Research suggests 30–40% of children with SM are also autistic. Many others have generalised anxiety, social anxiety or sensory processing differences.
Why this matters
- Standard SM therapy (sliding in, small steps) still works, but pace needs to slow down
- Sensory environment matters even more
- Predictability and visual support become essential
- Communication aids (AAC, written, picture cards) may help long-term, not just short-term
Signs of co-occurring autism
- Mutism continues in many places, not just one
- Difficulty with eye contact even at home
- Restricted interests, routines, sensory needs
- Social differences with peers at home
- Difficulty understanding non-verbal cues
Get autism assessed too
SM and autism need separate assessments. Don''t let professionals assume one rules out the other.
When anxiety is dominant
- General anxiety can fuel SM
- CBT adapted for younger children
- Family-based anxiety programmes
- For severe cases, medication is sometimes considered (specialist only)
At school
Combine SM strategies with autism-friendly adjustments: predictable timetable, sensory-aware classroom, visual supports, low-demand transitions.