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.

  • Haui@discuss.tchncs.de
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    1 year ago

    I appreciate that you took the time. The long duration of the disturbance is certainly something autistic people (usually) don’t experience.

    But the fact that it is cited in the dsm-v does not mean it is true. A couple years back you could not have adhd and autism at the same time it was either or.

    Thanks again and a have a good one.

    • ioen@lemm.eeOP
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      1 year 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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        1 year 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.

    • BOMBS@lemmy.worldM
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      1 year ago

      DSMs 1 & 2 had homosexuality as a mental health disorder. DSM 3 had “sexual orientation disturbance” & DSM3-R had “sexual disorder not otherwise specified” with “persistent and marked distress about one’s sexual orientation.” The current DSM5-TR has gender dysphoria. Source

      I think it’s important to understand that the DSM is an expression of the dominant culture.

  • EatYouWell@lemmy.world
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    1 year ago

    I wouldn’t be quoting the DSM-5 on autism. It’s horribly outdated on the topic. There’s a reason that many women don’t get diagnosed.

  • optissima@lemmy.ml
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    1 year ago

    You seem to be looking at DSM-5, not DSM-5-TR, the updated version. Do your claims still fit if you look at the DSM5TR?

  • Player2@sopuli.xyz
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    1 year ago

    I didn’t speak one word in school for 5 years. Talking fine at home. I’m not officially diagnosed or anything but pretty sure.

  • torpak@discuss.tchncs.de
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    1 year ago

    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.

    I am not arguing we should use non verbal but autistic shutdown is way to general because for me being (temporarily) unable to speak is only one of the first syptoms. It feels like a litteral “loss of words” since in those situations I’m unable to translate my thoughts into words.

  • webghost0101@sopuli.xyz
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    1 year ago

    Ok wise guy, how would you refer to this “mechanic” within autism?

    Also read up neurodivergent, medical labels aren’t hardcoded in reality

    • Deestan@lemmy.world
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      1 year ago

      You can and should give that feedback, and your opinion, without sarcasm and hostility.

      • webghost0101@sopuli.xyz
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        1 year ago

        I tried to to make it sound funny while going trough some difficult stuff myself.

        But your 100% correct, I usually try not to be judgmental and i slipped up, on the autism community of all places.

        I’ll leave the comment because otherwise people may assume worse if they see removed but I regret making it.

  • BOMBS@lemmy.worldM
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    1 year ago

    Kind of relevant:

    I verbally shut down when my brain is burnt out. It’s like my brain checked out, and now I’m a passive prisoner doomed to ride out the experience. I can’t say anything and don’t want to though I know everyone else is thinking I’m weird at the moment. The last time this happened, I was chilling with friends around a fire and just mesmerized looking at it. I don’t know how to explain it other than my brain said it was done. In cases where I absolutely have to talk (eg teach a class), I will talk slower and take ~15-minute breaks to go sit in a bathroom stall. Also, I may vomit ~1/10 times in the situations where I’m forced to speak 😬.