Diagnosis

A diagnosis of SM is usually provided after team assessment involving a Speech Pathologist, Paediatrician, Psychologist and/or Psychiatrist ASHA - http://www.asha.org/public/speech/disorders/selectivemutism/

You can approach your local General Practitioner for a referral to these services or look for services in the area that show on their website that they have experience in the area of SM.

A diagnosis of SM is typically made when assessment has demonstrated that the individual meets the following criteria:

Consistent failure to speak in specific social situations (in which there is an expectation for speaking, such as at school) despite speaking in other situations.
Not speaking interferes with school or work, or with social communication.
Lasts at least 1 month (not limited to the first month of school).
Failure to speak is not due to a lack of knowledge of, or comfort, with the spoken language required in the social situation not due to a communication disorder (e.g., stuttering).
It does not occur exclusively during the course of a pervasive developmental disorder (PPD), schizophrenia, or other psychotic disorder.

The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013). - See more at: http://www.asha.org/public/speech/disorders/selectivemutism/#sthash.LMIUKaQP.dpuf

It is essential that the assessment includes a detailed case history/parental interview, information gathering from school and 1:1 assessment with the child for hearing, speech and language concerns.

There is some confusion as to whether it is possible to have co-diagnosis of SM and Autism due to the criteria of the DSM above. However, there is a wide body of emerging evidence from those with lived experience and from clinicians that non-speaking for a variety of reasons (including speech phobia) is a very real experience within the Autistic community. This is an area that is benefiting from further research and outcomes are constantly being updated.

Non-speaking and discomfort around talking for individuals who are Autistic is incredibly nuanced and requires and inquisitive and collaborative approach to therapeutic intervention. There can be a wide number of reasons why an individual may not speak in a social situation and it is also important to acknowledge that speech is not the gold standard for communication! There are many other ways that we can communicate just as effectively when everyone has a shared understanding that all communication methods are valued. When working with children and young people who are experiencing speech phobia it is essential to recognize there is not a one-size-fits-all approach. Behavioral interventions in particular need careful consideration and collaboration with Autistic individuals and may not be appropriate at all for some.