Ep. 259: Autism and ADHD Masking: The Signs & Hidden Costs with Dr. Deanna Dow

We warmly welcome Dr. Deanna Dow to the podcast. ​​Dr. Dow is a licensed clinical psychologist with over two decades of experience supporting neurodivergent individuals and families. She is the founder and CEO of Spectrum Psych LA, a multidisciplinary clinic that provides assessment, therapy, occupational therapy, medication management, and community-based support, and she has trained and worked in autism clinics and research centers at major institutions including the University of Michigan, the University of North Carolina, Florida State University, and UCLA where her research has focused on early autism identification, parent-led intervention models, and co-occurring mental health concerns such as anxiety, depression, and suicidal ideation.

Dr. Dow also serves as President of the Spectrum Psych Foundation for Inclusion and Empowerment, promoting access, advocacy, and inclusive mental health care and continues to provide psychotherapy and assessment services using a strengths-based, neurodiversity-affirming approach.

In this episode, Dr. Dow helps us unpack the far too often unseen work that neurodivergent individuals put into “blending in” via masking and camouflaging. We explore how strategies such as suppressing natural behaviors, imitating peers, and adhering to social expectations can quietly shape a child's and/or adult's life. We discuss the toll that this effort can take, from drained energy and heightened anxiety to delayed or missed diagnoses, and why it’s especially prevalent among girls, high-achieving students, and those with strong cognitive or verbal abilities.

Dr. Dow shares with us some concrete examples of how masking shows up in classrooms, recess, and everyday social situations, highlighting subtle behaviors that often go unnoticed but signal that a child or teen could be struggling on the inside. We talk about the impact of masking on emotional well-being, academic performance, and social connections, while also addressing additional conditions such as ADHD and how overlapping symptoms can further complicate diagnoses and support systems.

We also explore the relief and empowerment that can come with later diagnoses and reframe neurodivergence as a difference rather than a deficit. This conversation is a close look at the hidden effort behind “fitting in” and what it takes to help neurodivergent individuals thrive on their own terms.

Show Notes:

[3:15] - Dr. Dow explains how masking helps allow neurodivergent individuals to fit in, but the effort can often cause exhaustion and anxiety.
[6:02] - Hear how children with autism or ADHD may mask behaviors, causing hidden stress and internalized anxiety.
[9:14] - Dr. Dow argues that social control can drain energy, creating crashes if breaks and regulation opportunities aren’t provided.
[12:30] - Many kids appear fine at school but release built-up tension at home from masking effort.
[13:04] - For a lot of kids, home can provide a safe space where they can unload, even if external masking still persists.
[15:45] - Early assessments can help prevent anxiety, build self-understanding, and teach when masking or authenticity is beneficial.
[18:12] - Dr. Dow points out how social withdrawal may reflect beyond negative feedback, not lack of motivation, and that masking can often delay diagnosis.
[21:08] - Many subtle autism signs go unnoticed, so early observation and education are incredibly important for support.
[24:30] - Hear how parents often feel relief after evaluation, realizing that cognitive strengths previously masked signs of autism.
[25:54] - Assessment has the potential to empower youth by explaining that struggles stem from brainwiring, not personal shortcomings.
[26:41] - Hear Dr. Dow explain how neurodivergence openly helps children understand their strengths and challenges.
[28:43] - Dr. Deanna Dow believes that reassuring parents too much can delay recognition of differences and necessary support for kids.
[30:20] - Dr. Dow explains how validating diverse behaviors can help build safety and acceptance.
[33:14] - Dr. Dow argues that educators who understand neurodivergence can help students regulate, feel authentic, and promote more inclusive classrooms.
[35:32] - Hear how you can get in touch with Dr. Dow.

Links and Related Resources:

• Episode 38: Understanding the Gifted and Twice Exceptional Child with Dr. Nicole Tetreault

• Episode 119: Autistic Girls – Overlooked and Underrecognized with Megan Beardmore, PhD, NCSP

• Episode 196: Gifted and/or Autistic with Megan Helmen, Psy.D., L.P.

• Episode 226: Is It Autism? Recognizing, Assessing & Supporting Children and Teens with Dr. Chandni Singh

• Episode 197: Five Best Practices for Math Instruction – Dr. Sarah Powell

• More Podcast Episodes

 

Connect with Dr. Deanna Dow:

• Spectrum Psych

Join Our Diverse Thinking Different Learning Community:

• Substack