I remember buckling my child into the car after a long clinic day. The binder said 90 percent success. My kid stared out the window, jaw tight, hands tucked between knees. When I offered a snack, the reply was bright and scripted. Then a whisper followed: “Can we stop being good now?” That was the moment I understood. My child was not thriving. My child was masking.
Masking looked like “quiet hands,” perfect eye gaze, and yes to every request. It looked like smiling on cue and falling apart at home. Our ABA team called it progress. I saw a child working painfully hard to appear fine. Insurance had fast-tracked us into high hours because it was easy to approve. OT and speech were waitlisted, capped, or “pending.” We mistook quick authorization for best care. It was the cheapest for them, not the right fit for us.
If progress requires pretending, it is not progress. It is survival.
Short fact: Studies link long-term masking to higher anxiety and depression in autistic people (Autism journal).
Here were our red flags that looked like success on paper:
- Your child holds it together with adults, then crashes at home.
- Smiles and “I’m fine” appear on cue, but play and curiosity fade.
- Scripts replace real communication, especially when tired or hungry.
- Recovery after sessions takes hours: clingy, quiet, or explosive.
- Data sheets rise while sleep, appetite, and joy fall.
If your child struggles to stay focused in therapy, that is information. Ask for movement breaks, sensory tools, and shorter blocks. If your child uses scripts or a device, they deserve support for that communication, not pressure to perform on demand. If stimming helps your child settle, treat it as a signal to understand, not a habit to erase.
What helped us step off the masking treadmill:
Choose evaluations that fit your child’s nervous system. Request Occupational Therapy for sensory regulation and daily living. Ask Speech Therapy to focus on functional communication and AAC in your real spaces. Add feeding therapy if meals are stressful. Pressure does not build trust with food.
Start small and track real life. Run short trials of any therapy and log sleep, appetite, willingness to join, and spontaneous language. If home gets harder, change course.
Observe and set non-negotiables. Watch how distress is handled. Comfort should not be withheld. Breaks should be real. Consent matters. Goals must serve daily life, not just clinic checkboxes.
It can feel overwhelming to push back. You are not alone. Insurance steered us toward what was simple to bill, not what helped our child feel safe. When we centered regulation, communication, and family coaching through OT, ST, and feeding support, the masking eased. We saw fewer meltdowns, more genuine language, and energy return to play.
Your gut is data. If a plan makes your child pretend to cope, pause. Ask for care that protects trust and lets your child be fully themselves.
