The Clinical Phenotype of Early Selective Mutism and Later Autism Spectrum Disorder in Girls: A Case Series Analysis

<b>Background:</b> The presentation of autism spectrum disorder (ASD) in girls often differs from that of boys, leading to delayed diagnosis. Selective mutism presenting at a young age can obscure autism symptoms, particularly in girls who exhibit “masking” behaviors. In this study, we e...

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Main Authors: Hagit Nagar Shimoni, Efrat Zilbershot Fink, Yael Leitner
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/12/2/237
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author Hagit Nagar Shimoni
Efrat Zilbershot Fink
Yael Leitner
author_facet Hagit Nagar Shimoni
Efrat Zilbershot Fink
Yael Leitner
author_sort Hagit Nagar Shimoni
collection DOAJ
description <b>Background:</b> The presentation of autism spectrum disorder (ASD) in girls often differs from that of boys, leading to delayed diagnosis. Selective mutism presenting at a young age can obscure autism symptoms, particularly in girls who exhibit “masking” behaviors. In this study, we examined the early manifestation of selective mutism in four girls who were later diagnosed with ASD. <b>Method:</b> The study describes four case studies of girls who underwent an ASD diagnostic process. All were either diagnosed at an early age with selective mutism or had selective mutism suspected as a potential diagnosis during their preschool years. Clinical information was collected through detailed developmental history and clinical evaluations by a multidisciplinary team. <b>Results:</b> All girls were diagnosed at a young age with selective mutism by a child psychiatrist and later with ASD by a multidisciplinary team. They all demonstrated normal-range intelligence. This is in agreement with Muris and Steffenburg asserting that in a certain group of children, an early manifestation of selective mutism may be an early marker of ASD. <b>Conclusions</b>: Special follow-up should be given to girls diagnosed with selective mutism during their preschool years because this could be an early marker for a later ASD diagnosis.
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spelling doaj-art-9c8f76652d5d4f38bbae0b5aad94fe842025-08-20T03:12:16ZengMDPI AGChildren2227-90672025-02-0112223710.3390/children12020237The Clinical Phenotype of Early Selective Mutism and Later Autism Spectrum Disorder in Girls: A Case Series AnalysisHagit Nagar Shimoni0Efrat Zilbershot Fink1Yael Leitner2Marot Autism Center, Child Development Institute, Dana-Dwek Children’s Hospital, Tel Aviv Sourasky Medical Center, 6 Weizmann St., Tel Aviv 6492403, IsraelMarot Autism Center, Child Development Institute, Dana-Dwek Children’s Hospital, Tel Aviv Sourasky Medical Center, 6 Weizmann St., Tel Aviv 6492403, IsraelMarot Autism Center, Child Development Institute, Dana-Dwek Children’s Hospital, Tel Aviv Sourasky Medical Center, 6 Weizmann St., Tel Aviv 6492403, Israel<b>Background:</b> The presentation of autism spectrum disorder (ASD) in girls often differs from that of boys, leading to delayed diagnosis. Selective mutism presenting at a young age can obscure autism symptoms, particularly in girls who exhibit “masking” behaviors. In this study, we examined the early manifestation of selective mutism in four girls who were later diagnosed with ASD. <b>Method:</b> The study describes four case studies of girls who underwent an ASD diagnostic process. All were either diagnosed at an early age with selective mutism or had selective mutism suspected as a potential diagnosis during their preschool years. Clinical information was collected through detailed developmental history and clinical evaluations by a multidisciplinary team. <b>Results:</b> All girls were diagnosed at a young age with selective mutism by a child psychiatrist and later with ASD by a multidisciplinary team. They all demonstrated normal-range intelligence. This is in agreement with Muris and Steffenburg asserting that in a certain group of children, an early manifestation of selective mutism may be an early marker of ASD. <b>Conclusions</b>: Special follow-up should be given to girls diagnosed with selective mutism during their preschool years because this could be an early marker for a later ASD diagnosis.https://www.mdpi.com/2227-9067/12/2/237selective mutismautism spectrum disorderearly diagnosisclinical presentationgirlsmasking behaviors
spellingShingle Hagit Nagar Shimoni
Efrat Zilbershot Fink
Yael Leitner
The Clinical Phenotype of Early Selective Mutism and Later Autism Spectrum Disorder in Girls: A Case Series Analysis
Children
selective mutism
autism spectrum disorder
early diagnosis
clinical presentation
girls
masking behaviors
title The Clinical Phenotype of Early Selective Mutism and Later Autism Spectrum Disorder in Girls: A Case Series Analysis
title_full The Clinical Phenotype of Early Selective Mutism and Later Autism Spectrum Disorder in Girls: A Case Series Analysis
title_fullStr The Clinical Phenotype of Early Selective Mutism and Later Autism Spectrum Disorder in Girls: A Case Series Analysis
title_full_unstemmed The Clinical Phenotype of Early Selective Mutism and Later Autism Spectrum Disorder in Girls: A Case Series Analysis
title_short The Clinical Phenotype of Early Selective Mutism and Later Autism Spectrum Disorder in Girls: A Case Series Analysis
title_sort clinical phenotype of early selective mutism and later autism spectrum disorder in girls a case series analysis
topic selective mutism
autism spectrum disorder
early diagnosis
clinical presentation
girls
masking behaviors
url https://www.mdpi.com/2227-9067/12/2/237
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