My daughter M…… who is almost six has been mute in school and with adults since the age of three. She has been on 10mg of Prozac since May of this year and began treatment the end of March. She has been making good progress with eye contact and talking to her immediate family in front of others but she still refuses to talk in school, even to the children (one is her neighbor who she always talks with at home). She started Kindergarten last week and she said she will not talk because she is shy. I don’t know what to do. I know her psychiatrist will want to increase her dose but I have heard that 10mg is usually the magic number. Also, is medication going to make her talk? I am trying so hard to be patient but I know this is a critical year for her.

Thank you.


A few things, first off, she is not REFUSING to speak, she CANNOT speak.

You mentioned that she is on 10 mg of Prozac. What are you doing in terms of behavioral treatment? Is she working with someone to help her build coping skills? Using medication alone will not MAKE her overcome her SM. It will, however, lower anxiety ( when monitored correctly) enough to DO the behavioral treatment necessary to TRULY overcome SM

In addition, you sound a bit ANGRY and frustrated. I suggest that you, too, work with someone, or get some support in helping YOU cope with your child’s anxiety. Believe me, I UNDERSTAND your feelings, and I know it can be very hard when your child does not speak and you feel as if you ‘have done everything’ and you are simply frustrated as to what else to do.

I recommend this: Speak to your psychiatrist about a treating professional who can work with your daughter on an ongoing basis. Also, this treating professional should be able to offer you parental support, guide you and help you COPE and understand how to really help your child with the day to day issues that arise.

Your daughter is telling you she “won’t speak because she is shy,” simply because she is trying to make sense of her inability to speak. She is rationalizing it by saying she is shy, so she can feel OKAY about her mutism.

I can tell you, from working with hundreds of SM children, she needs to be working with someone to help her truly confront and gain control over her mutism, until she can do this, progress will be limited.