Why Masking Can Lead to Burnout in Neuro Divergent Girls & Women: A NYC Speech Therapist’s Personal Perspective

Throughout my childhood and academic career I received glowing teacher reports and high grades while often receiving perfect marks.

My parents would often hear from teachers at our parent-teacher conference nights that “they wished all their students were as studious, conscientious, and as hard working as Heather.”

All those things were true – I was a dedicated, passionate and a super focused student.

However, there can be a darker underbelly to these perfectionist and hard working tendencies that can often lead to physical and emotional burnout over one’s lifetime.

I hid my struggles really well in the classroom during the school day hours. Teachers read my well edited homework and gave it high grades while complimenting my attention to detail.

But secretly many nights after school I completely crashed.

Exhausted from a day filled with classroom time, after school tutors, physical therapy and required participation on athletic teams.

Often homework ended in tears and inner and outer combustions that only those closest to me were ever in witness of.

My parents would often hear me proclaim vehemently on homework nights that I would simply never be able to divide or spell correctly.

Fast forward – spell check and calculators are definitely on my trusted tool list!

To the outer world – I was succeeding and thriving.

But many nights I was muscling through tasks and spending hours on homework each night; desperate to achieve what appeared to come naturally to others like: reading, writing and math.

Looking back with 20/20 vision, now armed with my many decades of knowledge and practical application of the tools I have learned about energy management and neurodiversity I can now handle these periods of frustration with more grace and some laughter!

I only wish that these tools were more readily available to me at the time of my education.

I started writing my Creating Voices ™ blog to provide accessible, compassionate resources and support for all my readers and clients.

Creating Voices Blog was formed to provide accessible, practical knowledge to teachers, parents, caregivers, helpers, healers and neurodivergent people alike – all looking for an easier path forward to learning and living.

I Have Traveled This Same Path.

In writing Creating Voices Blog – I have forged a path forward filled with resources and support from professional and personal lived experiences for neurodivergent children and adults alike.

I still have days where I run out of spoons and need to pause and recharge.

However, as I implement the tools I have learned to use daily in my own life – I now live a more balanced and authentic life.

I am longer chasing cycles of over performance, burn out and recovery.

My personal journey and path has been traversed by learning how to listen to my body’s inner signals and engaging in self-care for myself daily in small regulating activities and windows each day – well before fatigue or overwhelm take hold.

And sometimes, I stumble. Then, get back up and practice again.

This level of introspection can be an area of challenge for neurodivergent people, but with the right support and guidance you and your child can learn the skills needed to successfully co-regulate tougher – improving equanimity and resilience.

Masking Can Commonly Lead to Extreme Fatigue.

Many young girls and women that are twice exceptional, highly sensitive or neurodivergent struggle to fit into the bell curve of overachievement containers that we are so often placed into.

Teachers and bosses often praise and reward our advanced and speedy abilities to read, synthesize and apply information.

But too often these same teachers and bosses inadvertently fail to recognize the emotional, social , academic or career pressures that are felt by highly sensitive, neurodivergent or twice exceptional women.

Neurodivergent Women Are Expert Level, Ninja Warrior Level – Maskers!

We are excellent maskers because it’s extrinsically rewarded by society and within our everyday lives – all the time – by belonging, fitting in and achieving high levels of success.

Sometimes these high-level masking behaviors can lead to serious short term or even long term consequences to your health and well being that are far too often overlooked or not spoken about.

Neurodivergent burnout can creep up on you slowly after years of over-masking and over-performing.
Neurodivergent burnout can also come out of nowhere and hit you one day like a ton of bricks.

The important and powerful idea to remember is that you, your child, and your family can learn how to heal and prevent burnout cycles with trusted and knowledgeable support and resources from professions that care.

You can learn how to prevent further cycles of over performance, burnout and recovery from occurring again – stopping the cycle in its tracks.

Burnout Is Often Caused By Years of Over Masking and Over Compensating.

Let’s talk about masking in the neurodivergent population and how it can create a pattern of over performance followed by burnout and needed recovery time.

