Lindsey Mack's Substack

Lindsey Mack's Substack

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Lindsey Mack's Substack
Lindsey Mack's Substack
50 Traits of Autism in High-Masking Adults: Clinically Relevant but Commonly Missed

50 Traits of Autism in High-Masking Adults: Clinically Relevant but Commonly Missed

With Corresponding DSM-5-TR Criteria. A 7-page Resource for Individuals, Clinical Providers, and Autistic Allies.

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Lindsey Mackereth
Jul 13, 2025
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Lindsey Mack's Substack
Lindsey Mack's Substack
50 Traits of Autism in High-Masking Adults: Clinically Relevant but Commonly Missed
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a close up of a plastic model of a human brain
Photo by Maxim Berg on Unsplash

I’ve been sitting with a question lately:
Why do so many brilliant, intuitive, self-aware adults—who’ve spent their lives “doing the work”—walk into my office wondering if they might be Autistic... and leave with a resounding yes?

The answer, I believe, lies in how thoroughly the Autistic experience can be hidden—even (and especially) from the people living it.

High-masking Autistic adults are often the ones who have, for years, absorbed, contorted, and mirrored the world around them. They may not appear outwardly “different” in the ways we were taught to expect. But what’s happening internally—the relentless cognitive load, the sensory strain, the deep need for pattern and precision, the profound empathy paired with system overwhelm—can be life-altering.

And yet… many of these internal traits aren’t part of the typical diagnostic narrative.


A Different Kind of List

That’s why I created a resource I wish more people had access to earlier in their journey:
50 Traits of Autism in Highly Masked Adults, each one directly linked to the formal DSM-5-TR criteria used in clinical assessment.

This is not a list of stereotypes. You won’t find “doesn’t make eye contact” or “likes trains” here.

Instead, you’ll find things like:

  • A tendency to script conversations or rehearse social exchanges in advance

  • Chronic burnout from "performing normal"

  • A deep sense of justice that can come off as rigidity

  • Difficulty knowing what you want vs. what’s expected

  • Hyper-awareness of other people’s emotions, with difficulty managing your own

These are traits that show up again and again in high-masking clients—especially those who have spent decades camouflaging, compensating, and adapting to neurotypical norms without realizing that’s what they were doing.


Who This Is For

This guide is for you if:

  • You’re preparing for an Autism assessment and want to articulate your experience more clearly

  • You’re exploring the possibility that you might be Autistic (or already know you are, and are learning what that means)

  • You’re a clinician, coach, or healer wanting to better support neurodivergent clients

  • You’re trying to understand an Autistic loved one through a more nuanced, affirming lens

👉 You can download the full resource below.


Why It Matters

Autism isn’t new, but our understanding of it is still evolving. The traits that define Autistic experience—especially in adults who have survived by blending in—don’t always show up in the ways we expect. But they are real. And they matter.

Whether you're reading this for yourself, someone you love, or the clients you serve, my hope is that this list helps connect some dots—and affirms that what you’ve sensed all along is worth paying attention to.

Let me know what resonates in the comments.
You’re not alone in this.

Stay curious. Stay weird.

Warmly,
Lindsey Mackereth, MA, LPCC, LADC
Autism Assessor & Founder of Method Creative

Download 7-Page Resource Here:

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