What To Know About Selective Mutism

May 20, 2024|Mental Health|
A young girl sits alone on a school bus

Selective mutism is a complex childhood anxiety disorder characterized by a child’s inability to speak and communicate effectively in select social settings, such as school. However, it’s not limited to children; adults can also experience it. This condition can be mistaken for shyness, but it’s much more severe and can significantly impact a person’s social and educational development or career and personal life.

In this article, we’ll dive deep into what selective mutism is, how it’s connected to other conditions like autism, its symptoms, causes and the available treatment options.

Understanding Selective Mutism

Selective mutism is often misunderstood, and raising awareness is essential. It’s not a choice or stubborn behavior; it’s a mental health disorder that requires understanding and patience from those around the affected individual.

What is selective mutism?

Selective mutism was once called “elective mutism,”which suggested that it was a choice. We now know that it’s far from voluntary. The term “selective” better reflects the condition, as children or adults with selective mutism can speak freely in situations where they feel comfortable, like at home with their family, but are unable to speak in other social settings.

Selective Mutism in Children and Adults

While selective mutism is primarily diagnosed in children, typically before the age of five, it can continue into adulthood if not treated appropriately. Adults with selective mutism often experience social anxiety and may struggle with speaking at work, in college or in social gatherings.

Selective mutism and autism

Selective mutism and autism can co-occur, but they are distinct conditions. Autism is a developmental disorder that affects communication and behavior, while selective mutism is an anxiety disorder affecting the ability to speak in certain environments. However, a child or adult with autism may also develop selective mutism as a response to the stress of social interactions.

Recognizing the Symptoms of Selective Mutism

Recognizing selective mutism can be challenging, but awareness of the symptoms can lead to early intervention. Selective mutism symptoms may include:

  • Consistent failure to speak in specific social situations despite speaking in others.
  • The inability to speak interferes with educational, occupational or social communication.
  • The duration of mutism lasts at least one month (not limited to the first month of school).
  • Failure to speak isn’t due to a lack of knowledge or comfort with the spoken language.

The Causes of Selective Mutism

Understanding selective mutism causes is of paramount importance when it comes to effectively addressing and treating this complex and often misunderstood condition. By delving into the underlying factors that may contribute to a child’s inability to speak in certain social situations, therapists and healthcare professionals can tailor their interventions and strategies to best support the individual in overcoming their communication challenges. In addition, a thorough understanding of the root causes of selective mutism can help to dispel misconceptions and stigma surrounding the condition, promoting greater empathy and acceptance within the broader community.

Biological and environmental factors

Research suggests that selective mutism may be associated with both biological and environmental factors. These could include:

  • A family history of anxiety disorders.
  • Inhibited temperament.
  • Speech and language abnormalities.
  • Environmental factors such as social anxiety, past trauma or an overbearing parenting style.

Selective Mutism Treatment Options

Treatment for selective mutism is tailored to the individual’s needs. It may include therapy, medication or a combination of both.

Behavioral Therapy

Cognitive-behavioral therapy (CBT) is commonly recommended as the initial course of treatment for individuals struggling with various mental health conditions. This therapeutic approach is designed to address and modify negative thought patterns and behaviors that may be contributing to emotional distress or dysfunctional coping mechanisms. For children specifically, the treatment plan may incorporate play-based therapy techniques, which aim to create a safe and engaging environment for the child to gradually express themselves and develop effective communication skills. Through the use of play activities and interactions with a trained therapist, children can explore and process their emotions in a developmentally appropriate manner, ultimately fostering healing and growth.


In certain situations where individuals struggle with speaking due to underlying anxiety, a healthcare provider may choose to prescribe medication as part of a comprehensive treatment plan. These medications are designed to specifically address the symptoms of anxiety, helping to alleviate the feelings of fear and nervousness that may accompany speaking in certain situations. By managing these underlying feelings of anxiety, individuals may find it easier to communicate effectively and confidently in various settings. It is important to work closely with a healthcare provider to determine the appropriate medication and dosage that best fits the individual’s needs and to monitor any potential side effects or adjustments needed to ensure optimal treatment outcomes.

Family and school involvement

Treatment for children with communication disorders often requires a comprehensive approach that involves not only the child themselves, but also their family members and educators. This collaborative effort is crucial in ensuring that the child receives the support they need to improve their communication skills. Parents can benefit from education on various techniques and strategies that can help their child communicate effectively without feeling pressured or overwhelmed. Additionally, schools can play a key role in providing accommodations and support to create a positive and inclusive learning environment for the child. These accommodations may range from modified curriculum to assistive technology, all aimed at helping the child feel more comfortable and confident in their ability to communicate. By working together, families and educators can create a supportive network that empowers the child to succeed in their communication goals.

Strategies for Supporting Someone With Selective Mutism

Supporting someone with selective mutism requires patience and understanding. You can provide support for a loved one with selective mutism in some of the following ways.


  • Be patient and understanding.
  • Recognize and celebrate small achievements in communication.
  • Create a supportive environment that encourages but doesn’t force speech.


  • Do not pressure the individual to speak.
  • Avoid speaking to the person, or speak around them.
  • Don’t treat them as if they are incapable of understanding or participating in relationships.

Navigating Selective Mutism in Education and Career

Selective mutism can have a significant impact on education and career development. Here are some strategies for navigating these challenges.

In education:

  • Work closely with educators to develop an individualized education plan (IEP).
  • Incorporate accommodations, such as alternative ways of participating in class.

In the workplace:

  • Seek employment in environments that are understanding and accommodating of selective mutism.
  • Use written communication when necessary and work on gradual exposure to speaking situations.

Selective mutism is a challenging condition that can impact every aspect of an individual’s life, from childhood through adulthood. With the right support and treatment, however, individuals with selective mutism can learn to manage their symptoms and lead fulfilling lives. It’s important for parents, educators and employers to recognize the signs of selective mutism and provide a supportive environment that fosters communication and growth.

If you or someone you know may be struggling with selective mutism, don’t hesitate to seek professional help. Hartgrove Behavioral hospital in Chicago, IL, has several programs, including adolescent programs, that can support patients who are experiencing selective mutism. 

You can call today at 773-572-3300 to see if Hartgrove is the right place for you or your loved one to seek treatment. Or, you can check out our online resources to learn more about our suite of programs.


Hartgrove Hospital

Hartgrove Hospital is a Modern Behavioral Health Hospital that specializes in personalized treatment for adults, adolescents and children. We pride ourselves on delivering quality care provided by our compassionate and thoughtful staff. Our mission is to restore the emotional well-being of our patients, while giving them the proper resources for their future.

Some of our programs include our inpatient and outpatient services. As well as our trauma and Partial Hospitalization Program (PHP). These programs are offered with an all-encompassing psychiatric healthcare service that is both effective and efficient. Located in Chicago, IL, our facility has a friendly and welcoming atmosphere.

To schedule a no-cost assessment or for more information, please call 773-572-7900 .

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