I’ll discuss why the neurodivergent population is at risk for these common cycles of over masking.
I’ll share tips on how we can be better proactive detectives and protectors for our wellness by becoming more aware of the signs and symptoms of overwhelm – well before burnout takes hold.
We address some of the root causes of these cyclical patterns of burnout using preventive and proactive awareness, nervous system regulation tools and individualized self care protocols.

These simple and actionable tools can bring increased equanimity and calm for your family and home.

What Is Masking?

Masking is a term that the Neurodivergent, Autistic and ADHD communities use to describe when a person suppresses their natural tendencies or talents to conform to a neurotypical norm.

Masking is performed to avoid negative consequences for appearing outside of a societal typical, acceptable, or agreed upon norm within a given culture, organization, institution or assigned role.

What Are Some Examples of Masking Behavior:

Repressing soothing behaviors – like tapping, spinning, flapping hands or legs.
Maintaining eye contact – even when it feels uncomfortable with a communication partner.
Tolerating sensory environments or stimuli that are painful or uncomfortable for your sensory system or body.
Censoring your ideas and thoughts due to fear of judgement and sense of belonging.
Overcompensating through overworking, over producing and overgiving.

Can Neurodivergent Masking Lead to Burnout?

Continued and prolonged masking can absolutely result in a negative effect on one’s well-being, authenticity and overall quality of life and success.

Consistent over masking can have health consequences that affect one’s mental health, emotional health and physical well being.

Can Masking Lead to Other Health Challenges?

Women are 80 percent more likely to be diagnosed with chronic autoimmune and chronic fatigue conditions in their lifetimes.

I imagine that a high percentage of these women are also neurodivergent and have masked, over-given and over-performed most of their lives to fit into an agreed upon structure or system that does not authentically align with them.

New studies coming out are also linking ADHD to an increased risk of heart attack, high blood pressure and stroke.

Here is the latest research: Cerebrovascular diseases in ADHD patients with metabolic comorbidities: a retrospective cohort study – PMC

I personally hypothesize that these higher incidences could be related to a lifetime of outer physical nervous system dysregulation and inner emotional challenges; coupled with frequent sensory system overloads and years of masking which can cause stress on the entire vascular system.

There is hope!

This is my personal mission!

I educate neurodivergent girls and women how to reclaim their lives through practical and effective tools that teach neuro-affirming practices leading to improved regulation and health.

What Can We Do To Live A More Balanced Life Today?

How can we start to embrace and model these skills of balance and compassion for ourselves and for our children?

How can we live a more balanced life filled with peace and equanimity?

I have 3 simple actions that you can begin today to create a more balanced life for yourself and your family.

Edit your family’s schedule – say no to activities that don’t bring you shared joy, connection and regulation and say yes – to those that do. Allow time for rest, relaxation, and creativity – with no planned activities.
Notice when an activity or event creates tension or overwhelm in your body – consider how you can modify that activity to make it more enjoyable or maybe cut it out of the schedule.

Notice when a certain environment or activity creates pause and calm throughout your day and add more of that into your day.

Create a daily log of your child’s activities and tasks. Note the activity and how your child felt during it . Then modifications can be made in the future to increase feelings of calm and confidence – particularly during transitions.

Engage in a personalized proactive, daily mixture of regulating activities of your choice – maybe it’s meditating , dancing, journaling, walking or spending time with friends. Take moments to rest and restore after a busy school or work day.

Taking 10 minutes to pause and breathe and smell the roses – goes a long way.

I love to use this simple breathing technique for quick relaxation practice with my clients.

Hold out your finger out in front of you and repeat:

Smell the flowers – inhaling deeply and slowly for a count of 3 in through your nose.
Blow out the birthday candles – exhaling deeply and slowly for count of 6 out through your mouth.

With awareness and practice you can teach yourself and your child how to stop cycles of masking and burnout in their tracks.

Reach out to me at: heatherb@chattychild.com for added tips and tricks and 1:1 support.

Drop in the comments below your favorite regulating activities after a long day of work – I might just try them myself!

