The Camouflaging Autistic Traits Questionnaire (CAT-Q) is a 25-item self-report measure developed by Laura Hull and colleagues (2018) to assess the extent to which individuals camouflage their autistic traits in social situations. The CAT-Q measures three dimensions of camouflaging: Compensation (9 items), Masking (8 items), and Assimilation (8 items), using a 7-point Likert scale with a total score range of 25–175. A total score of 100 or above suggests significant camouflaging behavior. The CAT-Q demonstrates excellent internal consistency (α = 0.94) and good test-retest reliability (r = 0.77) and was validated on 832 participants (354 autistic, 478 non-autistic adults). Zentake’s digital CAT-Q provides automated subscale scoring, reverse-item handling, and longitudinal tracking of camouflaging patterns over time.
The CAT-Q uses a 7-point Likert scale ranging from 1 (Strongly Disagree) to 7 (Strongly Agree) across 25 items. Before summing scores, five items must be reverse-scored: items 3, 12, 19, 22, and 24. For these items, the scoring is inverted (1 becomes 7, 2 becomes 6, etc.).
The total CAT-Q score is the sum of all 25 items after reverse scoring, with a range of 25–175. Three subscale scores are also calculated:
A total score of 100 or above indicates significant camouflaging. Average scores differ by group: autistic females average 124.35, autistic males average 109.64, non-autistic females average 90.87, and non-autistic males average 96.89 (Hull et al., 2018).
Zentake automatically calculates total and subscale CAT-Q scores upon form submission, handling all reverse-scoring logic and generating visual score profiles for clinical interpretation.
Step 1: Determine appropriateness. The CAT-Q is validated for individuals aged 16 and older with average to above-average cognitive ability. It is a self-report measure, meaning the client completes it independently. With Zentake, you can send the assessment as a secure link for remote completion before an appointment.
Step 2: Provide instructions. Explain that the questionnaire asks about strategies used in social situations. Emphasize there are no right or wrong answers and that honest responses lead to the most useful results. Zentake displays standardized instructions at the top of the digital form.
Step 3: Allow independent completion. The CAT-Q takes approximately 5–10 minutes to complete. The client rates each of the 25 statements on a 7-point scale. Zentake presents items one section at a time for a clear, non-overwhelming experience.
Step 4: Review scored results. After completion, review the total score and three subscale scores. High scores on specific subscales can guide clinical discussion about which camouflaging strategies the individual relies on most. Zentake generates an instant score summary with subscale breakdowns and normative comparisons.
Step 5: Integrate into assessment. Use CAT-Q results as one component of a comprehensive autism evaluation. The CAT-Q is particularly valuable for identifying individuals — especially women and non-binary individuals — who may camouflage autistic traits and present atypically during clinical observation. Zentake stores results alongside other assessment data for a complete clinical picture.
Scoring: Paper requires manual reverse-scoring of 5 items and summing 25 responses across 3 subscales, risking calculation errors. Zentake auto-calculates total and subscale scores instantly with automatic reverse-scoring.
Completion: Paper forms take the same 5–10 minutes but must be printed and physically distributed. Zentake delivers the CAT-Q via secure link for completion on any device, at any location.
Delivery: Paper assessments require in-person distribution or mailing. Zentake sends the CAT-Q digitally before an appointment, saving session time for clinical discussion.
Data Storage: Paper forms require physical filing and manual data entry for research or record-keeping. Zentake stores all responses in HIPAA-compliant cloud storage with instant retrieval.
Longitudinal Tracking: Comparing paper CAT-Q scores over time requires pulling charts and manual comparison. Zentake automatically displays score trends across multiple administrations.
Security: Paper forms containing sensitive information about autistic identity can be accessed by unauthorized personnel. Zentake uses encrypted storage and role-based access controls.
Integration: Paper scores must be manually transcribed into clinical records. Zentake integrates directly with EMR systems for seamless documentation.
