By Dr. Elisa Shipon Blum and Dr. Jenna Blum

🏡 The Biggest Clue: What Happens at Home?

When trying to understand whether a child has Selective Mutism (SM), Autism Spectrum Disorder (ASD), or both, one of the most important questions is simple:👉 What happens at home? Home is usually where a child feels most comfortable. It is often the place where their natural communication style is easiest to see.

🧠 When it may be SM:

In classic Selective Mutism, the difference between settings can be striking. At home, a child may be:

  • Talkative 🗣️
  • Silly 🤪
  • Expressive 🎭
  • Socially engaged 💞

In other settings, that same child may:

  • Become silent
  • Speak very little
  • Appear frozen or shut down

This contrast is a strong indicator that anxiety is playing a central role. The child has the ability to communicate, but anxiety interferes with access to speech in less comfortable environments.

🧠 When it may be ASD

With autism, there may still be differences between settings, but the core challenges tend to remain present. At home, a child may:

  • Have difficulty with back-and-forth conversation 🔄\
  • Struggle with flexibility 🔁
  • Find it hard to interpret social cues 🧠
  • Show reduced or inconsistent social engagement 🤝

You may also notice:

  • Strong or focused interests 🎯
  • Repetitive behaviors 🔁
  • Unique speech patterns 🗨️
  • Ongoing sensory sensitivities 👂

Comfort can help, but it does not fully remove these underlying differences.

🎭 The Role of Masking and Support

Some children mask their challenges well. Others receive a great deal of support at home without anyone realizing how much help is being provided. Parents may:

  • Prompt responses
  • Fill in gaps
  • Explain social situations
  • Guide conversations

As a result, the child appears to manage, but the level of support may be easy to overlook.

🔍 What to Notice at Home

To better understand your child’s communication, consider the following:

🗣️ Conversation

  • Can your child answer open-ended questions?
  • Do they expand on their responses?

🔄 Give-and-take

  • Do they engage in back-and-forth conversation?
  • Do they respond and then ask something in return?

🚀 Initiation

  • Do they start conversations on their own?

🎲 Flexibility

  • How do they handle changes in plans or routines?

👨‍👩‍👧 Social situations

  • What happens during playdates?
  • Family gatherings?
  • Unstructured moments?

🎥 Why Observation Matters

Home videos, parent input, and thoughtful questions provide valuable insight. They help show what communication looks like when a child is comfortable and whether challenges are situation-based or more consistent across environments.

The home environment often provides the clearest clues. It helps answer an important question: Is communication present but blocked by anxiety, or are there broader social communication differences that persist across settings?

❤️ A Note to Parents

Your observations matter. You see your child in the setting where they are most at ease. What you notice helps guide understanding and supports the path toward the right interventions.

If you’re seeking an Autism Evaluation, we’re here to help! Call us at (215) 887 5748, or email us, to learn more!