Quantifying compensatory strategies in adults with and without diagnosed autism

Lucy Livingston, Punit Shah, Victoria Milner, Francesca Happé

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74 Citations (SciVal)


There is growing recognition that some autistic people engage in ‘compensation’, showing few behavioural symptoms (e.g. neurotypical social skills), despite continuing to experience autism-related cognitive difficulties (e.g. difficulties in social cognition). One way this might be achieved is by individuals consciously employing ‘compensatory strategies’ during everyday social interaction. However, very little is currently known about the broad range of these strategies, their mechanisms and consequences for clinical presentation and diagnosis.

We aimed to measure compensatory strategies in autism for the first time. Using a novel checklist, we quantified self-reported social compensatory strategies in 117 adults (58 with autism, 59 without autism) and explored the relationships between compensation scores and autism diagnostic status, autistic traits, education level, sex and age at diagnosis.

Higher compensation scores—representing a greater repertoire of compensatory strategies—were associated with having an autism diagnosis, more autistic traits and a higher education level. The link between autism diagnostic status and compensation scores was, however, explained by autistic traits and education level. Compensation scores were unrelated to sex or age at diagnosis.

Our sample was self-selected and predominantly comprised of intellectually able females; therefore, our findings may not generalise to the wider autistic population.

Together, our findings suggest that many intellectually able adults, with and without a clinical diagnosis of autism, report using compensatory strategies to modify their social behaviour. We discuss the clinical utility of measuring self-reported compensation (e.g., using our checklist), with important implications for the accurate diagnosis and management of autism and related conditions.
Original languageEnglish
Article number15
Pages (from-to)15
JournalMolecular Autism
Issue number1
Publication statusPublished - 12 Feb 2020

Bibliographical note

Funding Information:
LAL was funded by a doctoral studentship from the Medical Research Council. FH is part funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. VM is funded by the Economic and Social Research Council (grant number: ES/M011488/1, awarded to FH).

Publisher Copyright:
© 2020 The Author(s).


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