Speech problems and speech delay Possible underdiagnosis of selective mutism

With great interest, we noticed the article by Zengin-Akkus, Celen-Yoldas, Kurtipak & Özmert concerning speech delay in young children that was published in Volume 60, number 2 of 2018. We think that some aspects of the study warrant closer attention. Zengin-Akkus et al.1 investigated speech delay in 100 children and they focused specifically on isolated speech delay, autism spectrum disorder and global developmental delay. As measures, the investigators used medical history, physical examination, head circumference and play observation. An assessment was done of developmental domains (cognitive, emotional, motor and language development).Regarding the focus of the study, we would like to underline that possibly the diagnosis of selective mutism could have been missed. Selective mutism is a rarely occurring anxiety disorder with a prevalence of 0.2-1.9%.2,3 It encompasses the absence of speaking in situations where children are supposed to speak. Age of onset is typically before the age of 5 years, and it seems more frequent in girls, and bilinguals