A Systematic Review of Passing as Non-autistic in Autism Spectrum Disorder

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Libsack, E. J., Keenan, E. G., Freden, C. E., Mirmina, J., Iskhakov, N., Krishnathasan, D., & Lerner, M. D. (2021). A Systematic Review of Passing as Non-autistic in Autism Spectrum Disorder. Clinical Child and Family Psychology Review, 24(4), 783-812. https://doi.org/10.1007/s10567-021-00365-1

Publication date: 9 Sep 2021 Added to AutiHub: 9 Aug 2026 Type: Article Article language: English
Publisher source (DOI) Full text OpenAlex source

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Authors

Publication authors
7
Publication authors identified as autistic
1 / 7 (14.3%)
  1. Erin J. Libsack
  2. Elliot Gavin Keenan *
  3. Caroline E. Freden
  4. Julianne Mirmina
  1. Nathaniel Iskhakov
  2. Darsiya Krishnathasan
  3. Matthew D Lerner

Abstract

While long described in anecdotal accounts of the lived experiences of autistic individuals, the phenomenon of behaving in ways that appear inconsistent with the presence of autism (or passing as non-autistic; PAN) has recently seen a dramatic increase in scrutiny in the published scientific literature. Increased research attention has coincided with a proliferation of methods, definitions, measures, and population assumptions associated with PAN. To date, however, no review has sought to systematically identify and synthesize the literature on PAN. This systematic review reflects the state of the PAN literature as of May 2020. Ninety articles were screened, 66 were identified for evaluation, and 46 met inclusion criteria and were reliably coded for study characteristics and participant characteristics. Results reveal that the PAN literature includes a relatively even mix of qualitative, quantitative, and mixed-method studies, and that a variety of terms are used for PAN (with masking and camouflage being the most frequent). Sample sizes varied widely (from one to 832 participants), with 63.06% of participants being categorized as autistic. Nearly all studies reported methods for confirming autism diagnoses, with community and clinical diagnoses being most common. The majority of studies reported participant gender, with slightly more females included than males on average, but fewer than half of all studies compared PAN across genders. Nearly all studies reported participant age, demonstrating a wide range of 2 to 79 years, with a mean age of 23.85. Conversely, only 23.91% of studies provided participant race or ethnicity data. Nearly all studies formally or informally excluded participants with intellectual disability. Finally, measures of internalizing symptoms, which are often thought to be linked to PAN, were reported in only 17.4% of studies. Implications for gaps in understanding of PAN and future directions for the field are discussed.

Bibliography cited by this reference

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Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 2 Oct 2026 02:39.

Cited references
136
With a DOI
128
Without a DOI, from raw bibliography text
7
12 / 136 (8.8%) cited references include at least one author identified as autistic.
References with data to complete
3 / 136 (2.2%)
References with detected author names
133 / 136 (97.8%)
Without detected author names
3
Without a structured title
3
Without a stable identifier
5
References with raw author names still to review
0
References with external metadata lookup issues
1
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
680
From DOI or external metadata
680
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
3
275 / 680 (40.4%) names are linked to an author already present in AutiHub. 405 / 680 (59.6%) names are not yet linked.
Names linked to a person identified as autistic
16 / 680 (2.4%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 16 / 275 (5.8%). Distinct people identified as autistic: 14 / 526 (2.7%).
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