About Selective Mutism
Here’s what individuals with selective mutism, their families, educators, and treating professionals should know about selective mutism.
What is selective mutism (SM)?
If you know an individual who can talk freely at home but freezes up in public settings or who seems excessively shy, you may know someone with selective mutism. Selective mutism is an anxiety disorder characterized by a person’s inability to speak in certain social settings such as at school, work, or in the community. People with SM are typically able to speak comfortably and communicate well in other settings, such as at home with family.
What are the symptoms of selective mutism?
A child, adolescent, or adult diagnosed with selective mutism may experience significant impairment in daily functioning due to an extreme and pronounced fear of speaking, typically in educational or occupational settings. This difficulty in speaking results from anxiety rather than from a language or learning disorder or autism. Unlike these disorders, SM is often only present in specific settings and/or with certain people.
What causes selective mutism?
There is no single cause of SM, but it is generally understood to be an anxiety disorder that can be related to shyness, social anxiety, and inhibited temperament in which speaking situations are avoided and this avoidant behavior gets reinforced over time. SM is not the same thing as being shy, and not everyone with SM presents as socially anxious or inhibited outside of specific situations in which speech is expected. However, research does show significant correlations between SM and anxiety in general. Some evidence suggests a genetic link between children with SM and anxious parents or family members. There is further evidence that behaviorally inhibited children have a decreased threshold of excitability in the amygdala, the area of the brain that receives and processes signals of potential threats. Disorders such as expressive/receptive language and communication disorders may increase a person’s risk for developing SM. Some research also suggests that being bilingual may increase a person’s risk for developing SM as compared to monolingual speakers. Although extremely rare, traumatic or stressful events may be related to the onset of SM. The majority of people with SM do not report a history of traumatic events.
How does SM differ from shyness?
Selective mutism is a diagnosable mental health disorder and shyness is a normal personality trait. Shyness is marked by a tendency to withdraw from people, particularly unfamiliar people. Everyone has some degree of shyness; it may be experienced a lot, a little bit, or somewhere in between. Like other inheritable traits, such as height and eye color, shyness is largely influenced by genes (Stein & Walker, 2002). However, it is not characterized by extreme inhibition that interferes with a person’s daily functioning like mental health disorders including SM, social phobia, and avoidant personality disorder.
How is selective mutism treated?
There are many research-based treatment options for selective mutism, including behavioral and cognitive-behavioral (CBT) strategies, medication, and speech-language therapy. All treatments should be pursued under the care of an experienced professional.
Selective Mutism Facts
1 in 140
Children are affected by selective mutism
2 – 4
Age when signs typically start to appear
2 : 1
SM is more prevalent in females than males
~70%
Of children with SM also meet criteria for social anxiety disorder
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Selective Mutism Association International Annual Conference 2025
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