Selective Mutism

Selective Mutism is a disorder where individuals (most commonly children) do not initiate speech or reciprocally respond when spoken to by others. This lack of speech occurs in both social interactions with children or adults. Children with selective mutism will speak in their home in the presence of immediate family members but often not even in front of close friends or second-degree relatives, such as grandparents or cousins. The mutism often carries with it high social anxiety.

Children with selective mutism often refuse to speak at school, leading to academic or educational impairment, as teachers often find it difficult to assess skills such as reading. The lack of speech may interfere with social communication, although children with this disorder sometimes use nonspoken or nonverbal means (e.g., grunting, pointing, writing) to communicate and may be willing or eager to perform or engage in social encounters when speech is not required (e.g., nonverbal parts in school plays).

Risk Factors

Selective mutism is more common in females than males.

Criterion A

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.

Criterion B

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

Criterion C

The duration of the disturbance is at least 1 month (cannot be during first month of school).

Criterion D

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

Criterion E

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