Selective Mutism

What Is Selective Mutism?

Children with selective mutism can talk, but they don’t talk in certain places or around certain people. This pattern may start when a child goes to school, but symptoms can appear earlier. For some, selective mutism may continue into teenage years and adulthood. It’s important to know that this silence is not a choice.

What Are the Signs of Selective Mutism?

Here are some signs that a child may have selective mutism:

• They talk in some places but not others. Your child talks freely at home but not at school, around friends, or in public places like restaurants. This behavior is the same across similar situations or types of people.
• Their silence makes it hard to participate. Not talking makes it harder for your child to learn, build friendships, or take part in activities.
• Their silence lasts more than one month. This pattern continues for at least a month—excluding the first month of school, a time when many children are still adjusting.
• This behavior is not explained by other conditions. Your child’s silence is not due to autism, stuttering, not knowing the language used, or other conditions.

What Are the Causes of Selective Mutism?

Although there is no single cause of selective mutism, it’s often linked to anxiety or social anxiety. Some additional contributing factors include:

• a family history of anxiety or selective mutism
• feeling overwhelmed in social or public situations
• wanting to be alone and not talk to others

What Does Testing for Selective Mutism Look Like?

If you believe that your child may have selective mutism, start by talking to your doctor. The doctor may refer your child to a psychologist or a psychiatrist to see if they have anxiety. An SLP can test your child’s speech and language skills.

In speech and language testing. the SLP may:

• check your child’s hearing
• see how your child’s mouth (lips, jaw, and tongue) moves
• see how your child understands what others say
• talk with you about patterns of when and where your child does or does not speak
• listen to how your child says words and expresses ideas
• see how your child communicates without speaking—such as gestures, writing, or facial expressions.

Some children may not be ready to talk during their appointment—and that’s OK. If that happens, the SLP may ask for video or audio recordings of your child talking. Or they may ask to watch how you and your child interact. This helps the SLP get a full picture of how your child communicates best, and then design treatment to help.

What Is the Treatment for Selective Mutism?

Every person’s experience with selective mutism is different, so support is tailored to their needs. In some cases, a doctor may suggest medication to help with anxiety.

SLPs focus on helping your child become more confident talking in different situations. They may use the following techniques:

• Stimulus fading. The SLP slowly introduces your child to situations that they are less comfortable speaking in. This may begin with your child speaking to a person they’re comfortable talking to. Later, a new person may slowly join the conversation. This gradual method helps ease your child into new speaking environments.
• Shaping. The SLP will encourage your child’s communication and celebrate small moments of progress with praise or rewards. This positive reinforcement builds trust and motivation. Your child may progress from whispering or mouthing words to speaking aloud.
• Self-modeling. The SLP may ask you to record your child talking at home or in another familiar situation. Showing your child these videos can be empowering, particularly in places or situations where your child usually doesn’t talk.

The SLP may also:

• work with your child’s teachers, counselors, coaches, or family members to help create supportive spaces where your child can feel comfortable communicating
• assist your child with speech sound difficulties, challenges in expressing ideas, or discomfort with their own voice.

All of this can help your child feel comfortable talking in many situations.

Progress varies from child to child—but with empathy, support, and the right strategies, your child can learn to feel confident speaking up and using their voice.

To find an SLP near you, visit ProFind.

Resources

Inclusion on this list does not imply endorsement.

• Child Mind Institute
• Selective Mutism Association