Cost: Paper involves printing and administrative overhead per administration. Zentake eliminates material costs and reduces scoring time from minutes to seconds.
What does the CAT-Q measure?
The CAT-Q measures autistic camouflaging — the conscious or unconscious strategies people use to mask autistic traits in social situations. It assesses three dimensions: Compensation (active strategies to navigate social interactions), Masking (hiding autistic characteristics), and Assimilation (efforts to fit in socially). It was developed and validated by Hull et al. (2018) with 832 autistic and non-autistic adults.
How do you score the CAT-Q?
First, reverse-score items 3, 12, 19, 22, and 24 (so 1 becomes 7, 2 becomes 6, etc.). Then sum all 25 items for a total score ranging from 25 to 175. Subscale scores are calculated by summing the relevant items: Compensation (items 1, 4, 5, 8, 11, 14, 17, 20, 23), Masking (items 2, 6, 9, 12, 15, 18, 21, 24), and Assimilation (items 3, 7, 10, 13, 16, 19, 22, 25). Zentake handles all reverse-scoring and calculations automatically.
How long does the CAT-Q take to complete?
The CAT-Q takes approximately 5–10 minutes to complete. It is a self-report questionnaire with 25 items rated on a 7-point scale, making it quick to administer as part of a clinical assessment battery or as a standalone screening.
Is the CAT-Q free to use?
Yes, the CAT-Q is freely available for clinical and research use. The original questionnaire was published open-access by Hull et al. (2018). Zentake provides a digital version with automated scoring and tracking at no additional cost during your free trial period.
What age group is the CAT-Q designed for?
The CAT-Q is validated for individuals aged 16 and older with average to above-average cognitive ability. It has been most widely studied in adults, with growing evidence supporting its use in older adolescents. It is not suitable for young children or individuals with significant intellectual disability.
Who should administer the CAT-Q?
The CAT-Q is a self-report measure completed by the individual being assessed. It should be administered and interpreted by a qualified healthcare professional, such as a clinical psychologist, psychiatrist, or other specialist experienced in autism assessment. Clinical context is essential for accurate interpretation.
Can the CAT-Q diagnose autism?
No. The CAT-Q measures camouflaging behavior, not autism itself. High CAT-Q scores indicate that an individual is using significant strategies to mask social difficulties, which is common in autistic individuals but can also occur in people with social anxiety or other conditions. It should be used as part of a comprehensive assessment, not as a standalone diagnostic tool.
Why is the CAT-Q important for women and non-binary individuals?
Research shows that autistic women and non-binary individuals tend to camouflage more than autistic men, which can lead to later or missed diagnoses. The CAT-Q helps clinicians identify individuals whose camouflaging may cause their autistic traits to be under-recognized during clinical observation, contributing to more equitable diagnostic processes.
What do high subscale scores mean?
High Compensation scores suggest the person actively develops strategies to manage social interactions. High Masking scores indicate they invest effort in hiding autistic characteristics. High Assimilation scores suggest they push themselves to fit into social environments that feel uncomfortable. Together, these patterns help clinicians understand the individual’s social presentation and potential burnout risk.
1. Hull, L., Mandy, W., Lai, M.-C., Baron-Cohen, S., Allison, C., Smith, P., & Petrides, K. V. (2018). Development and validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q). Journal of Autism and Developmental Disorders, 49(3), 819–833.
2. Hull, L., Petrides, K. V., Allison, C., Smith, P., Baron-Cohen, S., Lai, M.-C., & Mandy, W. (2017). "Putting on my best normal": Social camouflaging in adults with autism spectrum conditions. Journal of Autism and Developmental Disorders, 47(8), 2519–2534.
3. Lai, M.-C., Lombardo, M. V., Ruigrok, A. N., Chakrabarti, B., Auyeung, B., Szatmari, P., Happe, F., & Baron-Cohen, S. (2017). Quantifying and exploring camouflaging in men and women with autism. Autism, 21(6), 690–702.
Last updated: March 2026
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