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Symptoms - Selective mutism

Selective mutism is an anxiety disorder. It is an intense fear (phobia) of talking in certain situations. Selective mutism is also known as situational mutism.

Selective mutism mainly affects children, but it can continue into adulthood.

A person with selective mutism usually speaks freely in some situations, but not in others. For example, a child may talk at home but does not speak in preschool or school. They may talk to close family members but they may be silent around other people.

A person with selective mutism does not refuse to speak - they simply cannot speak in some situations. They want to talk but their fear and anxiety stops them.

How selective mutism starts

Selective mutism usually begins between ages 2 and 4, but it can start at any time.

Selective mutism is usually first noticed when a child starts to mix with people outside their family. This could be when they go to preschool or school.

It is often preschool staff, a teacher or childminder who tells you your child is not talking. It may be difficult for you to spot because your child talks at home.

Symptoms of selective mutism

The main symptom of selective mutism is your child not being able to speak in some situations.

If your child is not able to talk outside their home for more than 4 weeks, it could be a sign that they have selective mutism.

If someone speaks to them, they may:

  • become suddenly still
  • have a frozen expression on their face
  • blush or tremble
  • avoid eye contact

They may appear:

  • nervous, uneasy or socially awkward
  • rude, disinterested or sulky
  • clingy
  • shy and withdrawn
  • stiff, tense
  • to have poor co-ordination
  • stubborn or aggressive - they may have a tantrum later, having bottled up intense emotions

They may tell you after an episode that their throat felt closed or tight.

Symptoms can vary

Some people with selective mutism communicate a little. For example, some children may nod for 'yes' or shake their head for 'no'.

Some children might say a few words. They may speak in an unusual voice, or whisper. Sometimes they will speak through a parent, or someone they trust.

Children affected more severely avoid any form of communication.

Your child may have tummy aches or sleeplessness or show other signs of anxiety.

Selective mutism and other conditions

A child with selective mutism can sometimes have other conditions such as:

  • other types of anxiety - for example, separation anxiety
  • phobias - including social phobia

Sometimes people think a child with selective mutism is shy or has difficulty talking. They may think the child is stubborn or is choosing to be silent.

Also, some children with autism can feel too overwhelmed to talk in some situations. This can be mistaken for selective mutism. There is no direct link between selective mutism and autism, but a child can have both.

Causes of selective mutism

Page last reviewed: 29 January 2024
Next review due: 29 January 2027