SELECTIVE MUTISM INFORMATION & RESEARCH ASSOCIATION
Registered Charity No. 1022673
One question that comes up frequently, with relation to Selective Mutism, is how can we diagnose SM in a case where the patient also has a diagnosis for another disorder such as ASD?
At SMIRA we have seen many cases of comorbid (or co-existing) SM with other disorders particularly those on the Autism Spectrum (ASD).
Many of the diagnoses of SM precede ASD assessments, although some SM assessments do come after an ASD assessment. The problem we see is that in some cases the SM assessment is not performed because it is assumed that the ASD assessment is enough to explain all of the behaviours apparent in the patient.
SMIRA’s position on diagnosis of SM
a. Diagnosing practitioners should make an assessment for SM where they believe the patient meets the criteria for such a diagnosis.
- The preferred diagnostic criteria at this date are those published in APA DSM5, which lists SM as an anxiety disorder.
b. Diagnosing practitioners should make a separate diagnosis for SM even if there is a preexisting diagnosis for another disorder. SMIRA believes that ‘excluding’ SM as a comorbid diagnosis has been very unhelpful to medical practitioners and their patients. This is especially true in the case of ASD. Of course a person with ASD can also be selectively/situationally mute (SM).
This position was made clear in the Tackling Selective Mutism book, which was then endorsed by Professor Sir Michael Rutter (Institute of Psychiatry, King’s College London).
Alice Sluckin and Benita-Rae Smith
(see ‘Tackling Selective Mutism’, Smith and Sluckin 2015).
SM – Selective Mutism
ASD – Autism Spectrum Disorder
Tackling Selective Mutism, Sluckin-Smith, 2015
Please refer to the SMIRA bibliography published on the www.selectivemutism.org.uk site.
© Copyright 2016 SMIRA