Selective Mutism

What is selective mutism?

Selective mutism is when a child can’t speak in certain settings but can speak fine in others. For example, a child may not be able to speak at school but can speak with no problem at home. Because the child is only mute in select situations. It’s a rare childhood condition. It can cause problems with school and social situations.

A child with selective mutism may find certain social situations very stressful. This may cause anxiety so severe that the child feels unable to speak. Selective mutism is not caused by a child’s willful refusal to speak.

In some cases, a child may have other speech problems as well. But in many cases, a child may not have any trouble at all when he or she feels comfortable.

It often starts in very young children, around ages 2 to 4. But it may not be recognized until a child starts school.


Researchers are still learning about factors that can lead, such as:

  • An anxiety disorder
  • Poor family relationships
  • Untreated psychological issues
  • Self-esteem problems
  • Problems with sound processing
  • A speech or language problem, such as stuttering
  • Family history of anxiety disorders
  • A traumatic experience

It can also run in families.

Signs and Symptoms:

If you believe that your child may be struggling with it, look for the following symptoms:

  • Expression of a desire to speak that is held back by anxiousness, fear, or embarrassment
  • Fidgeting, eye contact avoidance, lack of movement, or lack of expression when in feared situations
  • Inability to speak in school and other specific social situations
  • Use of nonverbal communication to express needs (e.g., nodding head, pointing)
  • Shyness, fear of people, and reluctance to speak between 2 and 4 years of age
  • Speaking easily in certain situations (e.g., at home or with familiar people), but not others (e.g., at school or with unfamiliar people)

Some children with this disorder may show additional signs, such as:

  • Anxiety
  • Social withdrawal
  • Excessive shyness
  • Obsessive-compulsive disorder
  • Depression
  • Developmental delay
  • Communication disorders


A child can successfully overcome selective mutism if it’s diagnosed at an early age and appropriately managed.

It’s important for selective mutism to be recognized early by families and schools so they can work together to reduce a child’s anxiety. Staff in early years settings and schools may receive training so they’re able to provide appropriate support.

If you suspect your child has selective mutism and help is not available, or there are additional concerns – for example, the child struggles to understand instructions or follow routines – seek a formal diagnosis from a qualified speech and language therapist.

You can contact a speech and language therapy clinic directly or speak to a health visitor or GP, who can refer you. Do not accept the opinion that your child will grow out of it or they are “just shy”.

Who is at risk for selective mutism?

A family history of the condition may increase your child’s risk. Your child may also be more likely to show signs of anxiety disorders running in your family. A traumatic event may increase the risk, too.


The main treatment for selective mutism is behavior therapy. Behavior therapy involves gradually exposing a child to increasingly difficult speaking tasks in the context of a supportive relationship. Practice begins with easier steps and gets progressively harder – like climbing a ladder.

Children are asked to complete tasks that they will meet with success. Success is rewarded with praise and small prizes. In time, children learn that the anxiety they feel when they are asked to speak decreases without having to avoid the situation in order to feel better.

It’s important to remain patient with your child. Remember, your child is not choosing to not speak. Your child is too anxious to be able to speak.

For the best outcome, stay closely involved with your child’s therapy. You may be able to find ways to structure situations outside the home that can increase your child’s communication. Work closely with your child’s teachers.