April 29, 2026

570. Autism Mini-Series: Exploring the Camouflaging Paradox

49 minutes

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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

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Featured Resources

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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.

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