Selective mutism in children: what it is, how it manifests, and how to deal with it

Published on July 16, 2025 – by editorial team

When we talk about an issue like selective mutism, we are essentially referring to a condition that affects school-age and adolescent children. It is in all respects a disorder linked to anxiety and fear that a child may feel in certain situations and contexts. Precisely because some of these situations cause a high level of anxiety, the child automatically stops speaking. The phenomenon manifests as a complete absence of verbal communication by the child when placed in a context that they perceive as anxiety-inducing or stressful. The term selective refers to a kind of internal filtering mechanism. The child will speak only to selected individuals, usually family members, and will have significant difficulty speaking in other environments such as school.

Is this condition a consequence of sensory or neurological problems? No, it is a block in communication that occurs due to an internal form of social anxiety. The behavior is not random—it is a clear avoidance strategy.

The child might be in a situation where there is a social expectation placed on them—like when teachers expect the child to speak and express opinions. In those moments, the child perceives pressure, or at least interprets it that way, because they believe the teachers are waiting for them to speak.

However, the child experiences unpleasant feelings that lead them to remain silent. Is it a widespread disorder among children or a rare condition? It is actually quite rare, with a prevalence of about one percent.

Onset of the disorder

Is there a specific age when symptoms appear? Yes, around age two or three, early signs may include:

• The child is notably shy
• The child shows fear in the presence of certain people

However, the problem becomes apparent around age five or six, typically in social contexts such as school. This is when verbal communication begins to be expected of the child.

Challenging diagnosis

Is this an easy disorder to diagnose? Not really. Due to its nature, diagnosis can be slow. Parents might not notice the issue until the child starts school.

In school, the need for interaction with peers and adults increases. Children are also expected to do classwork and homework, which may raise anxiety levels in those affected by this condition.

Scientific research and evolution of the disorder

Over time, many studies have aimed to understand the disorder's development. Its name and classification in diagnostic manuals have changed. It was once believed to be intentional and was called elective mutism. It is now recognized as an anxiety-based disorder.

This reclassification has made it possible to define specific diagnostic criteria that help guide accurate diagnosis.

Diagnostic criteria

To diagnose selective mutism today, five key criteria are used:

• The child consistently fails to speak in specific social situations where there is an expectation to speak (e.g., school)
• The disorder interferes with academic performance and social communication
• The symptoms last at least one month
• The issue is not due to a speech or language impairment specific to that context

Children with this condition may exhibit the following behaviors:

• Lack of eye focus or attention
• Neutral or inexpressive facial expressions
• Mild agitation
• Occasional oppositional or aggressive behavior

Non-verbal communication

Children with selective mutism often communicate non-verbally. They might:

• Use gestures
• Nod their head
• Shake their head
• Push objects or people
• Write instead of speak
• Use monosyllabic sounds

Contributing factors

What factors influence the development of this disorder? Three main areas have been identified:

• Children from families with anxiety-related issues may be genetically predisposed
• Temperament plays a role: excessive shyness or fear in specific social situations
• Overprotective parenting styles can contribute to the problem

Children interact mainly in family and school settings. Collaboration between parents and teachers is crucial. Parents must avoid common mistakes—like pressuring the child to speak or speaking on their behalf in social situations.

Therapeutic approaches

Treatment is typically cognitive-behavioral therapy (CBT), aiming to:

• Reduce the child’s anxious responses in triggering situations
• Boost self-esteem and confidence
• Provide strategies to manage negative emotions effectively

Equally important is educating parents about the child’s condition so they can adopt supportive strategies at home.

Another common mistake parents make is substituting themselves for the child during verbal exchanges. For example, when someone asks the child a question, and the parent answers in their place. This reinforces avoidance behavior and can hinder progress.

For more information, visit the Wikipedia page on Selective Mutism.

Frequently Asked Questions

← Also read: Morgellons Syndrome

← Back to homepage