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Gayle M. Perreault, Psy.D, is a 2026 graduate of the Psy.D. Program in Clinical Psychology at Antioch University, New England

Dissertation Committee:

  • Monique Bowen, PhD, Chairperson
  • Rachel Chickerella, PhD, Committee Member
  • Kristen Lauer, PsyD, Committee Member

Keywords

autism, camouflaging, late diagnosis, environmental influences, qualitative research, ecological model

Document Type

Dissertation

Publication Date

2026

Abstract

Some autistic individuals reach adulthood without receiving a diagnosis, and the processes contributing to delayed recognition are not yet fully understood. This study explored how contextual conditions across development related to the emergence and use of camouflaging behaviors in late-diagnosed autistic adults from groups historically underrepresented in autism research. Using an inductive collective case study design, narrative interviews were conducted with seven autistic adults diagnosed after age 15. The analysis examined how participants described learning, maintaining, and interpreting camouflaging behaviors across childhood through early adulthood within social, environmental, and institutional contexts, with attention to how participants experienced environmental expectations and responses related to camouflaging over time. Participants described camouflaging as gradually emerging through repeated social evaluation and feedback and becoming increasingly anticipatory over time. Effortful self-regulation was portrayed as emerging through interactions among intrapersonal experiences (including monitoring, anticipation, and emotional effort), interpersonal expectations, environmental fit, and institutional interpretations of behavior. Camouflaging was described as less prominent in predictable and accepting environments and more prominent in contexts characterized by uncertainty, correction, or high social demand. Across cases, participants linked increases in camouflaging to environments in which behavioral norms were unclear, socially consequential, or inconsistently interpreted, and described substantial cognitive and emotional effort associated with sustaining these behaviors. Participants frequently described receiving diagnoses later in life after periods in which competence, compliance, or alternative interpretations of their behavior shaped how their experiences were understood by others, particularly as contextual demands increased. These findings suggest camouflaging may be understood as a context-sensitive regulatory process rather than solely an individual strategy.  Framing camouflaging within environmental and developmental contexts helps illustrate how social expectations, institutional responses, and forms of environmental fit—including authentic, apparent, and adverse fit—were described as influencing whether camouflaging intensified or receded across participants’ lives. Consideration of effort, environmental demands, and interpretation of behavior may help inform contextually responsive clinical understanding and support for autistic individuals whose experiences may be interpreted as successful functioning within some contexts while remaining effortful or unsupported in others. This dissertation is available in open access at AURA (https://aura.antioch.edu) and OhioLINK ETD Center (https://etd.ohiolink.edu).

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ORCID iD 0009-0007-9543-9882

Gayle M. Perreault, M.B.A., M.Ed., M.S., BCBA, is a doctoral candidate in Clinical Psychology (Psy.D.) at Antioch University New England. Her dissertation, Hiding in Plain Sight: Environmental Influences on Camouflage in Late-Diagnosed Autistics, examines how environmental factors shape masking behaviors in autistic individuals diagnosed later in life.

Perreault brings over a decade of clinical and leadership experience in applied behavior analysis and neurodevelopmental services. Her work spans autism assessment, differential diagnosis, and intervention across the lifespan, with specialized training in neuropsychological assessment and evidence-based therapies including ACT, DBT, and EMDR. She has held roles in clinical program development, consultation, and higher education, and has led multidisciplinary teams supporting individuals with developmental disabilities and co-occurring conditions.

Her professional interests center on neurodevelopmental conditions across the lifespan. She is committed to advancing accessible, evidence-based care and contributing to research that informs both clinical practice and systems-level change.

Presentations

Perreault, G. M. (2026, March 21). Hiding in plain sight: Environmental influences on camouflage in late-diagnosed autistics. Poster presented at the Massachusetts Psychological Association Conference, Cambridge, MA. 3rd Place Poster Award.

Chaffee, M., Ciccoria, M., Milinder, L., and Perreault, G. M. (2016, October). Self-Care for the Behavior Analyst: Evidence-Based Practices. Panel discussion at NHABA Fall Conference, Manchester, NH.

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