower on the AQ than autistic men.

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The Camouflaging Autistic Traits Questionnaire (CAT-Q) is a self-assessment specifically meant to gauge social camouflaging behaviors. An autism masking test, if you will. Though it is not a formal diagnostic tool for autism, the CAT-Q, which you can find embedded directly beneath this section, can provide meaningful information for individuals wondering whether they might be autistic and are considering a clinical assessment.

The Camouflaging Autistic Traits Questionnaire (CAT-Q) is an autistic masking quiz that was developed to measure social camouflaging behaviors associated with autism spectrum disorder. 

It’s a fairly short self-assessment tool: 

• Statements: 25
• Duration: 5-10 minutes
• Authors: Laura Hull et al.
• Seminal paper: Development and Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q) (2018)

In addition, the CAT-Q is a relatively new test, published in 2018, and is the first self-assessment tool to explicitly evaluate for camouflaging as a behavior associated with autism. 

The CAT-Q test questions are designed to assess the three categories of social camouflaging behavior: 

• Compensation, or strategies to compensate for difficulty with social interaction
  
  • For example, mirroring facial expressions or body language, or learning social cues from movies and TV
• Masking, or strategies to conceal or suppress autistic traits
  
  • For example, suppressing stimming and forcing oneself to make eye contact
• Assimilation, or strategies to fit in socially
  
  • For example, participating in social situations and feeling like you’re putting on an act

The 25 prompts in this high masking autism test are further divided into nine compensation statements, eight masking statements, and eight assimilation statements. 

Each question can be answered with one of the following seven options:

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• 1 - Strongly disagree
• 2 - Disagree
• 3 - Somewhat disagree
• 4 - Neither agree nor disagree
• 5 - Somewhat agree
• 6 - Agree
• 7 - Strongly agree

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The CAT-Q test is often used as a supplement to other self-screeners like the RAADS-R and the AQ. Research shows that, on average, autistic women score lower on the AQ than autistic men, likely because of higher rates of masking behaviors among autistic women and girls. The CAT-Q test can provide additional data for individuals who report camouflaging, painting a fuller picture of their potential autistic traits.
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The CAT-Q test is not a formal diagnostic tool. However, it can be self-administered by individuals hoping to gain a better understanding of themselves and their potential masking in the context of possible autistic behaviors/traits.

The CAT-Q was designed for anyone aged 16 or older who does not have an intellectual disability. The test is suitable for adults of all genders; however, because of gender and sex differences in camouflaging behavior, it may feel more resonant for autistic or potentially autistic women and non-binary people, who typically score higher than autistic men on the CAT-Q.
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“The CAT-Q is especially useful for those exploring why they may feel socially exhausted or disconnected, even if they’ve never had a formal diagnosis,” says Angeleena Francis, LMHC, Vice President of Adult Residential Operations at AMFM Healthcare. “Researchers also use it to study gender differences in autism presentation, since camouflaging tends to be more common among autistic women and AFAB [assigned female at birth] individuals.”

• CAT-Q scores can range from 25 to 175.
• Each response corresponds to a score between 1 and 7.  
• A score of 100 or above indicates the potential presence of autistic camouflaging behaviors.
• Higher scores suggest a greater prevalence of these behaviors.

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The CAT-Q test on this page will automatically calculate your score for you once you complete it.

Keep in mind, however, that an above-threshold score on the CAT-Q is not the same as an autism diagnosis. An autism assessment is a much more in-depth evaluation of an individual’s potential autistic characteristics against diagnostic criteria, and it's the only way to receive a formal diagnosis.

“The CAT-Q test is considered a fairly reliable tool for measuring camouflaging behaviors,” says Francis. “That is, the ways autistic individuals might consciously or unconsciously mask or hide their traits to fit social expectations.” 
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Researchers asked 30 autistic individuals to retake the CAT-Q three months after their first test and found no significant differences from their original scores, showing good test-retest reliability. Researchers also found the CAT-Q exhibits strong internal consistency, meaning the different questions corresponding to each type of camouflaging behavior all assess for that same behavior. The CAT-Q test is seen overall as a valid preliminary screening tool that effectively measures traits associated with autism, although this does not make it a diagnostic tool.
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“Results can be influenced by self-awareness, interpretation of the questions, and current emotional state,” cautions Francis. “It’s reliable as a screening or insight tool, but not a clinical diagnostic instrument.”

