Our 5 yo daughter was diagnosed with SM in May/oo. She showed signs for about 2 years prior-we thought her to be shy. She usually would only whisper VERY quietly when others were present, but when people stopped trying to make her talk, she started talking to us out loud in front of others. She now will sometimes say uh-huh to people she wouldn’t talk to before, but she won’t use words. How long should we let this progress before trying meds? She does see a psychologist, but I don’t think she has progressed from the visits. We are holding her back from K this year because we stand the thought of kids constantly asking why she won’t talk-we worry about a slip back. Thanks in advance for any advice.


Thanks for writing in. Your question brings up a lot of very pertinent thoughts.

  1. when to consider medication and
  2. whether to hold your child back in school

Regarding Medication. If you see your child progressing, I would hold off for a little while. Sounds like she is verbalizing. I usually recommend medication when you have ‘exhausted all other options’ and/or ‘a child’s mutism is impinging on their well-being’. For example, many children, especially as they approach 5, 6 and 7 years old become more and more aware of the mutism and ‘inability’ to speak. Many kids actually become depressed and anxious over this, which in turns causes increasing stress. If your child is making strides, and showing improvement, hold off until after school starts and see how she does. Is she going back to the same school? The reason I ask is because she ‘see’s herself as a non-talker’ there. IF she were to go to a new school, where no one knows she ‘doesn’t speak’, it can sometimes be just the cure for some children’s mutism!

I am not quite sure why you are holding your child back from Kindergarten. Is it because she is not academically ready? Her birthday falls right on the cut-off? She is emotionally immature? If your decision is based on her mutism, I am not sure you are making the decision for the right reasons. Many extremely bright and mature children are mute due to their profound social phobia. I do not believe the extra year will help that much. In fact, it can hinder them in many respects.

From research I have read, holding back can often cause more stress….and academically-ready children are not stimulated enough with another year of pre-k. Please write in and let me know your reasons. Remember being Mute does not mean a child is immature! ……..just socially phobic…

Dr. Elisa Shipon-Blum