Selective Mutism

Also known as: elective mutism, anxiety disorder, phobia.

What is selective mutism?

Selective mutism is a complex childhood anxiety disorder in which the child will speak at certain times when in a comfortable secure and relaxed environment, but not necessarily in other situations (lasting for more than one month). An example might be that the child will speak while at home, but not at school. Most of these children have social phobia or social anxiety.

What causes selective mutism in children?

Many children have a genetic predisposition to anxiety, or are temperamentally shy, self-conscious, are sensitive to sounds, light, touch, taste and smell and have difficulty in managing them with a result that they become anxious and avoid and withdraw when exposed.

About 20%-30% of children with selective mutistm have subtle speech, hearing and/or language difficulties or other learning disabilities which cause the child feel more anxious, insecure or uncomfortable in situations where they are expected to speak.

What are the symptoms of selective mutism?

Children will speak in most situations but may consistently fail to speak in certain social situations. When anxious these children will have poor eye to eye contact, rarely smile, hold their bodies stiffly, avoid crowds and noise, and have a problem expressing emotions. The condition often can interfere with a child’s ability to connect with others, as well as his or her performance in school and other activities.

What are selective mutism care options?

Treatments include individual behavioral therapy, family therapy, psychotherapy and medications which may include antidepressant and anti-anxiety drugs.

Reviewed by: Jack Wolfsdorf, MD, FAAP

This page was last updated on: September 16, 2025 12:26 PM