An exploration of clinician and family perceptions of the children’s masking questionnaire (CMQ) in an adolescent fatigue clinic, 2025, Delara

https://adc.bmj.com/content/110/Suppl_1/A341

British Association of General Paediatrics (BAGP)

8045 An exploration of clinician and family perceptions of the children’s masking questionnaire (CMQ) in an adolescent fatigue clinic

1. Lema Delara1,
2. Najette Ayadi O’Donnell2,
3. Laura Hull3

Abstract
Why did you do this work?Many autistic people camouflage to cope with the neurotypical world.1 Camouflaging entails behaviours and strategies that mask autistic traits in social settings in order to appear less autistic.1 This can pose diagnostic challenges. An adolescent fatigue clinic recently saw a rise in referrals for patients with myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS) exhibiting autistic traits, despite lacking a formal autism diagnosis. This may be due to camouflaging.

The Children’s Masking Questionnaire (CMQ) was developed as a screening tool for this. This study explored the perceptions of clinicians, young people aged 11–17, and their parents on using the CMQ to identify patients within this clinic who camouflage their autistic traits and may be overlooked by current autism diagnostic criteria.

What did you do?Two online surveys were created for clinicians and families. Each survey asked questions about the clarity, relevance, usefulness and accessibility of the CMQ, as well as factors facilitating or hindering its use. These were completed by 15 young people, 15 parents and 3 consultant paediatricians. Reflexive thematic analysis was conducted to elucidate perceptions and experiences of camouflaging.

What did you find?All young people identified with multiple camouflaging behaviours in the CMQ. Figure 1 summarises key responses from clinicians, young people and parents. Figure 2 depicts 3 themes and 8 subthemes defined upon reflexive thematic analysis.

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Abstract 8045 Figure 1
A table of key clinician and family responses

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Abstract 8045 Figure 2
Thematic map depicting 2 themes and 8 subthemes upon reflexive thematic analysis


What does it mean?Clinicians and families found the CMQ clear, comprehensible and relevant, welcoming its implementation within this clinic. Next steps would involve piloting the CMQ to assess its effectiveness in identifying camouflaging, validating it for clinical use. Focus groups with a more diverse range of healthcare professionals from the clinic team would be useful in gaining more perceptions, as well as clarifying the logistics of the CMQ.

Reference

1. 1. Hull L. Journal of Autism and Developmental Disorders 2017.

https://doi.org/10.1136/archdischild-2025-rcpch.464

 

Masking or camouflaging in autism is what we in this community call faking being well.