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How to Recognize Selective Mutism

By Caraline McDonnell, BA, Senior Program Assistant

Shyness at a young age is often considered developmentally appropriate and can be normal for many kids. However, there's a point when shyness can start to interfere with a child’s ability to engage with peers, teachers, and other fun, recreational activities. Selective mutism is an anxiety disorder that makes it difficult for a child to speak with others in specific settings. For instance, a child who cannot answer a question when called on by a teacher in school. Typically, kids with selective mutism struggle to speak in public settings but can speak comfortably at home and with family that they are familiar with. In the home setting, kids with selective mutism may feel more secure and relaxed, and their anxiety does not impact them as much.

Children with selective mutism experience an actual fear of speaking and an inability to speak appropriately in interactions where they are expected to communicate outside of the home; for many kids, this fear is rooted in a worry about being embarrassed or negatively judged. For some kids, selective mutism may look like complete silence in these situations while others may be able to communicate through whispers. The degree to which selective mutism impacts a child’s ability to engage will differ for each child, dependent on the ways their anxiety manifests. Children and adolescents with selective mutism are viewed as extremely shy and timid compared to their peers.

Kids with selective mutism most often have a genetic predisposition to anxiety that has been passed along by one or more family members. Children who develop selective mutism often show more internalizing symptoms of anxiety, like crying, sleep problems, and extreme shyness, from infancy. Some research has found that children with selective mutism have a decreased threshold of excitability in the amygdala in their brains. The amygdala is the part of the brain that receives and processes fear signals. When confronted by fearful social situations, like birthday parties or being in class, children with selective mutism will experience enhanced feelings of danger and their body will react to these signals. Their ability to speak is inhibited as a result.

Many kids with selective mutism can engage with others at a developmentally appropriate level when in comfortable environments, they can be just as funny and loud as their peers when they feel safe. Here are some ways that selective mutism can show up in kids.

  1. All kids with selective mutism experience an inability to speak at an appropriate volume outside of the home environment and in social situations.
  2. Some kids may appear to have a blank facial expression, and they may freeze up or become tense when in social situations.
  3. Some kids may avoid eye contact or withdraw from a group or conversation
  4. Some kids will experience an inability to ask for assistance or help when needed
  5. Some kids will be able to engage with other peers or adults physically but will remain quiet in group settings.
  6. Many kids will experience physical anxiety symptoms, like tummy-aches, nervous feelings, shortness of breath, etc.
  7. Many kids will often be described as moody, bossy, or defiant at home. They also can be described as overly silly in front of family and friends. These kids have developed ways of managing the anxiety they feel outside of the home by taking control and letting it all out at home.

Diagnosing and treating selective mutism as early as possible is one way to maximize a child’s potential for positive treatment outcomes. While struggling with selective mutism, kids will have significant challenges forming social relationships, participating in academic activities, and asking for help when they need it. The longer that a child is inhibited by selective mutism in their life, the more challenging it will be to address it effectively later. If left untreated, selective mutism can lead to worsening anxiety, social isolation and withdrawal, school refusal, and possible symptoms of depression.

If you are concerned that your child, or someone you know, is struggling with selective mutism, seek support in the form of an evaluation and evidence-based treatments. 

Want to learn more?

Camposano, L. (2011). Silent suffering: Children with selective mutism. The Professional Counselor, 1(1), 46–56.
Stanley, C., Dabney, L., & Gorski, L. (2023, September 14). What is selective mutism: Selective mutism and anxiety disorders. Selective Mutism Anxiety & Related Disorders Treatment Center | SMart Center.
Wall, D. (2021, June 19). Selective mutism: Fact sheet - ABCT - association for behavioral and cognitive therapies. ABCT.
Wong P. (2010). Selective mutism: a review of etiology, comorbidities, and treatment. Psychiatry (Edgmont (Pa. : Township)), 7(3), 23–31.