Understanding Selective Mutism – A Guide for Parents and Carers

By Dr Katie Caddick, Head of Psychological Practice, and Lucy Shortt, Head of Speech and Language Therapy

Selective Mutism is an anxiety disorder where a person is unable to speak in certain social situations, even though they can talk freely in others.

For example, a child might chat happily at home with close family but be unable to speak at school, or when visiting relatives they don’t see often.

Although the term Selective Mutism is currently used for diagnostic purposes, many people prefer the term Situational Mutism. This is because Selective Mutism can wrongly suggest that the person is choosing not to speak, whereas Situational Mutism more accurately reflects the experience of being involuntarily non-speaking in certain circumstances – which can sometimes be difficult to predict or avoid.

The condition often begins in early childhood (between ages 2 and 4) and, if not addressed, can persist into adulthood. It affects around 1 in 140 young children and is more common in girls and in children who have recently moved to a new country.

When faced with certain people or environments, the expectation to talk can trigger intense anxiety and a “freeze” response. Speaking can feel physically impossible, no matter how much the child might want to.

Signs to Look Out For

Parents often first notice selective mutism when their child starts interacting with people outside the immediate family, such as at nursery or school. Key signs can include:

• A sharp contrast in how they communicate with familiar people versus others.
• Sudden stillness or a frozen facial expression when expected to talk.
• Avoiding eye contact.
• Appearing nervous, clingy, shy, withdrawn, or socially awkward.
• Stiff or tense body language.
• Using gestures (like nodding or shaking their head) instead of speaking – or avoiding all forms of communication.
• Speaking in whispers or altered voices in certain situations.

It’s important to note that a reluctant speaker is different from a child with selective mutism. While some children are shy or hesitant when starting school, children with selective mutism experience ongoing, severe anxiety that stops them from speaking altogether in certain situations. Without early help, a reluctant speaker can be at risk of developing selective mutism.

Why Does Selective Mutism Happen?

Experts often describe it as a phobia of talking to certain people. The causes vary, but it’s linked to anxiety and sometimes to other differences such as:

• Speech, language, or hearing difficulties.
• Sensory processing challenges (e.g. struggling with loud noises or busy environments).
• Social anxiety.
• Past trauma (although this is less common and presents differently).

Children may also avoid activities that could draw attention – such as asking to use the toilet, eating in front of others, or raising their hand in class.

How is it Diagnosed?

Health professionals may still use the term Selective Mutism in clinical settings. Diagnosis usually involves checking for:

1. Consistent inability to speak in specific situations where talking is expected.
2. Impact on learning, social life, or work.
3. Lasting at least one month (beyond the first month of school).
4. Not due to lack of language knowledge.
5. Not better explained by another disorder.

The good news? With early diagnosis and the right support, children can overcome selective mutism. If you have concerns, seek advice promptly from your GP, school, or Speech and Language Therapist.

How Parents and Schools Can Help

Support for selective mutism is about reducing pressure and creating a safe, encouraging environment. Here are some helpful strategies:

At School

• Build an accepting, positive atmosphere where the child feels valued.
• Avoid putting them on the spot or drawing attention to their silence.
• Allow non-verbal communication (gestures, writing, AAC devices).
• Use “yes/no” or closed questions that can be answered without speaking.
• Adapt activities so they can join in without verbal demands.
• Give praise privately to avoid embarrassment.
• Pair them with quieter peers for group activities.
• Allow breaks in quieter spaces if needed.
• Focus on enjoyable activities – art, movement, role play – to build confidence.

At Home

• Reassure them they don’t have to speak – all communication is valued.
• Keep interactions relaxed and pressure-free.
• Encourage play dates or small group activities with familiar friends.
• Share school successes at home and vice versa.
• Celebrate progress, no matter how small.
• Respond naturally if they do speak – don’t make it a “big moment” that adds pressure.

Selective mutism can be worrying for parents, but it’s important to remember: your child isn’t choosing silence. With understanding, patience, and the right support, most children make great progress and find their voice in every setting.

If you suspect selective mutism, trust your instincts and seek professional advice early. The earlier the intervention, the easier it is to help your child build confidence and overcome anxiety.