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GUIDE
FOR PEDIATRICIANS
Recognize selective mutism and guide families to a next step.
A child may speak at home yet be unable to speak at school, during appointments, or with certain people. That pattern may indicate selective mutism.
A POSSIBLE REFERRAL FIT
WHO WE SERVE
Ages 3–24
CARE FORMAT
100% virtual
YOUR ROLE
Recognize, explain, refer
PROFESSIONAL GUIDES
WHAT TO NOTICE
Look for a consistent pattern across settings.
Ask families and schools how speaking varies across places and people; one quiet visit is not enough to identify selective mutism.
01
Speech differs across settings
The child speaks comfortably in some settings but is consistently unable to speak in others.
02
Speaking becomes difficult when expected
Direct questions or unfamiliar people may lead to freezing, avoidance, or nonverbal responses.
03
Participation is limited
The child may be unable to ask for help, join activities, or show what they know.
04
The pattern has continued
Difficulties persist despite time, reassurance, or general support.
QUESTIONS TO ASK
Where and with whom is speaking easier or harder?
Ask about duration, impact, languages used, and related communication or developmental concerns.
1
Compare settings
Where and with whom does the child speak comfortably?
2
Understand impact
How does the pattern affect school, medical care, friendships, or daily activities?
3
Review history
How long has it lasted, and what evaluations or supports have been tried?
TALKING WITH FAMILIES
Describe what you are noticing.
You might say: “Selective mutism is an anxiety disorder. A child may speak in some situations but be unable to speak in others. This pattern is worth evaluating.”
02
Avoid blame
Explain that the child is not choosing not to speak.
03
Recommend evaluation
Let the family know they can seek an evaluation without having a confirmed diagnosis.
COMMON QUESTIONS
Questions from pediatricians
What to know about evaluation, referral, and coordination.
Refer when the pattern warrants a closer look.
A diagnosis is not required. Braverly will review fit and availability.