What is the definition of Selective Mutism?

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.

What are the causes for Selective Mutism?

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.

What are the symptoms for Selective Mutism?

Symptoms include:

  • Ability to speak at home with family
  • Fear or anxiety around people they do not know well
  • Inability to speak in certain social situations
  • Shyness

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.)

What are the current treatments for Selective Mutism?

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.

What are the support groups for Selective Mutism?

You can find information and resources through selective mutism support groups.

What is the outlook (prognosis) for Selective Mutism?

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.

What are the possible complications for Selective Mutism?

Selective mutism can affect the child's ability to function in school or social settings. Without treatment, symptoms may get worse.

When should I contact a medical professional for Selective Mutism?

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.

  • Condition: Autism and Epilepsy
  • Journal: Journal of medical case reports
  • Treatment Used: Cannabinoid Extract Complementary Therapy
  • Number of Patients: 1
  • Published —
This case report describes a 15-year old patient with autism and epilepsy that was treated using a cannabinoid extract complementary therapy.
  • Condition: Children with selective mutism
  • Journal: Journal of consulting and clinical psychology
  • Treatment Used: Intensive group behavioral treatment
  • Number of Patients: 29
  • Published —
The study researched using intensive group behavioral treatment on children with selective mutism.
Clinical Trial
  • Status: Recruiting
  • Phase: N/A
  • Intervention Type: Behavioral
  • Participants: 60
  • Start Date: May 14, 2017
The Efficacy of Integrated Behavioral Therapy for Selective Mutism
Clinical Trial
  • Status: Recruiting
  • Participants: 1000
  • Start Date: October 2014
Nordic Study of the Cerebellar Mutism Syndrome in Children With Brain Tumours of the Posterior Fossa