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Selective mutism is disorder where your child does not speak in
public even though he can speak and understand spoken language. It
used to be called elective mutism.
The disorder occurs in about 1 in every 1,000 children. It is more
common in girls than boys.
You may notice your child is very shy when she enters school and
seems unable to talk to other children.
Many parents are confused by this behavior because their child is
often very outgoing at home. Some children will talk easily on the
phone to people, but cannot talk to them face-to-face.
Your child may have selective mutism if:
The cause of selective mutism is not known. It tends to run in
families. A child is more likely to have this disorder if other
family members have had problems with selective mutism, social
anxiety, or other anxiety disorders. It is not caused by abuse or
Children with this disorder do not choose to be silent. They are
afraid. Most children with selective mutism also have social phobia
or social anxiety. Social phobia is an anxiety disorder in which
people fear situations where they might say or do something
embarrassing. People with this disorder often fear speaking in
public or to strangers.
Your healthcare provider or therapist will ask about your child's
symptoms and any drug or alcohol use. Your child may have some lab
tests to rule out medical problems.
You may want to contact a mental health therapist who specializes
in working with children and teens. The therapist will ask
questions, observe the child, and may give some special tests.
Parents and teachers will also be asked about the child's behavior.
It is important to get a very thorough medical, social, and
psychological history from the child and family. The mental health
specialist will assess:
Children do not just grow out of this disorder. Treatment at an
early age is important. It helps if the child and parents learn
about the disorder.
The main goal with treatment is to lower anxiety and to increase
self-esteem and confidence in social settings. Cognitive behavior
therapy (CBT) helps children learn what causes them to feel anxious
and how to control it. CBT might also include social skills
training, role-playing, and learning relaxation skills. A speech
language pathologist (SLP) may be helpful. Medicine may be used
along with behavioral therapy to help with anxiety. Medicine should
be prescribed by a child psychiatrist familiar with this disorder.
Selective Mutism Foundation