Compensation might be an adaptive trajectory that can be differentiated from other trajectories in psychiatry, such as resilience, in which a negative outcome is avoided, behaviourally, cognitively, and neurologically, despite exposure to risk. Instead, autistic compensators, despite apparent lack of observable autistic behaviour, continue being autistic at the neurocognitive level. Importantly, compensation can generate challenges in diagnosing and supporting these individuals. Because autism spectrum disorder is diagnosed by behaviour alone, compensators might not receive a diagnosis and support until later in life, if at all. This issue is thought to be particularly acute in females, who are less likely than males to be diagnosed with autism spectrum disorder despite similar underlying autistic characteristics. Even for people with a diagnosis, a neurotypical appearance due to compensation might result in support needs being underestimated in educational and workplace settings. Additionally, compensation is thought to contribute to poor mental health in autism. Compensatory attempts are taxing, need to be sustained over time, and are often unsuccessful, resulting in a cost to wellbeing.
—Lucy Anne Livingston, Punit Shah, and Francesca Happé, in “Compensatory strategies below the behavioural surface in autism: a qualitative study”
Published to write.house by Bix Frankonis. Comments and replies by email are welcome.