Selective mutism
Key points
- Selective mutism is a condition in which a child who is fluent with language frequently fails to speak in certain situations where language is expected.
- Most experts believe that there are environmental, biological, interpersonal, and anxiety-related factors that cause selective mutism.
- The essential element of selective mutism is that the child has the ability to both comprehend and speak, but fails to speak in certain settings or environments.
- Current treatment combines behavior modification, family participation, and school involvement.
Definition
Selective mutism is a condition in which a child who is fluent with language frequently fails to speak in certain situations where language is expected.
It typically occurs in school or social settings. This pattern of mutism must be observed for at least one month (but the first month of school does not count, as excessive shyness is common during this period).
Parents often think that the child is refusing to speak, but usually the child is truly unable to speak in particular settings.
Causes, incidence, and risk factors
Most experts believe that there are environmental, biological, interpersonal, and anxiety-related factors that cause selective mutism. Most children with this condition have some form of extreme Social phobia.
Some affected children have a family history of selective mutism, extreme shyness, or Anxiety disorders that may increase their risk for similar problems. This condition is most common in children under age 5.
Symptoms
- Failure to speak in specific social situations
- Shyness
- Fear of people
- Speaks at home with family
Signs and tests
The essential element of selective mutism is that the child has the ability to both comprehend and speak, but fails to speak in certain settings or environments. This syndrome differs from mutism. Children with mutism never speak.
Cultural issues, such as recent immigration and bilingualism, should be noted. Children who are uncomfortable with a new language may be reluctant to use it outside of a familiar setting. This is not necessarily selective mutism.
Treatment
Current treatment combines behavior modification, family participation, and school involvement. Certain medications that address symptoms of anxiety and social phobia (extreme social shyness) have been used safely and successfully.
Support Groups
For additional information and resources, see selective mutism support groups.
Expectations (prognosis)
The prognosis for this syndrome varies. However, continued therapy and intervention for shyness and social anxiety into adolescence and adulthood may be required.
Complications
Frequently asked questions
What is selective mutism?
Selective mutism is a condition in which a child who is fluent with language frequently fails to speak in certain situations where language is expected. It typically occurs in school or social settings. This pattern of mutism must be observed for at least one month (but the first month of school does not count, as excessive shyness is common during this period). Parents often think that the child is refusing to speak, but usually the child is truly unable to speak in particular settings.
What are the risk factors for selective mutism?
Most experts believe that there are environmental, biological, interpersonal, and anxiety-related factors that cause selective mutism. Most children with this condition have some form of extreme Social phobia. Some affected children have a family history of selective mutism, extreme shyness, or Anxiety disorders that may increase their risk for similar problems. This condition is most common in children under age 5.
What are the symptoms of selective mutism?
- Failure to speak in specific social situations
- Shyness
- Fear of people
- Speaks at home with family
How is selective mutism treated?
Written and revised by
Gerald Hurowitz, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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