Glossary
What is selective mutism?
Also called: situational mutism, SM, child won't talk at school, elective mutism
Definition
Selective mutism is an anxiety disorder in which a child consistently cannot speak in certain situations, such as at school, while speaking freely in others, such as at home with family.
What it means
Selective mutism is listed as an anxiety disorder in DSM-5 and ICD-11. The child wants to speak but freezes, because speaking in that setting triggers intense anxiety. The old name, “elective mutism”, suggested the child was choosing not to talk, which is why it was dropped.
For a diagnosis, the pattern needs to have lasted at least a month, not counting the first month at a new school or nursery, and can’t be explained by not knowing the language or by another communication difficulty. It often starts in early childhood and is frequently spotted when a child starts nursery or Reception. Children learning a second language may go through a normal silent period, which is different. Some autistic children also have selective mutism, and assessment should look at both.
What it can look like for your child
Chatty and loud at home, completely silent in class. Able to whisper to one friend but no one else. Freezing, looking down or going stiff when spoken to, and relying on nodding or pointing. Unable to answer the register or ask to go to the toilet. Teachers may wrongly think the child is shy, rude or stubborn.
How counselling can help
Pressure to speak makes it worse, so sessions never require talking. Play, drawing and the sand tray let a child communicate in other ways while they relax. Small steps toward speech are planned with the child and family, often alongside a speech and language therapist and school, who may use structured approaches. We help parents and staff take the pressure off while keeping gentle chances to speak.