Moyna Talcer Consultant Occupational Therapist

12/11/2025

ADHD, Autism & Masking in Girls — The Hidden Struggle

Many girls who have ADHD or autism grow up feeling like they’re “just coping” — but often, they’re masking. Masking means hiding or suppressing natural behaviours to fit in or avoid judgment.

✨ Here’s what we know:

1️⃣ Girls are more likely to mask than boys, often copying others to appear “normal” or calm — even when they’re struggling inside.

2️⃣ Because of this, many go undiagnosed until adulthood, or are misdiagnosed with anxiety or depression instead.

3️⃣ Masking is exhausting — it can lead to burnout, emotional overwhelm, and loss of identity.

4️⃣ When girls finally feel safe to “unmask,” their real personalities and strengths begin to shine.

5️⃣ The more we understand masking, the more we can support honesty, rest, and acceptance instead of perfection.

Let’s stop saying “but she seems fine!” — and start asking, “What helps you feel safe being yourself?” If you work in a school and are asked if a child is masking, be aware you are likely not to know! This IS masking. Its important to discuss how the child is at home and see if there is a disconnect, if there is, it is likely that masking is at play.

🧠 References:

Hull, L. et al. (2017). "Putting on My Best Normal": Social Camouflaging in Adults with Autism Spectrum Conditions. Journal of Autism and Developmental Disorders. PMCID: PMC5564380

Gershon, J. (2002). A Meta-Analytic Review of Gender Differences in ADHD. Journal of Attention Disorders.

ADHD Foundation (UK). Masking and Mental Health in Girls. adhdfoundation.org.uk

💗 Let’s make invisible struggles visible — because understanding saves energy, and acceptance changes lives.

12/11/2025

AuDHD, the "tug-of-war" profile where you have a diagnosis of both Autism and ADHD. This profile can feel like a walking, talking contradiction.

Rather than being a seperate diagnosis, its more of a term used by the neurodivergent community to describe their lived experience.

You need routine, but also seek novelty making it really hard to maintain routines.

You can focus really well on a favorite topic yet get distracted and find it hard manage your time effectively making it difficult to prioritize other important tasks like eating, drinking, sleeping.

You can struggle to interpret non verbal cues yet can be impulsive and inturrupt conversations or not know when to stop sharing about an exciting topic.

You can feel easily overwhelmed by sensory input but simultaneously feel a need for constant movement or fidgeting due to an internal need to move.

You may have meticulous and detail-oriented approaches in specific areas but struggle significantly with general organisation, planning, and task completion in other areas of life.

These internal conflicts can lead to masking and also burnout.

12/11/2025

Love this post about play. As professionals, we need to be aware that when assessing play and development in neurodivergent people, we need not compare them to neurotypical norms. To my knowledge, we do not have neurodivergent developmental norms and this is a area where research is needed. Be aware of how you describe the skills and needs of our neurodivergent clients without pathologising their natural way of engaging.

11/11/2025

This website may be helpful for accessing free worksheets for all ages!

11/11/2025

This goes out to all the parents who HAVE to parent differently, to all those parents who face criticism and judgement for their parenting style and who have to bite their tounge when they get unsolicited (and unexperienced) "advice" from others including family members, other parents, and professionals. This road is NOT easy, BUT you walk this different road to protect your child's mental health, because you know that parenting in the "usual" way does not fit your childs sensitive nervous system and makes things far worse. As a parent, who lives with your child, you see them day in and day out. You see the impact of unsuitable environments and the impact on their nervous system from masking all day when their frustration, overwhelm and sadness boils over as soon as they get home, their safe space. This is not an easy road, far from it, but you walk this path because you know its right for child.

When professionals write “mum is the problem,” they stop looking for the real one.

A few years ago, I received a file that described me as “controlling” and “the source of anxiety” as well as accusing me of seeking unnecessary diagnoses.

There was no evidence.
No collaboration.
Just a wall of silence when I asked questions.

What they didn’t see was a mother navigating emotionally based school anxiety, juggling advocacy meetings, and fighting to be heard — not for herself, but for her children.

Every word in that file carried weight.
And when those words became assumptions, they became harm.

I faced parent-blame.
I faced false allegations of FII (Fabricated or Induced Illness)
And I fought — with advocacy, evidence, and truth — until I cleared my name.

Something, that deeply upsets me, is that I know there are many other families still living in that fear. The resources I create is to stop this happening and to try and make the difference.

When services blame instead of listen, they stop children from getting the support they need.

