Physical Freezing in Children and Adolescents with Selective Mutism

Area of Science:

• Psychology
• Child Psychiatry
• Neurodevelopmental Disorders

Background:

• Selective mutism (SM) is an anxiety disorder characterized by a consistent failure to speak in specific social situations.
• Emerging evidence suggests a significant overlap between SM and autism spectrum disorder (ASD).
• Physical freezing is increasingly recognized as a potential feature of SM.

Purpose of the Study:

• To investigate the prevalence and characteristics of speech difficulties and physical freezing in children with SM, autism, or both.
• To explore the relationship between freezing behaviors, autism comorbidity, and SM severity.

Main Methods:

• A cross-sectional online survey was administered to parents of children diagnosed with autism only, SM only, both autism and SM, or neither condition.
• Data on speech and freezing behaviors were collected, including a subset of children completing their own survey.
• The Selective Mutism Questionnaire (SMQ) was used to assess SM severity.

Main Results:

• Children with SM, regardless of autism comorbidity, reported experiencing throat and body freezing.
• The most frequent reasons cited for speech difficulty included pressure to speak, fear of judgment, and fear of errors.
• Children with both autism and SM reported the lowest SMQ scores, indicating higher SM severity, and increased freezing correlated with lower SMQ scores.

Conclusions:

• Physical freezing is a notable symptom in children with selective mutism, irrespective of autism diagnosis.
• The co-occurrence of autism and SM may be associated with more severe SM symptoms.
• Understanding the interplay between anxiety, autism, and freezing is crucial for effective intervention.