Symptoms of Selective Mutism in Non-clinical 3- to 6-Year-Old Children: Relations With Social Anxiety, Autistic Features, and Behavioral Inhibition

Abstract

Selective mutism (SM) is a psychiatric condition that is characterized by a failure to speak in specific social situations (e. g., at school) despite speaking normally in other situations (e.g., at home). There is abundant evidence that anxiety, and social anxiety in particular, is a prominent feature of SM, which is the main reason why this condition is currently classified as an anxiety disorder. Meanwhile, there is increasing support for the notion that autism-related problems are also involved in SM. The present study examined the relations between SM and social anxiety, autistic features, and behavioral inhibition to the unfamiliar (i.e., the tendency to react with restraint and withdrawal when confronted with unfamiliar stimuli and situations). Parents of 172 3- to 6-year-old preschool children completed an online survey for measuring the relevant constructs. Results showed that there were positive and statistically significant correlations between SM and social anxiety, autistic features, and behavioral inhibition. Regression analyses revealed that (1) both social anxiety and autistic features accounted for a significant and unique proportion of the variance in SM scores, and (2) that both of these variables no longer made a significant contribution once behavioral inhibition was added to the model. It can be concluded that while the involvement of social anxiety is unambiguous in SM, autism-related problems are also implicated. Furthermore, behavioral inhibition seems to play a key role in the non-speaking behavior of non-clinical young children.

Symptoms of Selective Mutism in Middle Childhood: Psychopathological and Temperament Correlates in Non-clinical and Clinically Referred 6- to 12-year-old Children

“…Second, besides a sample of nonclinical children (Sample 1), the present study also included clinically referred children with SM and children with other social-emotional psychopathology (Sample 2). In keeping with our previous study [28], we expected to find positive correlations between social anxiety, behavioral inhibition, and ASD symptoms on the one hand and symptoms of SM on the other hand. We also anticipated that social anxiety and ASD symptoms would each explain a unique and significant proportion of the variance in symptoms of SM, but that these variables would no longer make a significant contribution once the temperament trait of behavioral inhibition was added to the model [28].…”

“…In keeping with our previous study [28], we expected to find positive correlations between social anxiety, behavioral inhibition, and ASD symptoms on the one hand and symptoms of SM on the other hand. We also anticipated that social anxiety and ASD symptoms would each explain a unique and significant proportion of the variance in symptoms of SM, but that these variables would no longer make a significant contribution once the temperament trait of behavioral inhibition was added to the model [28]. Finally, in the clinically referred children with SM, we anticipated not only higher levels of social anxiety and behavioral inhibition but also elevated levels of ASD symptoms.…”

“…In our previous investigation of this hypothesis, we explored the relative contributions of social anxiety, anxiety proneness (i.e., the temperament trait of behavioral inhibition), and ASD symptoms to symptoms of SM [28]. Constructs were measured by means of a set of parent-report questionnaires that were completed by the mothers and/or fathers of 3-to 6-year-old non-clinical children (N = 172).…”

“…The present research employs a similar method as the earlier Muris et al [28] study. Thus, a parent-report survey was used to assess the constructs of social anxiety, behavioral inhibition, ASD problems, and SM symptoms in children.…”

Silence and related symptoms in children and adolescents: a network approach to selective mutism

“…Second, there are studies that have investigated the relationship between symptomatology of SM and various constructs assessed by validated questionnaires or interviews. Here, studies suggest the temperamental trait of behavioral inhibition (BI), which is expressed, for example, in terms of distress to novelty, shyness, and fear responses such as a strong inhibition in new environments or toward strangers [ 16 ], to be important in children with SM [ 17 , 18 ]. Furthermore, it has been consistently shown that children with SM have, on average, clinically relevant levels of social anxiety [ 8 ].…”