Please — look beneath the behaviour, beneath the paperwork, beneath the parent-blame narrative. Because when we work with parents, not against them — that’s when change begins.

Have you ever faced parent-blame, or felt judged instead of supported?

11/11/2025

NEURODIVERGENCE PMDD AND MENOPAUSE:

Did you know that neurodivergent women with PMDD experience significant, challenges during the perimenopause and menopause transition due to hormonal fluctuations worsening existing neurodivergent symptoms?

The hormonal drops can intensify issues like brain fog, anxiety, and sensory sensitivities, while the loss of routine and predictability associated with perimenopause adds to stress and can make masking neurodivergence harder.

For many, menopause becomes the period that prompts a late-life diagnosis of autism or ADHD because symptoms escalate beyond what they can manage or mask.

Impact of perimenopause and menopause:

🎈Worsened ADHD symptoms: Estrogen's decline negatively impacts dopamine, leading to increased brain fog, forgetfulness, and reduced focus.

🎈Increased autism presentation: Emotional regulation, social anxiety, and sensory sensitivities can intensify.

🎈Increased anxiety: Hormonal fluctuations can disrupt the sense of control that many neurodivergent people rely on, leading to heightened anxiety.

🎈Difficulty masking: Hormonal changes can make it harder to maintain the "mask" used to conform to neurotypical standards, because the impact is greater than the persons ability to mask, often leading to burnout and distress.

🎈Late diagnosis: The escalating severity of challenges can be the catalyst for a late-life diagnosis of ADHD or autism.

Management and support:

🎁Hormone-sensitive care: Specialized medical care that considers the link between hormones and neurodivergent traits is crucial. Treatments like HRT may need careful tailoring due to sensitive systems.

🎁Stress and anxiety management: Techniques like mindfulness, meditation, yoga, sensory strategies and acupuncture can be helpful for managing stress, which in turn can help regulate emotional and cognitive symptoms.

🎁Support systems: Creating accessible support systems is vital. Traditional women-only spaces like "menopause cafes" may not be inclusive, so consider neurodiversity-specific groups.

🎁Workplace accommodations: Employers can provide support through policies that acknowledge the unique challenges, such as creating an environment where employees don't need to mask their neurodivergent traits.

11/11/2025

Did you know that high levels of cortisol (stress hormone), has been shown to damage cells in the hippocampus. The hippocampus is a part in our brain, responsible for memory (learning). Cortisol hinders the cells in our brain from receiving enough energy (glucose) as it is instead sent to the muscles for a response (fight/flight/fright reactions) to the percieved stress or danger.

This is the very reason why a stressed brain is incapable of learning. In order to support students to access learning, they must first feel safe and calm. If a child is in an anxious state in school, or even before they get to school, they will not benefit from being in school unless they are calm amd regulated.

10/11/2025

A recent research paper by Recio et al (2024), looked into autistic sensory and psychological distress and investigated how the role of worry and intolerance of uncertainty impacted distress. Their findings highlight the importance of worry and intolerance of uncertainty as specific targets in interventions aimed at improving stress and anxiety problems in autistic people.

This is why its so important that autistic people are informed about change, no matter how small that change is, because this will have a direct impact on their feelings of safety and sensory processing.

In schools, this will look like advanced warnings of :

Teacher change/ staff change.
Time table change.
Seasonal events.
Off plan days.
School photos.
School visitors.
Wet play/ dry play.
Change of seating position.
Change of lunch options.

There are so many changes happening in schools and this is often an area of high stress for students which can.lead to emotionally based school avoidance.

If you work in schools, colleges and universities, how do you pre plan for informing your students of changes?

Please share your good practice here to support other teachers and staff in developing good practices around this area.

These findings highlight the importance of worry and intolerance of uncertainty as specific targets in interventions aimed at improving stress and anxiety problems in autistic adults.

09/11/2025

ADHD masking, or "camouflaging," involves hiding or compensating for symptoms like inattentiveness, hyperactivity, and impulsivity to appear "neurotypical" and avoid social stigma.

While it may offer short-term social benefits, it often leads to significant long-term negative consequences such as exhaustion, burnout, anxiety, delayed diagnosis, and a confused sense of self.

Key Facts About ADHD Masking:

🎭Survival Strategy: Masking is fundamentally a coping or survival mechanism developed to fit in with societal expectations and avoid criticism or rejection.

🎭Common Behaviors: Examples include forcing oneself to sit still, over-preparing for social interactions or tasks, mimicking others' behaviors, obsessively checking belongings, and suppressing emotional responses or stimming (self-stimulating behaviors like leg bouncing or pen clicking).

