570. Autism Mini-Series: Exploring the Camouflaging Paradox

Would you rather read the transcript? Click here. In this episode, I examine the diagnostic paradox of autism masking and camouflaging, specifically focusing on how clinicians can identify autism when a client’s surface behavior appears neurotypical. I discuss the limitations of traditional observational tools like the ADOS-2 and explain how the DSM-5-TR provides a framework for recognizing compensation and historical symptoms. By looking at the cognitive mechanisms behind masking and the significant mental health toll it takes, I offer a perspective that re-conceptualizes autism as a neurobiological reality rather than a purely behavioral one. My goal is to help practitioners understand that the ability to camouflage is not a reason to rule out a diagnosis but is often evidence of the diagnosis itself. Main Topics 00:01: Introduction to the diagnostic paradox of observable deficits versus effective camouflaging 02:20: Explicit recognition of compensation and the currently or by history clause in the DSM-5-TR 05:50: The cognitive shift from intuitive social cognition to rule-based learning and executive function 08:30: Why the need to camouflage confirms the presence of underlying social cognitive differences 13:50: Neuroimaging and the persistence of brain-based markers despite behavioral changes 18:00: Assessing functional impairment through the lens of exhaustion, burnout, and mental health burden 24:10: Re-conceptualizing autism as a neurobiological profile and the role of clinical consensus 27:30: Practical implications for clinicians and the risks of false negatives in adult evaluations Cool Things Mentioned Craft: the premier membership community for testing psychologists Crafted Practice: the only in-person business retreat for testing psychologists Reverb : the premier AI-powered report-writing platform for testing psychologists Featured Resources TherapyNotes is the leading EHR system for mental health practitioners. I’ve used TherapyNotes for over 10 years, and it just keeps getting better. Use this link and the promo code “testing” to get two free months and try it for yourself! NovoPsych brings 150+ standardized measures into one platform. If you’re interested in high quality measures for personality, disability, ADHD or Autism, try NovoPsych with a 15-day free trial via this link: The Testing Psychologist podcast is approved for CEU’s! I’ve partnered with At Health to offer CE credits for podcast episodes! Visit this link to access current and past episodes available for CE credit. You can use code “TTP10” for a discount on ALL the course credits you purchase from At Health! About Dr. Jeremy Sharp I’m a licensed psychologist and Clinical Director at the Colorado Center for Assessment & Counseling , a private practice that I founded in 2009 and have grown to over 20 clinicians. I earned my undergraduate degree in Experimental Psychology from the University of South Carolina before getting my Master’s and PhD in Counseling Psychology from Colorado State University. These days, I specialize in psychological and neuropsychological evaluation with kids and adolescents. As the host of the Testing Psychologist Podcast, I provide private practice consulting for psychologists and other mental health professionals who want to start or grow psychological testing services in their practices. I live in Fort Collins, Colorado with my wife (also a therapist) and two young kids. Ready to grow your testing services? Click below to get on the waitlist! Join the Waitlist

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570. Autism Mini-Series: Exploring the Camouflaging Paradox is an episode from The Testing Psychologist Podcast by Dr. Jeremy Sharp: Licensed Psychologist & Private Practice Consultant .

This episode is 49:29 long.

This episode was published on Apr 29, 2026.

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