In current classification systems, selective mutism (SM) is included in the broad anxiety disorders category. Indeed, there is abundant evidence showing that anxiety, and social anxiety in particular, is a prominent feature of SM. In this article, we point out that autism spectrum problems in addition to anxiety problems are sometimes also implicated in SM. To build our case, we summarize evidence showing that SM, social anxiety disorder (SAD), and autism spectrum disorder (ASD) are allied clinical conditions and share communalities in the realm of social difficulties. Following this, we address the role of a prototypical class of ASD symptoms, restricted and repetitive behaviors and interests (RRBIs), which are hypothesized to play a special role in the preservation and exacerbation of social difficulties. We then substantiate our point that SM is sometimes more than an anxiety disorder by addressing its special link with ASD in more detail. Finally, we close by noting that the possible involvement of ASD in SM has a number of consequences for clinical practice with regard to its classification, assessment, and treatment of children with SM and highlight a number of directions for future research.

在当前的分类系统中，选择性沉默症（SM）被包含在广泛的焦虑症类别中。事实上，有大量证据表明焦虑，尤其是社交焦虑，是 SM 的一个显着特征。在这篇文章中，我们指出，除了焦虑问题之外，自闭症谱系问题有时也与 SM 有关。为了构建我们的案例，我们总结了证据，表明 SM、社交焦虑症 (SAD) 和自闭症谱系障碍 (ASD) 是相关的临床病症，并且在社交困难领域具有共同点。在此之后，我们讨论了典型的 ASD 症状、限制性和重复性行为和兴趣 (RRBI) 的作用，假设这些症状在社会困难的维持和加剧中发挥着特殊作用。然后，我们通过更详细地阐述 SM 与 ASD 的特殊联系来证实我们的观点，即 SM 有时不仅仅是一种焦虑症。最后，我们最后指出，自闭症谱系障碍可能参与 SM 对 SM 儿童的分类、评估和治疗方面的临床实践产生许多影响，并强调了未来研究的一些方向。