Camouflaging Autistic Traits Questionnaire (CAT-Q)
A 25-item self-report measure of how much a person camouflages autistic traits in social situations.
Last reviewed: July 2026
- Full name
- Camouflaging Autistic Traits Questionnaire (CAT-Q)
- Measures
- The CAT-Q (Camouflaging Autistic Traits Questionnaire) is a 25-item self-report measure developed by Hull and colleagues (2019) at University College London to quantify the strategies people use to mask, compensate for, or assimilate around autistic social and communication differences.
- Format
- 25 items · ~8 min · Self-report
- Score range
- 25 to 175
- Reliability
- Hull et al.
- Population
- Adults and adolescents aged 16 and over, in clinical and community settings.
- Interpretation
- 25–74Low
- 75–99Moderate
- 100–137Above Threshold
- 138–175High
Scoring & Interpretation
Each of the 25 items is rated from 1 (Strongly Disagree) to 7 (Strongly Agree), giving a total score from 25 to 175. Five items (3, 12, 19, 22 and 24) are reverse-scored so that higher values consistently indicate more camouflaging; in ClientForms this reversal is applied at the point of response, so the total is a simple sum. Three subscale scores are also reported: Compensation (9 items, range 9 to 63), Masking (8 items, range 8 to 56) and Assimilation (8 items, range 8 to 56). The developers did not define a diagnostic cut-off, so interpretation is norm-referenced: a total around 100 is commonly read as a marker of high camouflaging, and the subscale profile is reviewed alongside the total.
| Score Range | Severity | Clinical Action |
|---|---|---|
| 25–74 | Low | Low camouflaging reported across the three subscales |
| 75–99 | Moderate | Moderate camouflaging, below the commonly used threshold — monitor in context |
| 100–137 | Above Threshold | Score ≥100 indicates significant camouflaging — review alongside the broader assessment |
| 138–175 | High | Very high camouflaging — consider comprehensive assessment and supports |
- Hull et al.
- (2019, Journal of Autism and Developmental Disorders) validated the CAT-Q on 354 autistic and 478 non-autistic adults.
- Internal consistency was high for the total scale (Cronbach's alpha = 0.94) and for each subscale (Compensation = 0.91, Masking = 0.85, Assimilation = 0.92), with test-retest reliability over three months of ICC = 0.77.
- No diagnostic cut-off was defined, so scoring is norm-referenced; a later gender-differences study (Hull et al., 2020, Autism) reported autistic women averaging 124.4 (SD 23.3) and autistic men 109.6 (SD 26.5), so the result is interpreted against these norms in context.
When to Use This vs Alternatives
| Instrument | Measures | Items | Reach for it when |
|---|---|---|---|
| CAT-Q This page | Autistic camouflaging | 25 | The comprehensive option you are reading about |
| AQ-10 | Autistic traits (screen) | 10 | You want a brief first-line screen for autistic traits. The AQ-10 flags whether fuller assessment is warranted; the CAT-Q then helps explain why a screen may understate the picture in someone who masks heavily. |
| RAADS-R | Autistic traits, 4 subscales | 80 | You need a fuller, structured profile of autistic traits across social, sensory and language domains. Pair it with the CAT-Q when camouflaging may be flattening the trait picture, particularly in adults assessed later in life. |
| ASRS | ADHD symptom frequency (screen) | 6–18 | ADHD is part of the differential. The ASRS screens for adult ADHD symptoms; sustained social effort can reflect ADHD as well as autistic camouflaging, so it helps to map both. |
Autistic camouflaging · 25 items
Autistic traits (screen) · 10 items
You want a brief first-line screen for autistic traits. The AQ-10 flags whether fuller assessment is warranted; the CAT-Q then helps explain why a screen may understate the picture in someone who masks heavily.
Autistic traits, 4 subscales · 80 items
You need a fuller, structured profile of autistic traits across social, sensory and language domains. Pair it with the CAT-Q when camouflaging may be flattening the trait picture, particularly in adults assessed later in life.
