Selective Mutism (SM) is an anxiety-based disorder that results in the person having an underlying fear of speaking in public or less comfortable speaking situations (e.g., school, restaurants, around unfamiliar people, etc.). People with SM often speak freely at home or with family members whom they are most comfortable with. They do not always have an underlying speech or language disorder, but they can co-occur. SM can present in children as young as 2-years-old. It is essential to seek treatment through a multidisciplinary approach, especially for children, to ensure that the avoidance of speaking situations doesn’t become reinforced, making it more difficult to speak as the child gets older. Multidisciplinary teams treating SM often include a psychologist/psychiatrist or mental health counselor, speech-language pathologist, and special educators. For children with SM, school can be one of the most challenging environments for them to speak in. Therefore, it is essential that their treatment doesn’t just take in place in the confines of an office, but that they also receive accommodations in the classroom or have classroom support to help generalize the skills and strategies that they learn into natural speaking contexts.

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) lists the following criteria for a diagnosis of SM:

• The child shows consistent failure to speak in specific social situations in which there is an expectation for speaking (e.g., at school), despite speaking in other situations.

• The disturbance interferes with educational or occupational achievement or with social communication.

• The duration of the disturbance is at least 1 month (not limited to the first month of school).

• The failure to speak is not attributable to a lack of knowledge of, or comfort with, the spoken language required in the social situation.

• The disturbance is not better explained by a communication disorder (e.g., child-onset fluency disorder) and does not occur exclusively during the course of autism spectrum disorder, schizophrenia, or another psychotic disorder.

If you or someone you know exhibits characteristics consistent with a diagnosis of SM, please feel free to reach out to our office to speak to a clinician about next steps. Below are a few resources to visit to learn more about SM and possible interventions:

The Selective Mutism Association provides numerous resources for families and treating professionals. They also offer courses, webinars, and present at conferences to spread the word about SM and to provide support for individuals, caregivers, and professionals working with this population.

The American Speech-Language-Hearing Association (ASHA) also provides information about SM, including signs and symptoms, assessment, treatment, and additional resources.