Selective Mutism (SM) is an anxiety disorder when a person does not speak in specific situations or to
specific people. As an anxiety disorder, the prevailing symptom is that speaking in certain settings
evokes a sense of intense fear and terror.
The age of onset is usually in preschool years and without intervention, can persist for years. Parents are
often unaware of the problem until the child starts school as many of these children speak openly at
home and are only mute in school or other social settings.
It is important to note that there are many reasons a child may not speak in the school setting. These
include: hearing difficulties, learning disabilities, poor language comprehension (as with children from
multilingual families) or even autism spectrum disorder. These challenges ARE NOT considered classic
SM. Before treating any such condition, it is important to receive a proper diagnosis.
The child’s behavior could become more entrenched as time goes on, so early intervention is prudent. If
left untreated, there is a risk of developing social anxiety into adulthood.
For treatment to be successful, there should be collaboration between the therapist, school, and the
parents. Although SM falls under the general category of anxiety disorders, the intervention needs to be
custom-tailored to SM, so a clinician with training and experience in this diagnosis is vital.