Selective mutism is an anxiety disorder which means that a child or young person does not speak in select situations and environments – for example, at school. They are, however, able to speak well in other places – for example, at home. Children who experience selective mutism can often freeze when they are in situations where they are expected to speak to someone, which makes talking impossible.
Selective mutism usually begins in early childhood and can only be diagnosed when a child is over the age of three years and has developed their ability to speak. It can persist into adulthood if not treated.
The disorder affects roughly 1 in 140 young people. It happen to any child or young person who suffers with anxiety, although it is more common in girls. There is a myth that children or young people who are on the autistic spectrum are more likely to have selective mutism, but this is not the case.
It can be helpful to consider selective mutism as a phobia of speaking, for which there can be several causes. There is no one specific cause of selective mutism.
How can selective mutism be treated?
Identifying selective mutism as early as possible is key, as it can lead to social anxiety, low self-esteem and frustration if left untreated.
Treatment doesn’t focus on speaking, but on reducing the anxiety that is linked to speaking. People around the child or young person can also do a lot to help – for example, by taking off the pressure to speak at school or at home. Support for parents and teachers is therefore very important.
The Speech and Language Therapy (SaLT) team is often the most helpful service to treat selective mutism but if the anxiety is severe, then it is helpful for CAMHS to be involved. Cognitive behaviour therapy (CBT) is a proven treatment for anxiety and so can help in some cases of selective mutism.
More information and support
iSpeak - a collective voice for people with selective mutism
Speaking out about selective mutism - Young Minds blog