Parental Influence on the Development of Autistic Masking

AbstractBackground: Masking is conscious or unconscious social adaptation through the suppression of autistic traits to meet mainstream social norms, to the detriment of an autistic individual’s mental health. Little is known about when masking behaviors start and how relationships impact their development. This study looked at the role parents play in the development of masking, if childhood masking predicts adult masking, and if adult romantic and/or sexual relationships influence masking’s relationship with mental health. Methods: 193 autistic adults completed an online survey on childhood/adulthood masking, perceived parental reactions, parental support behaviors, internalized stigma, expectation of rejection, relationship satisfaction, and mental health. Using a cross-sectional design, mediation analysis examined if parental support behaviors mediated perceived parental reactions and childhood masking; a serial mediation looked at internalized stigma and expectation of rejection on childhood/adulthood masking; and finally, if relationship satisfaction moderates adult masking and mental health. Results: Negative perceived parental reactions and non-supportive behaviors strongly predicted childhood masking. However, supportive behaviors did not. Childhood masking was a significant predictor of adult masking but was not mediated by internalized stigma or expectation of rejection. Replicating previous work, higher adult masking was associated with higher rates of poor mental health. However, relationship satisfaction did not moderate this relationship. Conclusion: Results support the hypothesis that parent/caregiver(s) play a significant role in the development of masking, and that masking behaviors begin in childhood persisting through adulthood. Findings suggest early developmental relationships, such as parents, play a greater role than adult relationships in mental health as a result of masking. Community BriefWhy is this an important issue?Masking is when autistic people try to appear ‘normal’ to fit in socially with non-autistic people. While this may provide short-term social acceptance, it often leads to long-term mental health issues. Autistic people might start to mask at home if their families struggle to accept their autistic traits. It is important to understand how masking might start so that we can understand how to help autistic people with poor mental health sooner. What was the purpose of this study?(1) To understand what role, if any, parents have in autistic people starting to mask. (2) To see if childhood masking might predict adult masking and if negative attitudes towards one's own autistic traits and or expecting to be rejected play a role.(3) To see if adult, romantic and/or sexual, partners influence the relationship between masking and mental health. What did the researchers do?We surveyed 193 autistic adults online about their parent relationship(s) during childhood, masking during childhood and now, current attitudes towards autism, expectation of rejection, satisfaction with their current or most recent romantic and/or sexual relationship, and their mental health. What were the results and conclusions of the study?(1) Negative parent(s) reactions and non-supportive behaviors of autistic traits predicted autistic masking in childhood. (2) Childhood masking predicted adult masking. However, negative attitudes and expectation of rejection were not linked in a pathway from childhood to adult masking. (3) As previous research has shown, adult masking does lead to poor mental health. However, adult romantic and/or sexual relationships did not influence or change the link between masking and poor mental health. What is new or controversial about these findings? Masking likely starts in childhood and parent relationships play a role, with negative experiences having more impact than positive. Autistic people are known to face stigma and negative social experiences. As a result, positive parent behavior may not be able to overcome this, whereas negative parental behavior may reinforce this messaging.What are potential weaknesses in the study?(1) We were not able to collect enough data to explore if a parent’s autism status impacts if a child masks.(2) This study asked autistic adults to reflect on their childhood. Their answers may not be as true as asking children/teens directly about their parent relationships and masking. Also, answers may change over time, so it could be better to ask these questions to a group of autistic children/teens several times throughout their childhood to see when and how their answers change. (3) Compared with the general autistic population, people who answered the study were not ethnically diverse, and many had one or more university-level degrees. As a result, these findings may not reflect the wider diverse autistic population.How will these findings help autistic adults now or in the future?This study shows parent-child relationships are important because they can affect life-long masking, which is known to cause poor mental health. As a result, an emphasis on positive autistic-affirming environments is important for autistic people to develop into mentally healthy adults.