Though it isn’t a formal diagnostic assessment, the CAT-Q can be an illuminating tool for people who are questioning whether they might be autistic. Getting a formal autism assessment can be daunting and often inaccessible; the CAT-Q test is a quick and easy way for individuals who feel they employ camouflaging strategies to explore these behaviors.

“For many autistic or autistic-identifying individuals, the CAT-Q can provide powerful self-insight,” says Francis. “It helps people recognize patterns of masking, such as mimicking social behaviors, suppressing stimming, or overanalyzing conversations, that can contribute to exhaustion or ‘autistic burnout.’” 

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Regardless of diagnoses, the CAT-Q can also support a person’s introspection and self-discovery. “Understanding these tendencies can validate someone’s lived experience and help guide discussions with their providers about healthier coping strategies or further diagnostic evaluation,” observes Francis.

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Critiques of the CAT-Q

Though the CAT-Q can provide great value for those looking to explore their potential autistic traits, it has been critiqued for its inability to distinguish between social camouflaging behaviors in autistic and allistic (non-autistic) people. 
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“Some criticisms of the CAT-Q are that it relies heavily on self-awareness and introspection, traits that can vary widely among autistic individuals,” says Francis. “Others note that masking behaviors are influenced by factors like gender, culture, and environment, which the questionnaire doesn’t fully capture. Additionally, because camouflaging is a relatively new area of study, researchers are still exploring how to interpret high versus low scores across different populations.”

While camouflaging behaviors can be a sign of autism, they are not exclusive to autistic individuals. People with other mental health conditions may exhibit similar behaviors to try to blend in, conceal their conditions, and gain acceptance—this is particularly true for individuals with social anxiety. These people might also receive higher scores on the CAT-Q test even if they are not autistic.

Social camouflaging is a social behavior some autistic people exhibit to conceal autistic traits from others. Camouflaging is a protective action—autistic individuals who camouflage do so to avoid experiences like stigma, social rejection, and loss of social and economic mobility.

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The term camouflaging is sometimes used interchangeably with masking. In the context of the CAT-Q, masking is considered one type of camouflaging behavior, alongside compensation and assimilation behaviors.

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Many autistic people who camouflage begin to do so in childhood, particularly those assigned female at birth (AFAB), who may camouflage autistic traits as early as elementary school. Girls and those who are AFAB face different social demands than young boys, making autistic girls/AFAB more likely to understand and respond to social expectations at a young age.

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While masking can be a lifeline for an autistic person, it can cause several problems. It’s associated with poorer mental health outcomes, lower self-esteem, and autistic burnout. Camouflaging can also lead to autistic people being missed for assessment and diagnosis, leaving those individuals without appropriate resources and support.

If you’d like to discuss your CAT-Q score in more depth with a clinician, Prosper Health can connect you with highly experienced professionals who work with autistic adults. Prosper Health offers autism assessments that are 100% telehealth, covered by insurance, and specifically designed for adults.

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Our providers also offer neurodiversity-affirming therapy and specialize in helping adults with a range of challenges associated with autism—including navigating a new diagnosis, or deciding to pursue a formal diagnosis in the first place.

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Wherever you are in your journey, Prosper Health is here to support you. If you’re ready to get started, click the button below to get connected to a clinician within days.
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Frequently asked questions (FAQs)

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What age is the CAT-Q for?

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The CAT-Q was designed for anyone aged 16 or older who does not have an intellectual disability.

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Is the CAT-Q free?

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Yes, the CAT-Q test is free, and you can take it right now by scrolling up to the top of the page. 

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Why might women and nonbinary people score higher on the CAT-Q?
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They typically score higher on the CAT-Q because the test is designed to root out social camouflaging strategies that are more common among autistic women and nonbinary people. 

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Does a high CAT-Q score mean I’m autistic?

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Not necessarily, because the CAT-Q is not a diagnostic evaluation. But a high score may validate your decision to pursue a formal autism diagnosis.

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What should I do after taking the CAT-Q test?

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If you’re interested in speaking with a neurodiversity-affirming therapist who can help guide you toward your next steps (whether it’s an autism diagnostic evaluation or therapy), Prosper Health can help. Support is just a click away!

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