Some autistic people are usually able to speak, but lose their ability to speak when subject to stress or exhaustion. It has become common in the online autism community to refer to these non-speaking episodes as “selective mutism”, due to a concern that calling it “non-speaking” or “non-verbal” is offensive to those with more severe autism.

As I will explain below, it is incorrect to use the term “selective mutism”, for three reasons:

  • selective mutism is a specific mental disorder with a diagnostic process, not just a term you can apply anywhere it sounds right;
  • autistic people’s non-speaking episodes do not fit the DSM-V diagnostic criteria for selective mutism;
  • the DSM-V criteria specifically state that you cannot diagnose selective mutism in an autistic person even if the symptoms do match.

Firstly, “selective mutism” is not simply a phrase meaning “sometimes can speak and sometimes can’t”. It is a mental disorder listed in the DSM-V. If someone hasn’t been diagnosed with selective mutism, or hasn’t made sure the diagnostic criteria apply to them in the case of self-diagnosis, you shouldn’t apply the term to them. The definition and criteria for selective mutism are linked here.

Secondly, the diagnostic criteria for selective mutism are not consistent with the non-speaking episodes suffered by autistic people. Here is Criterion A from the DSM-V:

Consistent failure to speak in specific social situations in which there is an expectation for speaking (e.g. - at school) despite speaking in other situations.

This is what is meant by “selective”, that the inability to speak only happens in certain social contexts. This is not true for autistic non-speaking episodes, which typically involve being unable to speak in any context, even to family and close friends. When the episode is over they regain the ability to speak in all contexts. This is not what the selective mutism checklist is describing.

Next is Criterion C:

The duration of the disturbance is at least 1 month (cannot be during first month of school).

Again this obviously does not apply to autistic people, whose temporary inability to speak may only last a few weeks, days or even a few hours.

The prognosis section notes that selective mutism is mostly found in children and most children grow out of it. This also does not describe the experience of autistic people.

But thirdly and most importantly, it is literally impossible to have both autism and selective mutism. Even if the above criteria do apply, along with Criteria B and D, this is what Criteria E says:

The disturbance is not better explained by a communication disorder (e.g. - childhood-onset fluency disorder) and does not occur exclusively during the course of autism spectrum disorder, schizophrenia, or another psychotic disorder.

Obviously autism spectrum disorder is a lifelong disorder, so anything that happens in your life occurs “exclusively during the course of autism spectrum disorder”. Therefore no one with ASD can be diagnosed with selective mutism.

They do not need to be diagnosed with a disorder to explain language and communication problems, because those problems are explained by the diagnosis of autism spectrum disorder.

As for what these non-speaking episodes should be called. The term “non-verbal” is not accurate since it means “without words” or “without language”. Indeed, it is rarely accurate even when used to describe permanently non-speaking adults, who are often able to understand speech, read and write, and who often prefer the term “non-speaking”.

In this post I have been using that term “non-speaking episodes” because it factually describes what is happening. Some people suggest “autistic shutdown” which is common in the community.

  • ioen@lemm.eeOP
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    8 months ago

    Thanks friend. The main criticism from all the comments seems to be that I’m treating the DSM-V as a source, so I’m not necessarily directing these comments at you, just replying because your comment is the highest up.

    So I get that people don’t trust the DSM-V, but what’s the other side of this issue? Is there a community of health professionals and of adults with selective mutism, who say that it isn’t caused by anxiety, that it’s brought on being overwhelmed, that it’s intermittent and not long term, that it doesn’t depend on context (which seems to be the essential definition of the condition which distinguishes it from other disorders)?

    I’m happy to be told the DSM is wrong, but I’d want to be told that by people living with selective mutism. Not by people who don’t have it, who chose the term because the name sounds relevant, in order to apply it to other people!

    • Haui@discuss.tchncs.de
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      8 months ago

      Thanks for answering.

      Just to clarify: I don’t think the DSM-V is wrong and I think it is an excellent source.

      But if the DSM-V says that „…can’t be diagnosed while autism…“ does sound like the adhd/autism thing and this is what I think gets people worked up.

      That also may be the reason why someone said you treat it like the „bible“ which is a metaphor for using it too strictly as in „the dsm-v has been wrong before and only represents todays knowledge and could be changed tomorrow. Dont use it as sole reference“.

      And as I said as well, you did reference the minimum timespan which is afaik not the way autistics experience this kind of thing. So they really only don’t like the „you cant say selective mutism because dsmv says not autism“ thing.

      Sorry for repeating the same thing but I wanted to get the angle right to reduce misunderstandings. I hope I did a decent job.