ADHD symptom frequency (screen) · 6–18 items
ADHD is part of the differential. The ASRS screens for adult ADHD symptoms; sustained social effort can reflect ADHD as well as autistic camouflaging, so it helps to map both.
See It in Action
Sample: a completed CAT-Q, scored and interpreted.
At or above the autistic camouflaging threshold.
By domain
- Compensation
- 42/63
- Masking
- 36/56
- Assimilation
- 30/56
On ClientForms the total, its band and every domain flag are scored for you and ready to read or export as a PDF.
See the dashboard view
Synthetic sample for illustration — not a real patient.
What It Measures
It captures camouflaging as a measurable behaviour rather than a diagnostic feature, across three subscales: Compensation, Masking and Assimilation. Each item is rated on a 7-point scale, with five items reverse-scored. It was designed in part to surface presentations that are easily missed in conventional assessment, particularly among autistic women and gender-diverse adults.
- Compensation
- Strategies used to actively compensate for social and communication difficulties, such as copying others or rehearsing conversations.
- Masking
- Hiding autistic characteristics, and monitoring and adjusting behaviour to appear non-autistic.
- Assimilation
- Effort to fit in and feel part of a social situation, often at the cost of feeling like oneself.
When to Use the CAT-Q
Use the CAT-Q alongside an autism assessment when camouflaging may be obscuring the clinical picture, for example when a patient describes exhausting social effort, a history of being overlooked, or a mismatch between an apparently fluent presentation and significant internal distress. It is a measure of camouflaging behaviour, not a screen or a diagnostic instrument: a high total does not confirm autism, and a low total does not rule it out. The subscale pattern is often more informative than the total, and the result is intended to inform clinical formulation rather than stand alone.
Who It's For
Adults and adolescents aged 16 and over, in clinical and community settings. Self-report: the patient completes it themselves. It is not validated as a standalone diagnostic tool and is not designed for use without a clinical assessment. Scores can also reflect social anxiety, masking related to other conditions, or learned social effort, so an elevated result should be interpreted in context rather than read as autism-specific.
Frequently Asked Questions
What is the CAT-Q?
The CAT-Q (Camouflaging Autistic Traits Questionnaire) is a 25-item self-report measure developed by Hull and colleagues in 2019 to quantify how much a person camouflages autistic traits in social situations. It measures camouflaging behaviour across three subscales and is used to inform, not replace, a clinical assessment.
How is the CAT-Q scored across the Compensation, Masking and Assimilation subscales?
Each item is rated 1 to 7 and five items are reverse-scored, giving a total from 25 to 175. The items are grouped into three subscales — Compensation (9 items), Masking (8 items) and Assimilation (8 items) — and ClientForms reports the total and each subscale the moment the patient submits.
What are the CAT-Q cut-offs?
The developers did not define a diagnostic cut-off, so scoring is norm-referenced. A total around 100 is commonly read as a marker of high camouflaging; for comparison, a gender-differences study (Hull et al., 2020) reported autistic women averaging 124.4 and autistic men 109.6. The pattern across subscales is interpreted alongside the total.
Is the CAT-Q diagnostic?
No. The CAT-Q measures camouflaging strategies, not autism itself, and a high or low score neither confirms nor rules out a diagnosis. It is intended to add context to a comprehensive assessment, and the clinician owns the interpretation.
How does the CAT-Q complement the AQ-10 and RAADS-R?
The AQ-10 and RAADS-R measure autistic traits, while the CAT-Q measures the effort spent hiding them. A heavily masked presentation can produce a lower trait score, so the CAT-Q helps explain why a screen or trait profile may understate the picture, particularly in adults assessed later in life.
What is the CAT-Q licence?
The CAT-Q is free to use under a Creative Commons Attribution licence (CC BY 4.0) with attribution to Hull et al. (2019). In ClientForms the items are reproduced verbatim and scored automatically when the patient submits.
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