Selective mutism is a condition in which a child can speak, but then suddenly stops speaking. It most often takes place in school or social settings.
Selective mutism is most common in children under age 5. The cause, or causes, are unknown. Most experts believe that children with the condition inherit a tendency to be anxious and inhibited. Most children with selective mutism have some form of extreme social fear (phobia).
Parents often think that the child is choosing not to speak. However in most cases, the child is truly unable to speak in certain settings.
Some affected children have a family history of selective mutism, extreme shyness, or anxiety disorders, which may increase their risk for similar problems.
This syndrome is not the same as mutism. In selective mutism, the child can understand and speak, but is unable to speak in certain settings or environments. Children with mutism never speak.
This pattern must be seen for at least 1 month to be selective mutism. (The first month of school does not count, because shyness is common during this period.)
Treating selective mutism involves behavior changes. The child's family and school should be involved. Certain medicines that treat anxiety and social phobia have been used safely and successfully.
You can find information and resources through selective mutism support groups.
Children with this syndrome can have different outcomes. Some may need to continue therapy for shyness and social anxiety into the teenage years, and possibly into adulthood.
Selective mutism can affect the child's ability to function in school or social settings. Without treatment, symptoms may get worse.
Call your health care provider if your child has symptoms of selective mutism, and it is affecting school and social activities.
Bostic JQ, Prince JB, Buxton DC. Child and adolescent psychiatric disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 69.
Rosenberg DR, Chiriboga JA. Anxiety disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 38.
Simms MD. Language development and communication disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 52.