Selective mutism is when a child does not speak in certain situations or settings (like at school) but is comfortable speaking in others (like at home). It often starts before a child is 5 years old and is first noticed when the child starts school. It differs from mutism, a condition in which the child doesn’t speak in any situation.
Selective mutism is a type of anxiety disorder. It is not the same as shyness, which is a personality trait, although kids with selective mutism may also be extremely shy. Selective mutism is also different from age-appropriate behavior, such as when a child doesn’t talk much for the first few weeks at a new school. To be diagnosed, a child must have significant trouble in their daily lives because of a pronounced fear of speaking.
Signs of selective mutism may include:
- Consistently unable to speak in specific situations where speaking is expected (most commonly in school)
- Able to speak well in other situations
- Selective speaking issues persist for at least one month (and aren’t limited to the first month of school or another new situation)
- The problem is not caused by a lack of knowledge of the subject matter, unfamiliarity with the language spoken, or a communication issue like stuttering.
If children are having speaking problems, a speech-language pathologist, as well as a psychologist or psychiatrist in addition to their pediatricians, will usually evaluate them. Treatment for selective mutism often involves psychotherapy in addition to speech-language therapy. Often a behavioral treatment plan is tailored to meet the individual needs of the child and family. The child’s family, teachers, and friends may be asked to participate in the treatment.
It’s important for parents to realize that children with selective mutism are NOT refusing to speak. They are truly unable to speak in certain settings. Symptoms may get worse if left untreated, and the child’s ability to function in school or social settings is likely to suffer.
Selective mutism is rare, affecting less than 1 percent of children. But early treatment is important. So if you think your child may have signs of selective mutism, talk to your pediatrician.
Reviewed by Dr. Sara Connolly, January 2020
- Kids with selective mutism are unable to speak in certain situations, but speak well in others.
- Selective mutism is rare, affecting less than 1 percent of kids.
- Kids with selective mutism are NOT refusing to speak, but are unable to speak because of profound fear.
A friend of mine has a daughter who was recently diagnosed with Selective Mutism. She has her in therapy (both individual and small group). The small group has really helped, but it is a slow process. Hopefully over time she will continue to improve.