AQ 10 Autism Screener (AQ-10): How to Read Results as a High-Masking Woman

Last reviewed: 02/27/2026

Reviewed by: Dr. Kiesa Kelly

If you’re a high-masking woman who took the AQ 10 and got a “surprisingly low” score (or a score that feels ambiguous), it can stir up a lot: relief, doubt, grief, validation, or a looping “But what does this actually mean?”

The AQ-10 test is a quick autism screener, not a diagnosis. In real life, especially for women who’ve spent decades “passing,” the most important information isn’t just the number. It’s the lifelong pattern, the effort required to function, and the cost you pay afterward.

In this article, you’ll learn:

• What the AQ-10 is designed to do (and what it can’t do)

• Why high masking autism in women can lead to confusing results

• How to interpret your score using context, not perfection

• When a full adult autism evaluation may be worth considering

• Practical next steps, including autism assessment options in Tennessee and via telehealth

💡 Key takeaway: A screening score is a starting point, not a verdict. If your lived experience keeps pointing to autism, it’s worth looking at the bigger picture.

What AQ-10 is (and isn’t)

The AQ-10 (Autism Spectrum Quotient, 10-item version) was created as a brief “red flag” tool: something quick that can help identify who might benefit from a more complete autism assessment. It is commonly used with adults without a moderate or severe learning disability. [2]

A quick signal, not a label

Think of the AQ-10 like a smoke alarm. It can signal “something might be here,” but it cannot tell you what caused the smoke or what support you need.

A score at or above a commonly used cutoff (often 6 out of 10) can suggest that a full diagnostic assessment may be appropriate. [1]

Why “socially capable” doesn’t rule autism out

One of the biggest misunderstandings we see (especially in late diagnosed autism in women) is the belief that autism always looks like obvious social difficulty.

Some autistic adults are socially skilled in a “performance” sense. They can be warm, empathetic, funny, and competent. They can read a room. They may even thrive in people-facing jobs.

What often makes the difference is not whether you can socialize, but what it costs.

🧭 Key takeaway: Being socially capable and being socially effortless are not the same thing. Autism can be present even when someone appears socially confident. [3]

Why high-masking women can get confusing results

High masking autism in women is not about “faking it.” It’s about adapting to expectations, often starting early, and often at a significant cognitive and emotional cost. [3]

Learned scripts + “passing” at a cost

Masking (also called camouflaging) can include:

• Rehearsing conversation topics ahead of time

• Copying facial expressions, tone, or humor from others

• Mirroring interests or opinions to reduce conflict

• Studying social rules like a second language

• Hiding sensory needs so you don’t seem “too much”

Research on camouflaging describes both why people do it (to connect, to avoid rejection, to stay safe) and the emotional toll it can take over time. [3]

Here’s a practical way to apply that to the AQ10:

If an item asks whether something is “easy,” many high-masking women answer based on performance (“I can do it”), not effort (“It drains me”). That can lower your score even when autism is still a strong fit.

Burnout and sensory load in midlife

Autism in women over 40 is often where the “system” starts to show strain. Longstanding coping strategies may stop working as life becomes more complex: careers, caregiving, relationship demands, hormonal shifts, health changes, or cumulative stress.

Autistic burnout is described as a state of chronic exhaustion, reduced tolerance to stimulus, and loss of skills, often linked to a long-term mismatch between demands and supports. [5]

If you took an aq-10 test during burnout, your answers may reflect a phase of overwhelm. If you took it during a “managed” phase, your answers may reflect years of compensation. Both are real, and both need context.

🌿 Key takeaway: A single AQ-10 score can’t tell you whether you’re in a season of coping, collapsing, or recovering. Track patterns across time, not just a snapshot. [5]

The context that matters most when interpreting AQ 10 results

The AQ-10 can point you toward a conversation. To make that conversation meaningful, zoom out.

Lifelong pattern

A core misconception we want to gently challenge is: “If it were autism, someone would have noticed when I was a kid.”

In reality, diagnostic gender bias and the historical focus on a “male-typical” autism profile have contributed to missed or delayed diagnoses for many girls and women. [7]

When you review your history, look for patterns that were present across settings (even if they were subtle), such as:

• A sense of being “different” socially, even with friends

• Intense interests that were soothing or identity-defining

• Strong preference for predictability, routines, or clear roles

• Sensory sensitivities (sound, textures, light, crowds)

• Periods of shutdown (going blank, needing to withdraw) after stress

If you don’t have childhood records, you can still gather clues: old report cards, family stories, photos, and your own memories of play, friendships, and stress responses.

Effort, recovery time, and shutdown

For high-masking adults, “effort” is often the missing variable.

Try this quick reflection exercise after taking an adult autism test (including the AQ-10):

• Effort: What do you do internally to get through social demands?

• Recovery: How much downtime do you need afterward?

• Spillover: Do you get headaches, irritability, insomnia, shutdown, or emotional flooding?

Practical example #1 (masking + a low score):

A 44-year-old professional takes an aq10 test online and scores a 4. She’s relieved, then confused, because she’s also exhausted after every meeting and needs hours alone to reset. When she reviews the items, she realizes she answered based on what she can do at work, not the recovery time and sensory load afterward. A clinician would consider that “effort and cost” data as part of a broader assessment, not as something the screener can capture. [8]

🧩 Key takeaway: If you can do the thing but it costs you disproportionately, that still counts as clinically relevant information.

