Selective mutism

An anxiety disorder where a child can speak, and physically cannot in certain settings. Not shyness, and not a choice.

What it is

The name is unfortunate. Selective implies choosing, and that is precisely what is not happening.

Selective mutism is an anxiety disorder. A child speaks freely in settings where they feel safe, usually at home, and finds themselves physically unable to speak in others, usually school. The freeze response takes over and the voice will not come.

It affects around 1 in 140 young children. It responds well to the right approach and gets much harder to treat the longer it goes unrecognised, which is why the wait-and-see advice families are usually given is the wrong advice.

Signs you might notice

Talking normally at home and not at all at school, consistently, for more than a month beyond the settling-in period.

A frozen expression, avoided eye contact, and stillness when spoken to.

Communicating by nodding, pointing or writing.

Sometimes not eating, drinking or using the toilet at school either, because those also feel exposed.

Normal or advanced language when recorded at home, which rules out a language disorder.

How it can affect day-to-day life

The child is often described as well behaved and quiet, so nobody worries. Then the academic gap opens up, because assessment and participation are spoken.

Well-meant pressure makes it worse. Rewards for speaking, waiting for an answer, and putting a child on the spot all raise anxiety and deepen the pattern.

Untreated, it can persist into adolescence and adulthood as social anxiety.

Supporting someone well

Remove the pressure to speak entirely, first. Nothing else works until that happens.

Do not offer rewards for talking, and do not tell the child everyone is waiting.

Use the sliding-in technique: a trusted adult plays with the child alone, a new person joins gradually over sessions, and the child's talking is never the focus.

Accept every form of communication as valid: nodding, writing, a recorded voice, an app.

Avoid direct questions. Comment rather than ask, and leave a gap.

Get the school and home on the same plan in writing.

Fiducia Talk gives a child a voice they can use without speaking, which relieves the immediate pressure while the anxiety is treated rather than working around it forever.

Where to get help

Ask for a speech and language therapy referral, and mention selective mutism by name. Many areas also involve CAMHS.

SMiRA, the Selective Mutism Information and Research Association, are the UK charity and their handbook is what most schools need.

Act early. This is one where waiting genuinely costs.