Objective  To explore the social characteristics, psychological experiences and support needs of young people in Chinese online neurodiversity (ND) communities from an insider community perspective.

Methods A community-participatory mixed-methods approach was adopted. Participants were recruited through Chinese online ND communities. A total of 103 valid questionnaires were collected, and semi-structured interviews were conducted with 12 ND youth. In addition, artificial intelligence (AI)-assisted text analysis was used to quantitatively explore publicly available comments from online communities and interview transcripts.

Results Most ND youth (86.4%) expressed some desire for social connection but experienced varying degrees of social difficulty. Overall, 98.1% of participants reported using strategies to adapt to social interactions, with social camouflaging being a common coping strategy. Only 19.4% considered these efforts to be effective, and such efforts were accompanied by varying degrees of psychological and physical burden. Qualitative interviews showed that the social difficulties experienced by young ND individuals involved differences in cross-neurotype communication, adaptation to social rules, social masking, sensory environments, and social support. AI-assisted text analysis showed that neutral sentiment predominated (61.5%), while frequently occurring words concerned social difficulties, psychological distress, understanding, inclusion, and environmental support.

Conclusion The social difficulties experienced by ND youth should not be attributed simply to reduced social motivation, but are associated with differences in cross-neurotype communication, environmental fit, and the burden associated with social camouflaging. Greater emphasis should be placed on reciprocal person–environment adaptation and on developing more inclusive and accessible support systems.