Selective Mutism

About Selective Mutism

Selective mutism is an anxiety disorder in which a person, usually a child, consistently does not speak in certain social situations where speaking is expected, such as at school, while speaking comfortably in other settings, such as at home with close family. The difficulty lasts at least a month, is not limited to the first month of school, and is not explained by a lack of knowledge of the language or a communication disorder. DSM-5 moved selective mutism into the anxiety disorders chapter, reflecting its close relationship with social anxiety. Onset is typically in early childhood, and it is often first noticed when a child starts school. It is considered uncommon. Children with selective mutism are not choosing to be defiant, and pressure to speak can increase anxiety. Evidence based approaches include behavioral and cognitive behavioral therapy using gradual steps, close cooperation with parents and teachers, and in some cases medication.