Is It Selective Mutism, Autism, or Both? 

A Parent’s Guide to Understanding Overlapping Features and Key Differences

by Dr. Elisa Shipon-Blum

As a parent, it can be confusing—sometimes even overwhelming—when your child is struggling to speak in certain situations. You may hear words like Selective Mutism (SM) or Autism Spectrum Disorder (ASD) and wonder, “Which one is it?” Or even more puzzling: Could it be both?

The truth is, Selective Mutism and Autism can look very similar on the surface, especially when a child has difficulty speaking or engaging socially. However, understanding the underlying reasons why your child isn’t speaking or socially connecting is the key to getting the right support.

Let’s break it down.

🧩 What Is Selective Mutism?

Selective Mutism is a social communication anxiety disorder, not a willful refusal to speak. Children, teens, and even adults with SM are often able to speak comfortably in certain settings (like home), but become frozen or shut down in others (like school or public spaces). This is not shyness—it’s a phobic-level reaction to the expectation to communicate.

Core features of Selective Mutism:

• Speaks comfortably in familiar, low-pressure environments (often at home).
• Becomes nonverbal in specific social settings due to anxiety.
• Often socially observant, wants to connect, but feels stuck.
• Struggles with verbal initiation, expression, and elaboration—not just speaking.

Children with SM want to speak—they just can’t in certain settings due to intense anxiety, often triggered by social scrutiny or performance pressure.

🧠 What Is Autism Spectrum Disorder?

Autism Spectrum Disorder is a neurodevelopmental condition that affects how a person communicates, interacts socially, and processes the world. Challenges may be present across many environments—not just in specific situations.

Core features of Autism:

• Difficulty understanding the “social puzzle” (e.g., social cues, back-and-forth conversation).
• May have restricted interests or repetitive behaviors.
• Sensory sensitivities (e.g., to noise, textures, lights).
• Communication differences—can include speech delays, echolalia, or flat affect.
• Challenges with social reciprocity and perspective-taking.

Children with ASD may not realize or desire to socially engage in the same ways as peers—or they may want to but don’t know how.

🤔 Why Do They Get Confused?

Because both SM and ASD can involve:

• Difficulty speaking in social settings
• Limited eye contact
• Social withdrawal or seeming “shy”
• Sensory sensitivities
• Repetitive behaviors or rigidity

From the outside, a child with SM might look like they’re avoiding others, and a child with ASD might look like they’re “just shy.” But what’s causing those behaviors is very different—and that distinction changes everything when it comes to treatment.

⚖️ SM vs. ASD: Key Differences

🧠 What If It’s Both?

It’s absolutely possible for a child to have both Selective Mutism and Autism—and in fact, many children do.

Research and clinical experience show that many children with co-occurring SM and ASD have a unique profile:

• They may want to connect socially but struggle with how.
• They may be selectively mute due to anxiety but also have underlying communication or sensory differences that make social interaction more complex.
• They may not appear anxious in the typical ways, yet still be highly avoidant due to social confusion or overwhelm.

Understanding this dual presentation is critical—because it means the treatment must address both anxiety and social-communication support.

🔍 Why an Evaluation Matters

If you’re wondering whether your child has Selective Mutism, Autism, or both, the next best step is a Selective Mutism Evaluation (SME) or an Autism evaluation.  We do these evaluations at the SMart Center (telehealth or In-person).  Alway look for a team that understands both conditions and will assess:

• Social communication skills across settings
• Emotional and sensory regulation
• Cognitive, language, and behavioral patterns
• Your child’s baseline stage of communication using tools like the Social Communication Bridge®

🛠️ How the S-CAT® Approach Helps

Developed by Dr. Elisa Shipon-Blum, the Social Communication Anxiety Treatment® (S-CAT®) model focuses on the why behind Selective Mutism and builds communication gradually across a child’s comfort level.

For children with both SM and ASD, S-CAT® integrates:

• Anxiety-reduction strategies
• Social engagement and motivation tools
• Concrete social and communication Action Plans to help with social connection and navigating social conversation.
• Visuals, structured supports and step by step goals for communication scaffolding

💬 Real-World Example

Sam, age 8, was completely nonverbal at school and playdates. At home, he talked nonstop and even role-played imaginary games. Initially diagnosed with Selective Mutism, Sam did begin to speak, although inconsistent. His primary challenges became less about verbalization but challenges with social skills and give/take of conversation (social reciprocity)

Sam had an autism evaluation due to social skill challenges, difficulty with social imagination, flexible thinking, and understanding conversation flow.

Further evaluation revealed underlying Autism Spectrum Disorder.

With a combined S-CAT® approach and ASD-informed supports (e.g., visuals, communication mapping, sensory accommodations), Sam began progressing across the Social Communication Bridge®—not just speaking, but understanding how to socially connect.

🧭 Final Thoughts for Parents

If your child is struggling to speak in social settings, trust your instincts—but also dig deeper. Ask:

• Is this anxiety alone?
• Are there signs of a deeper social-communication challenge?
• Is my child’s struggle consistent across all settings—or tied to specific environments?
• Do they want to connect—but just don’t know how?

Understanding the WHYs behind the silence is the first step toward helping your child move forward.

📌 You’re Not Alone

At the SMart Center, we’ve worked with thousands of families facing these exact questions. Whether your child has SM, ASD, or both, there is hope—and there is a path forward.

If you’re unsure where to begin, a Selective Mutism Evaluation (SME) is often the first step. From there, we can guide you toward the right supports, tailored to your child’s unique profile.

📚 🧪 The SMart Center Offers Autism Evaluations

The SMart Center is not only a leader in the treatment of Selective Mutism but also offers comprehensive Autism Spectrum Disorder evaluations. These assessments are conducted by highly trained clinicians who specialize in both SM and ASD, ensuring a differential and accurate diagnosis.

Our evaluations look at:

• Core autism features (social, communication, behavioral)
• Selective Mutism-specific symptoms
• Overlapping and co-occurring conditions (e.g., ADHD, sensory processing issues)
• Functional communication across environments

This integrated approach ensures that families receive a clear diagnostic picture and a treatment plan that fits your child’s unique needs.

Want to Learn More?
Explore our resources on Selective Mutism, Autism, and how to support your child at www.SelectiveMutismCenter.org.