In recent years, the clinical view on selective mutism has shifted from willful silence in specific situations and with specific persons, to being anxious to communicate in social situations. These social communication difficulties make it challenging for clinicians to distinguish selective mutism from autism. Historically, selective mutism and autism could not be formally classifi ed side by side. Currently, however, there is a debate about whether these classifications can co-occur. This raises questions for clinical practice, such as what this means for the diagnostic and treatment process. In this review we will discuss these issues based on recent literature, and we will provide clinicians with recommendations for clinical practice.