Selective Mutism

Selective mutism (se-LEK-tiv MU-ti-zum) is a condition in which children feel so inhibited and anxious that they do not speak in particular situations, most commonly in school. Children with selective mutism are capable of speaking and communicating normally and do so in other situations, for example, at home.

Brandon's Story

When Brandon first started kindergarten, his teacher just thought he was a very quiet boy and that he would come out of his shell in a week or two. As the weeks passed into months, though, Brandon still never spoke a word at school, even when the teacher called on him. Sometimes if he needed something, he would point or gesture, but he would not speak. His teacher was concerned, and when she called his parents, they told her that Brandon spoke easily at home and that he had always been a little shy around others. It was clear that Brandon's problem was more than normal shyness. Because it was interfering with his ability to participate in class and on the playground, his parents took Brandon to a mental health professional, who diagnosed his problem as selective mutism.

What Is Selective Mutism?

Selective mutism is a condition in which children feel anxious and inhibited and do not speak in certain situations. Children with selective mutism are capable of speaking normally and do so in other situations where they feel more comfortable. These children often talk normally at home, but they may completely stop talking around teachers, other children, or other adults. Their behavior gets in the way of their making friends and doing well in school.

Selective mutism, once thought to be quite rare, was beginning to be more widely recognized in the early 2000s. It used to be called elective mutism, because it was thought that children were purposely choosing not to talk. It was sometimes thought that a child's refusal to speak was a way to rebel against adults or a sign of anger. The problem affects at least 1 in 100 school-age children. It usually begins before the age of 5, but it may not cause problems until children start school. The condition may last for just a few months, but in some cases, if left untreated, selective mutism can last for years. Some experts believe that untreated selective mutism in children leads to social anxiety disorders* in their adult years. Experts concluded that selective mutism is an extreme form of social anxiety in a child. Social anxiety is an intense, lasting fear or extreme discomfort in social situations, and usually leads to avoidance of many social situations. With selective mutism, children seem to feel so self-conscious or anxious in certain situations that they avoid talking altogether.

What Causes Selective Mutism?

There is no single cause of selective mutism. As with other forms of anxiety, some children may be more likely to have this problem if anxiety or extreme shyness runs in the family, or if they are born with a shy nature. Beyond genetics, in some families in which adults are anxious, children may learn to feel socially anxious by watching the way adults react and behave. Upsetting or stressful events such as divorce, the death of a loved one, or frequent moves may trigger selective mutism in a child who is prone to anxiety.