Yes. Selective Mutism is classified as an anxiety disorder. Since 2013, the DSM-5 – the manual psychologists and psychiatrists use to diagnose mental health conditions – has listed it alongside other anxiety disorders, and the World Health Organization’s ICD-11 does the same. Before that, it sat among conditions “first diagnosed in childhood”, and it was once called “elective mutism” – a name that wrongly suggested children were choosing not to speak.
What this means for your child
Seeing Selective Mutism as anxiety changes how we respond. A child with Selective Mutism isn’t being stubborn, rude or controlling. They want to speak but feel unable to in certain places or with certain people – often at school, preschool or kindergarten, or with relatives and adults they don’t know well. At home, with family, many talk easily and loudly.
Many children with Selective Mutism also have social anxiety, and some are anxious in other ways too.
What causes Selective Mutism?
There usually isn’t one cause. Common contributing factors include:
- Temperament. Many children were cautious or slow to warm up from a young age.
- Family patterns. Anxiety or shyness often runs in families.
- Speech or language difficulties. Some children also have trouble with speech sounds or language, which can make talking feel riskier.
- Learning a new language. Children who are learning English as a second language, or who have moved countries, can be more vulnerable.
- Patterns that keep it going. When others speak for the child or stop expecting them to talk, the anxiety is relieved in the moment – but the silence becomes a habit.
Selective Mutism is not usually caused by trauma, and it isn’t caused by “bad parenting”.
“Situational mutism” and other names
You may also see “situational mutism”, particularly from teenagers and adults describing their own experience. It’s another way of describing the same pattern: being able to speak in some situations but not others.
How is it diagnosed?
A clinical psychologist or psychiatrist diagnoses Selective Mutism by looking at:
- whether the person consistently doesn’t speak in particular situations (such as school) while speaking in others (such as home)
- how long it has lasted – at least a month, not counting the first month at a new school or preschool
- whether it gets in the way of learning, friendships or daily life
- other explanations, such as a language difficulty, a new language, autism or another condition.
Selective Mutism can occur alongside autism, ADHD or speech and language difficulties, so a careful assessment matters. Read more in Can Selective Mutism Look Like Autism?
How is it treated?
Because Selective Mutism is an anxiety disorder, treatment focuses on reducing anxiety about speaking step by step. Behavioural and cognitive behavioural therapy (CBT) have the strongest research support – read CBT for Selective Mutism: What Treatment Involves. Younger children usually progress faster, so it helps to start early.
How the Selective Mutism Clinic can help
At the Selective Mutism Clinic we work with children, teenagers and adults who are anxious about talking. We usually start with parent-only sessions, then sessions with your child, and video meetings with your child’s teacher or educator. Sessions are at our clinic in St Leonards, Sydney, or online anywhere in Australia.
Read more about our Selective Mutism treatment, online treatment for Selective Mutism and treatment for teens and adults.
You don’t need a referral to book. Medicare rebates may be available with a referral and Mental Health Treatment Plan from your GP or paediatrician. Private health funds and self-managed NDIS may also cover some costs. Get in touch or call 02 9438 2511.
More articles: What Is Selective Mutism? A Guide for Parents | CBT for Selective Mutism | Speech Therapy, Play Therapy or Medication for Selective Mutism? | Can Selective Mutism Look Like Autism?
Written by Dr Elizabeth Woodcock, Clinical Psychologist and Director of the Selective Mutism Clinic in St Leonards, Sydney. Elizabeth has over 20 years’ experience as a clinical psychologist and has seen or supervised more than 1,800 children, teenagers and adults with Selective Mutism. She runs the clinic’s webinars for parents, teachers and health professionals. Read more about Elizabeth
