Understanding Selective Mutism

What is Selective Mutism?

Usually starting in early childhood selective mutism is an extreme form of anxiety disorder, and if left untreated it can continue into adulthood.  It isn’t that the child or person is refusing to speak it’s that they are literally unable to do so.

Symptoms can vary between individuals, some may be completely mute, whilst others can speak only in whispers or through another person.  Then there are those that are only affected at school or in social situations and can talk to family and friends as they feel safe and secure. 

More than 90% of children with selective mutism will have social anxiety or social phobia and it often occurs in children who have developmental delays, language problems, panic disorder, depression or OCD (obsessive compulsive disorder).


As selective mutism is rare it is not fully understood what causes it, it was originally believed to have been as a result of childhood trauma or abuse.  However more recent research shows that it is related to extreme social anxiety. 

Genetics play a large part in its development, so if children have one or more family members that suffer from anxiety, then they are more like to be predisposed.  Often children who develop selective mutism will have shown signs of extreme shyness, tantrums, crying, moodiness, inflexibility and sleep problems from infancy.  They may also have suffered from severe anxiety or separation anxiety.  Children with selective mutism can often have subtle speech or learning difficulties.     


·      The reluctance to speak especially between the ages of two and four

·      Shyness or fear around people they don’t know

·      Lack of eye contact, prone to fidgeting

·      Lack of movement or expression when they feel anxious or afraid

·      Inability to speak at school or in social situations

·      Using non verbal methods of communicating like pointing or nodding

·      Looking as though they want to speak, but are holding back for fear of embarrassment or because they are afraid or anxious

·      The ability to speak at home or with family or friends but not at school or socially

·      Speaking through a close or trusted person

Associated Conditions or Risks

If the condition goes undiagnosed or untreated in early childhood it can lead to problems in later life.  This can include it having a negative affect on their education, social life and emotional development including:

·      Social withdrawal and isolation

·      Low self-esteem

·      Refusing to go to school

·      Lack of confidence

·      Not doing well at school

·      Anxiety symptoms worsening

·      Underachieving in the workplace

·      Turning to alcohol or drug use

·      Depression

·      Suicidal thoughts or attempted suicide

Professional Help

If you think your child is suffering with selective mutism you should see your doctor to enable them to make a diagnosis and rule out any other underlying conditions.  Generally it is diagnosed between the ages of three and eight years.  Your doctor will recommend seeing a psychotherapist who can help with therapies such as CBT (cognitive behavioural therapy) and behavioural therapy.  Written by Jan, Jeana and Wendy at Barnsley Hypnosis and Counselling (UK). For more free Information click above link.