First things first, many people within the neurodivergent community believe the term “selective mutism” ought to be done away with. The inability to speak in these situations is no more a choice or “selection” than the anxiety that causes it. The more welcomed term is “situational mutism”, in that in some situations you speak, and in others you do not.
What Is It?
Selective mutism is a severe anxiety disorder where a person is unable to speak in certain social situations, such as with classmates at school or to relatives they don’t see very often.
SELECTIVEMUTISM.ORG.UK
I’m going to get a bit big for my boots here. But I suspect a lot of autistic people, and parents of autistic people, would agree with me on this one…
Under current DSM-V criteria, it is technically impossible for an individual to be diagnosed as both autistic, and with SM. This is because people with SM diagnostically have normal social and language skills and, according to the DSM-V, autistic people do not. However, as many autistic people will attest, being autistic does not immediately mean you behave in the same way in all situations. Parents of children displaying non-verbal behaviours are often told things such as the following:
Autism and selective mutism may appear to be similar; when children with selective mutism feel anxious, they often react with a lack of eye contact, a blank expression, and a lack of verbal communication. However, children with selective mutism act differently across situations. They are often very social and talkative within comfortable situations, but shy and quiet in others. In contrast, if a child has autism and is non-verbal, they are usually non-verbal across all types of situations (e.g., at home and at school).
ANXIETY CANADA
I strongly believe this sort of information is both incorrect and damaging. While the DSM-V supports this as “fact”, insight into autism, its presentation as a spectrum, and the related behaviours, has improved dramatically since the DSM-V was published in 2013. Ten years is an incredibly long time in this field. When the DSM-V was published, it was believed that approximately 1 in 69 people was autistic. Now the stats are closer to 1 in 36 (and closing. Give it time, people. Give it time. We are EVERYWHERE).
So yes, while technically situational mutism and autism can’t be comorbid, frankly, they can be, and they frequently are. Ask the majority of autistic people and their families.
What Is It Not?
Situational mutism is not the same as being shy.
It is not a child who doesn’t have good manners, or who hasn’t learned appropriate social skills.
It is not malicious, targeted, or directed at specific people. However, as it is triggered by anxiety, some people can be more likely to trigger it than others.
Perceiving situational mutism as anything to be offended by, or critical of, means you don’t understand it.
It should only ever be met with acceptance and kindness, as should any expression of anxiety.
How Can I Help?
As situational mutism is a behaviour triggered by extreme anxiety, any person experiencing this should not be treated as a person unable to speak, but as a person who is feeling very anxious. Calm, kindness, and acceptance are key.
Where communication is important, or a relationship is being developed (often in order to reduce aforementioned anxiety), consider alternate means of communication.
For example, if your grandchild is visiting for dinner and is experiencing situational mutism when you ask what they’d like for dinner, instead consider bringing them the recipes you’re choosing from, or the two main ingredients, holding them within reach, and asking, “Which of these would you prefer?”.
Basic sign language, Makaton boards, or Augmentative and Alternative Communication (AAC) devices, are all excellent alternatives to speech, and should be considered equal. If a child with situational mutism communicates, that is a fantastic achievement.
Silent interaction, where communication isn’t necessary, can help ease anxiety, and develop trust which may reduce future SM episodes. Sitting down near a child who is watching TV, and simply watching with them; offering a puzzle piece; taking turns on a slide; there are many ways you can engage without the need for speech.
No-one wants to be judged for being anxious. Criticism or avoidance can be very damaging to someone experiencing SM. Even if you feel the best option is to back off, a positive comment like, “I’m going to be over here if you’re looking for me,” can allow them to know they haven’t inadvertently ostracised themselves, and are still welcome and accepted.