🎭High Effort, High Cost: The constant mental and emotional effort required to maintain the mask can be exhausting and cause significant internal stress. This can result in burnout, chronic fatigue, and emotional dysregulation.

🎭Delayed or Missed Diagnosis: Successful masking can effectively hide symptoms from parents, teachers, and even healthcare professionals, leading to a delayed or missed diagnosis of ADHD, especially in girls and women.

🎭Mental Health Impact: Long-term masking is strongly linked to mental health issues like anxiety, depression, low self-esteem, imposter syndrome, and a higher risk of substance abuse.

🎭Identity Confusion: Over time, individuals who mask may lose a sense of their authentic self, questioning who they are beneath the persona they present to the world.

🎭Not the Same as Coping: While healthy coping strategies (like using reminders or organizing a workspace) can be beneficial, masking is about hiding the struggle, which is ultimately unsustainable and harmful when done longer term..

🎭Gender Disparities: Girls and women are more likely to mask their symptoms due to societal expectations for them to be polite and composed, which contributes to the higher rate of ADHD diagnosis in males.

Addressing Masking
Recognizing masking is the first step toward living more authentically. Strategies include seeking a professional diagnosis and treatment (which may involve medication or therapy like Cognitive Behavioral Therapy (CBT) adjusted for neurodivergent people), joining support groups, practicing self-compassion, and setting healthy boundaries where you may choose not to do all the things and gain more rest and down time.

Image by The Contented Child, Child Wellbeing Consultancy

07/11/2025

Puberty can be particularly challenging for neurodivergent individuals due to increased sensory sensitivities, emotional dysregulation, and executive dysfunction, and a sense of transition not in their control which can be exacerbated by hormonal changes.

Many neurodivergent young people experience puberty outside the typical age range, and autistic girls may start puberty earlier than neurotypical girls. These changes require more support and clear communication to navigate, as they can increase anxiety, confusion, and the pressure to conform or "mask".

Challenges during puberty:
⚡️Hormonal and brain changes: Puberty brings significant hormonal shifts that reshape the brain, which can lead to a dramatic increase in sensory sensitivities and emotional intensity for neurodivergent individuals.

⚡️Increased sensory and emotional sensitivity: Puberty can heighten sensory issues, making things like menstruation more difficult. It also often increases emotional dysregulation and anxiety.

⚡️Executive dysfunction: Tasks that were once manageable may become overwhelming, and the need for structure and predictability can become more urgent, while the world demands more independence and social conformity.

⚡️Social pressure and masking: The pressure to "fit in" can become acute, potentially leading to masking (copying peers, over-preparing for interactions, or withdrawing), which can result in burnout and self-doubt.

⚡️Misdiagnosis risk: Traditional diagnostic frameworks for conditions like autism and ADHD are often based on male-centric models, leading to many neurodivergent girls and gender-diverse youth being overlooked during this period.

07/11/2025

My page has had a fair new followers recently so I thought I would say "Hi" and share a bit about me.

My name is Moyna and im a neurodivergent Consultant Occupational therapist who is passionate about improving the lives of neurodivergent people and those with specific needs. I've been qualified since 2005 and been working in the field of Occupational Therapy since 2001.

I opened my independent practice in 2015 after having my son who is now 10 and worked for the NHS for about 15yrs. I have designed and built my own clinic to be able to deliver Ayres Sensory Integration Therapy to meet fidelity and have created content and lectured on the MSc course in Sensory Integration and the National Centre for Autism and Mental Health. I have a MSc in Sensory Integration and also am dual qualified in Sensory Integration in both the UK and internationally. I published research in 2021 in the field of Autism and Sensory needs and continue to engage in research and evidenced based practice.

In my spare time, I volunteer for the National Autistic Centre local branch offering training and education to our members, work in my Kung Fu School Schools of Kung Fu Sutton and train regularly in Kung Fu where im working towards attaining my Black Belt. I am animal mad, and have been so grateful to be able to integrate my passion for animals into my work where I have trained our dog as a Therapy dog under Pawsitive Squad and also recently introduced 2 guineapigs into my theraputic work.

I love paddle boarding with my dogs as I enjoy the peaceful environment of the river and being surrounded by wildlife. In addition to this I have taken courses in Djembe drumming, and regularly add music into therapy when appropriate.

In my pre motherhood years I travelled extensively and have visited over 35 countries. I love learning about different cultures and seeing different landscapes.

Welcome to all my new and existing followers, I hope you enjoy my content and feel able to share authentically in this neuroaffirming space.