SMA Statement Regarding Different Terminology Used to Describe Selective Mutism

The Selective Mutism Association has become aware of an increase in variable terminology used as synonyms for Selective Mutism. Some of these terms include “Situational Mutism,” “Reluctant Speaker,” and “Reluctant Talker.” SMA strongly discourages the use of these terms at the present time as they can be misleading and also undermine the rationale of having an established and recognized medical term.

The term “Selective Mutism” is internationally recognized and has established diagnostic criteria within the Diagnostic and Statistical Manual (DSM 5) and the International Classification of Diseases (ICD 11). The use of this established term allows for continuity of research on this disorder and continuity of clinical collaboration and care.

The name of this disorder has undergone changes in the past, first being described as “Aphasia Voluntaria” in 1877, renamed “Elective Mutism” in the 1930s, and then shifting to “Selective Mutism” in 1994. These changes reflect the shift in understanding this disorder as one where there was thought to be some voluntary or elective nature to not speaking to the current conceptualization that removes the voluntary aspect. The current term “selective” does NOT imply that a person is selecting when to speak or not speak but rather is referencing that there are selective situations where speaking does or does not occur (i.e. speaking at home but not at school or to peers but not adults). The term “Selective Mutism” thus aims to focus on how speaking fluctuates in various situations as opposed to the outdated notion that a person is choosing or electing to not speak.

Some people mistake the “selective” in Selective Mutism as implying that there is a volitional quality to not speaking. It is important to understand that this is not what this term is referencing. Additionally, SMA is aware that as more is learned about this disorder, there is increasing evidence for the heterogeneity of presentations. Some presentations include speaking typically at home but mute at school, speaking across settings but with minimal volume in some, speaking but with limited initiation in certain settings, not speaking in some environments but communicating nonverbally, not speaking verbally or nonverbally in some situations, as well as some presentations that have generalized to complete lack of speech.  As such, it is clear that more research and development is needed to generate the terminology that best captures the entirety of this disorder. However, until such a time where there is scientific consensus for another official name change, the established terminology of “Selective Mutism” should be used.