Until next time …

Sincerely,

Heather Lynn Boerner MA CCC/SLP

Chatty Child Is Here to Help You, Your Child and Your Family.

We are an experienced team of speech-language pathologists and occupational therapists who can help create a tailored made program for your neuro-diverse learner.

If you are ready to experience the difference in personalized, holistic, neuroaffirming care today – reach out to the Chatty Child Team today – we are here to help you navigate this path.

We offer personalized neurodivergent affirming, speech, language, feeding and occupational therapy therapy,

as well as creative mindfulness classes for all ages and abilities.

In person and online options are available for all therapeutic sessions and classes.

Our speech and occupational therapists are here to support all your child’s therapeutic needs.

I invite you to schedule a tour – to discover the support waiting for your child – at Chatty Child.

Let’s create excellent communicators, confident voices, calm minds, and limitless possibilities – together!

Begin Children’s Speech and Occupational Therapy for Learning Success:

At Chatty Child, we believe every child deserves to feel capable, confident at school, at home, and in the community. If your child is struggling here is how to get started:

Contact us or call 347.491.4451 for a free 15-minute conversation to discuss the classroom challenges your child is facing and how speech therapy can help.
Schedule a comprehensive evaluation that may include school observations to understand your child’s needs in their actual learning environment.
Begin individualized therapy sessions with goals focused on the skills that support classroom success—from auditory processing to executive functioning to speaking confidence.
Collaborate with your child’s therapeutic team through regular communication, team meetings, and shared strategies that create consistency across home and school.

Your child doesn’t need to struggle alone. With the right support, they can build the communication skills and confidence that makes learning joyful, friendships easier, and confidence possible.

Holistic Speech, Feeding & Occupational Therapy Services for Children in NYC

At Chatty Child, we support children as they develop the communication, cognitive, and social-emotional skills that help them thrive at home, in school, and in their community. Our approach looks at the whole child, recognizing that language development is deeply connected to learning, relationships, and self-confidence.

Our services include:

Speech Therapy – Individualized, play-based support for language development, speech clarity, social communication, and everyday confidence.
InterAct – A storytelling and play-centered program that strengthens language, imagination, and connection through shared narrative experiences.
Mindfulness classes for all ages – support for emotional, sensory and self regulation, curated classes using mindfulness and meditation practices
Occupational Therapy – Support for sensory processing, motor development, and independence in daily routines and self-care skills.
hum studios – Mindfulness and compassion-based classes that foster emotional awareness, regulation, and accessibility for children of all ages.
Teletherapy – Flexible virtual speech and occupational therapy services available throughout New York State.
Tutoring – Personalized academic support focused on reading, writing, comprehension, and critical thinking skills.
Functional Nutrition – Developmental support strategies that use nutrition-informed approaches to support regulation, attention, and overall well-being.
Consulting – Collaborative guidance for parents, caregivers, and educators to support consistency across home, school, and community environments.
Group Programs – Small-group sessions that build communication, social interaction, and emotional skills through guided peer engagement.

Meet Heather Boerner, Trusted Pediatric Speech-Language Pathologist & Feeding Specialist in NYC

Heather Boerner, MA, CCC-SLP, is a licensed, nationally certified speech-language pathologist with over 23 years of experience supporting children through pediatric speech therapy in NYC. Her clinical work is shaped by training in mindfulness, a trauma-informed perspective, and her lived experience as a neurodiverse, differently-abled individual. These elements inform her deeply responsive, whole-child and neuro-affirming approaches to care.

Motivated by her personal journey, Heather founded Chatty Child Speech, Occupational & Physical Therapy, PLLC. The practice is built on creativity, collaboration, and individualized support. She works closely with schools through classroom observations and team meetings to ensure children receive consistent, coordinated care. Heather is also the author of Carrie the Colorful Chameleon, a children’s book created to encourage confidence, curiosity, and connection.

Heather and her team offer in-person therapy at the Tribeca clinic and virtual services throughout New York State. Together, they help children build the communication skills, confidence, and self-advocacy abilities they need to thrive in school and beyond.