When to consider a full adult autism evaluation

A full evaluation is not “about proving it.” For many late-diagnosed adults, it’s about clarity: understanding your nervous system, your needs, and why certain life demands have felt harder than they “should.” [6]

A comprehensive evaluation draws on multiple data points (history, current functioning, and structured measures) to determine whether you meet diagnostic criteria and what supports would be helpful. [8]

Persistent sensory/social exhaustion

Consider a full evaluation if you notice:

• Chronic “social hangover” after normal interactions

• Sensory overwhelm that drives avoidance or shutdown

• Burnout cycles that repeat despite good coping skills

• A feeling that you’re constantly monitoring yourself

Misconception #1: “If I make eye contact, it can’t be autism.”

Many autistic adults learn eye contact as a skill. The question is whether it feels natural or like a task you manage. [3]

Relationship and work impacts

Consider an evaluation if patterns are affecting your day-to-day life, such as:

• Misunderstandings with partners about tone, needs, or downtime

• Workplace strain from meetings, open offices, or unclear expectations

• Feeling “on edge” from constant context-switching

• Over-functioning and then crashing

Practical example #2 (a higher score + differential diagnosis):

A 38-year-old takes the AQ-10 and scores a 7. She assumes this guarantees autism, but she also has longstanding OCD and trauma symptoms. In a full assessment, clinicians consider the whole picture and use differential diagnosis to understand which symptoms fit autism, which fit anxiety/OCD, and where they overlap. The goal isn’t to talk you out of your experience, it’s to name it accurately so support actually fits. [8]

Misconception #2: “If my AQ-10 is low, I can’t be autistic.”

A low AQ-10 score does not rule autism out, especially when masking is strong or when the items don’t match your lived experience well. [3]

Misconception #3: “Masking means it’s not real.”

Camouflaging is common and measurable, and research suggests it may contribute to later diagnosis in women. [4,6]

Next steps

If you’re looking for a grounded way forward, here are steps that balance self-understanding with clinical accuracy.

1) Take the screener (or retake it thoughtfully).

Use our AQ-10 autism screener page so you’re using a consistent version of the tool and scoring instructions.

2) Add context notes.

Write down a few concrete examples for each domain: social effort, sensory load, rigidity vs flexibility, shutdown/meltdown patterns, and burnout history. (Two weeks of notes is often more helpful than perfect recall.)

3) If you’re in Tennessee (or need telehealth), consider a comprehensive evaluation.

If you’re looking for an adult autism test that goes beyond a quick screener, explore our psychological assessment options and how we approach differential diagnosis.

If you’re not sure what you need yet, you can reach out to our team to ask questions and explore whether an evaluation, therapy, coaching, or another option fits best.

4) Build support now, even while you’re deciding.

You don’t have to wait for a formal diagnosis to benefit from support. Many people start by exploring specialized therapy options, using our mental health screening tools, or learning about the clinicians on our Meet Us page.

✅ Key takeaway: The best next step is the one that reduces load and increases clarity. A diagnosis can be helpful, but support doesn’t have to be “earned” by suffering.

Conclusion

The AQ-10 is a useful first step, especially when you’re trying to name a lifelong pattern. But for high-masking women, the most meaningful interpretation comes from context: the effort behind the performance, the recovery time, and the long arc of how you’ve coped.

If your AQ 10 results left you with more questions than answers, that doesn’t mean you did it wrong. It may be a sign that you’re ready for a fuller look at your profile, your stress load, and the supports that help you function without burning out.

About the Author

Dr. Kiesa Kelly is a clinical psychologist and neuropsychologist by training with more than 20 years of experience in psychological assessment. She completed advanced clinical training at multiple academic medical centers and has a special interest in neurodiversity-affirming assessments for adults, including high-masking women and non-binary folks.

At ScienceWorks Behavioral Healthcare, Dr. Kelly focuses on helping clients find clarity through evidence-based assessment and specialized therapy approaches, with telehealth availability across many states, including Tennessee.

References

1. Allison C, Auyeung B, Baron-Cohen S. Toward brief “Red Flags” for autism screening: The Short Autism Spectrum Quotient and the Short Quantitative Checklist in 1,000 cases and 3,000 controls. J Am Acad Child Adolesc Psychiatry. 2012;51(2):202-212.e7. https://doi.org/10.1016/j.jaac.2011.11.003

2. National Institute for Health and Care Excellence (NICE). Autism spectrum quotient (AQ-10) test (CG142 implementation resource). 2012. https://www.nice.org.uk/guidance/cg142/resources/autism-spectrum-quotient-aq10-test-pdf-186582493

3. Hull L, Petrides KV, Allison C, et al. “Putting on My Best Normal”: Social camouflaging in adults with autism spectrum conditions. J Autism Dev Disord. 2017;47(8):2519-2534. https://doi.org/10.1007/s10803-017-3166-5

4. Hull L, Mandy W, Lai MC, et al. Development and validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q). J Autism Dev Disord. 2019;49(3):819-833. https://doi.org/10.1007/s10803-018-3792-6

5. Raymaker DM, Teo AR, Steckler NA, et al. “Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew”: Defining autistic burnout. Autism in Adulthood. 2020;2(2):132-143. https://doi.org/10.1089/aut.2019.0079

6. Milner V, Colvert E, Hull L, et al. Does camouflaging predict age at autism diagnosis? A comparison of autistic men and women. Autism Res. 2024;17(3):626-636. https://doi.org/10.1002/aur.3059

7. Loomes R, Hull L, Mandy WPL. What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry. 2017;56(6):466-474. https://doi.org/10.1016/j.jaac.2017.03.013

8. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). 2013. https://doi.org/10.1176/appi.books.9780890425596

Disclaimer

This article is for informational purposes only and is not medical advice or a diagnosis. If you have concerns about autism or your mental health, consider seeking an evaluation from a qualified clinician.