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What Is Selective Mutism?

Medically Reviewed by Poonam Sachdev on October 10, 2022

What is selective mutism? Selective mutism is an anxiety disorder that prevents a person — usually a child — from speaking when they’re in specific situations or around certain people. 

Selective mutism doesn’t have to do with the child’s actual ability to speak. Most of these children have no trouble hearing speech, comprehending complex language, and speaking when they are comfortable enough to do so. 

Learn more about selective mutism causes, symptoms, and diagnosis in the following guide.

What Are Symptoms of Selective Mutism?

Selective mutism symptoms vary from child to child, but it’s important to remember that this isn’t just another name for “shyness". Symptoms of selective mutism might mean that:

  • The child seems physically incapable of speech in specific (often predictable) situations, such as in the classroom at school. Sometimes, the child whispers to a close friend or family member instead of speaking out loud.
  • The child looks anxious or expresses clingy behaviors directed at parents during these social interactions.

What Is the Cause of Selective Mutism?

One of the most confusing aspects of selective mutism is that it might seem to pop up out of nowhere. You might worry that your child has suffered trauma that made them suddenly stop speaking — however, that is not typically the case if a child is selectively mute.

Selective mutism causes aren't entirely clear to researchers. Reasons for mutism might include a personal or family history of anxiety and psychological disorders, low self-esteem, speech and language disorders, and genetics — or all of the above.

Selective Mutism vs Shyness: What's the Difference?

Selective mutism is a diagnosable anxiety disorder that causes a child to be unable to speak. It’s not as common as shyness, which is a personality trait that can affect any person at any time throughout their life. A selectively mute child may seem to have a completely different personality at home than when they are at school, whereas a shy child might simply take a while to warm up to new friends or groups of people.

Shyness is a term that captures a wide range of symptoms such as feeling socially anxious and worrying about judgment from others, blushing, or stammering when trying to speak. It’s not a medical or psychiatric diagnosis. This doesn’t mean that shyness can’t be debilitating, though — it can, especially if it’s severe. 

How Is Selective Mutism Diagnosed?

Selective mutism diagnosis is difficult because this condition can resemble several others. Your doctor will first perform a physical examination to determine that your child is able to hear and speak normally. A speech-language pathologist might evaluate your child for problems with physical parts of the body related to speaking, such as the mouth, vocal cords, and tongue. During this time, you will be asked many questions and will probably have to fill out questionnaires related to your child’s physical, mental, and emotional development.

Don’t worry if your child is asked to undergo a psychiatric assessment. A mental health professional is often consulted to determine whether selective mutism is the cause of your child’s inability to speak in certain situations. A psychologist who has experience in this area can diagnose your child and develop a selective mutism treatment plan with your input. Your child will then learn coping skills such as practicing nonverbal skills while participating in class, speaking to one or two children at a time, or receiving accommodations to make their school days easier. 

Is Selective Mutism a Type of Autism or Language Delay?

No, these are separate different diagnoses. Consider the following differences between these commonly confused conditions if you’re concerned about your child’s lack of speech.

Autism. Some children with autism experience language delays or do not speak, being termed “nonverbal” by teachers and doctors. Autism, though, isn’t an anxiety disorder, and it usually encompasses many other symptoms such as sensory issues, OCD-like symptoms, and an obsession with specific routines.

Above all, children on the autism spectrum have trouble understanding social and nonverbal cues. Kids with selective mutism, in contrast, might have a great grasp of nonverbal communication and use it regularly to “talk” to others when they are unable to speak with words. It’s possible, though, for a child on the autism spectrum to also be diagnosed with selective mutism. 

Language delay. If your child is young, you might be concerned that their language isn’t developing normally. A two-year-old who isn’t speaking at all would probably be evaluated for a language delay. A six-year-old who cannot speak when in a group of peers but is talkative at home, on the other hand, might be evaluated for selective mutism.

How Can I Help a Child With Selective Mutism?

Parents. While parents can’t cure their child’s selective mutism with love and acceptance, showing understanding that the child is not behaving this way because of shyness or defiance can help the child learn to deal with the condition. It’s not a good idea to force your child into a social situation or make them uncomfortable to learn to deal with social interaction, though. Try not to get frustrated and work with your child’s psychologist or speech therapist to create a treatment plan.

Teachers. Teachers should understand that the child with selective mutism is very much present in the classroom and is paying close attention to what’s happening. They are simply unable to speak or participate as other children would. It’s best not to ignore the child or to force them to speak if they have this condition. Instead, look for ways to ease them into the classroom at a comfortable pace. This may include asking them to write down answers, nod, or whisper answers to a trusted friend.

Siblings and friends. Siblings of children with selective mutism, as well as friends in the classroom, can help ease the social burden of this condition by decreasing isolation and bullying. Educating peers about selective mutism and teaching them to advocate for their friends can make all the difference to an already anxious child who is dealing with a difficult condition. 

Remember that a person with selective mutism would probably speak if they could. They aren’t trying to be difficult. 

If you’re concerned about your child’s inability to speak in certain situations, please get help sooner rather than later. Learning more about this condition and meeting with pediatricians, psychologists, and speech therapists who have a good understanding of selective mutism can be beneficial to the whole family. 

Show Sources

SOURCES:
American Speech-Language-Hearing Association: “Selective Mutism.”
Cedars-Sinai: “Selective Mutism.”
Child Mind Institute: “Complete Guide to Selective Mutism.”
Cleveland Clinic: “Is Your Child Just Shy — Or Is It Selective Mutism?”
Nemours KidsHealth: “Selective Mutism Factsheet (for schools).”
Selective Mutism Association: “What is the Difference Between Selective Mutism and Autism?”
Stanford Medicine Children’s Health: “Age-Appropriate Speech and Language Milestones.”

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