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SELECTIVE MUTISM · START HERE
What selective mutism looks like.
SM is an anxiety disorder that can make speaking difficult or impossible in certain situations, affecting school, work, relationships, and daily independence.
Communication map
Lower-anxiety settings
A person may speak comfortably with familiar people.
Higher-anxiety settings
They may speak very little or not at all.
The overall pattern
Who is present, where the person is, and what they are being asked to do can all affect speech.
What it means
Selective mutism is not a choice not to speak.
A person with selective mutism may be able to speak normally in some situations and unable to speak in others. Anxiety, especially around the expectation to speak, is central to the pattern.
An anxiety disorder
The difficulty speaking is related to anxiety, not defiance, unwillingness, or lack of knowledge.
Situation-specific
Speech may change depending on the people, place, activity, and level of attention on the person.
Functionally significant
The pattern can interfere with school, work, relationships, or other parts of daily life.
Variable
Some people speak with a small number of trusted people, whisper, or use gestures, writing, or other ways to communicate.
How to understand the pattern
Look at what happens across people, places, and activities.
Assessment draws on information from more than one setting because the pattern may not be visible in a single conversation or appointment.
Compare
What changes when the person, place, activity, or expectation changes?
Consider impact
How does the pattern affect participation, relationships, learning, work, or daily needs?
Share context
Bring examples from the settings that show the clearest differences.
When to consider an evaluation
Consider an evaluation when the pattern persists or limits daily life.
A brief quiet period can be part of adjusting to a new environment or language. Selective mutism is considered when the pattern continues and interferes with daily life.
The pattern persists
The difference in speaking continues beyond an expected adjustment period.
Participation is affected
School, work, relationships, or everyday activities become harder.
The cause is unclear
An evaluation can consider anxiety, speech and language, hearing, development, and other relevant factors.
Common questions
Common questions about selective mutism.
Short answers to questions that often come up when people first learn about the condition.
Explore selective mutism by age and context.
Use the guides below to learn how the condition may appear at different ages and what assessment and treatment can involve.