Correlates of Selective Mutism in Young Children: A Preliminary Investigation of Social Anxiety, Autistic Traits, Extreme Demand Avoidance, and Sensory Processing Sensitivity.

Selective mutism (SM) is an infrequent pediatric condition defined by a sustained inability to speak in specific social contexts, despite demonstrating age-appropriate verbal communication in settings perceived as safe or familiar, such as the home environment. This parent-report survey study examined the roles of social anxiety, autistic traits, extreme demand avoidance, and sensory processing sensitivity in 3- to 6-year-old children with a diagnosis of SM (n = 11) and non-clinical peers (n = 55), of whom a considerable proportion also exhibited elevated levels of SM symptoms (n = 22). Results indicated that children with SM displayed significantly higher levels of social anxiety, autistic traits, extreme demand avoidance, and sensory processing sensitivity than their non-clinical counterparts. Additional analyses showed a gradient across clinical, subclinical, and non-clinical groups, with children with diagnosed SM scoring highest across all measures, children with elevated SM symptoms showing intermediate scores, and non-clinical controls scoring lowest. Correlational analyses revealed that greater SM severity was associated with elevated levels across all measured traits. These findings highlight that, in addition to the established contributions of social anxiety and autistic traits, extreme demand avoidance and sensory processing sensitivity may also contribute to the clinical profile of children with SM.