Past Issues

Objective: Selective mutism (SM) is the consistent absence of speech in specific social situations where speaking is expected, despite an individual showing normal speech in other contexts. In this study, we intended to explore and to analyze the clinical characteristics of preschool-aged children, school-aged children, adolescents, and young adults (age < 25 years) with SM in a community hospital in Taiwan. Methods: During a three-year period, the charts of patients with SM were retrospectively reviewed. Their parents completed the Child Behavior Checklist (CBCL) during the initial clinic visit. We also collected data on demographic characteristics, comorbidities, and clinical follow-up outcomes. Results: Of the 53 patients with SM (boys = 23 [43%] and girls = 30 [57%]), 19 patients (36%) were aged < 6 years, 22 (42%) were aged 6–12 years, and 12 (22%) were aged >12 years. Regarding neurodevelopmental deficits, nine patients (17%) showed motor delay, whereas 8 (15%) showed speech delay. Regarding comorbidities, six patients (11.3%) had autism spectrum disorder, and 5 (9%) had attention-deficit/ hyperactivity disorder. In adolescents and young adults, 7 of 12 (58%) had social phobia, and 3 of 12 (25%) had depressive disorder. The CBCL profiles indicated that the severity of internalizing symptoms significantly more increased with age (p < 0.05). Conclusion: Patients with SM showed evolving clinical features across developmental stages. Younger children had elevated risks of neurodevelopmental comorbidities, whereas adolescents had elevated risks of anxiety and mood disorders. Early detection and age-appropriate, multidisciplinary interventions are essential for improving long-term outcomes.