Selective mutism (SM) is a condition where children are able to talk comfortably in some situations such as at home or around familiar relatives, but are not able to use their voice in other social situations where there is an expectation for speaking such as at school or with less familiar people.

SM is a form of social anxiety where the child fears that when people hear their voice they will react in a way that might be embarrassing for them or that they may be judged for how they sound or what they say. This fear prevents the child from being able to speak freely. Sometimes children with SM are unable to speak to adults or peers at school. Sometimes they can speak to select people (e.g., 1 or 2 peers, or adults but not peers), and sometimes children are able to whisper to a large number of people but unable to use their vocal cords.

Although Selective mutism usually becomes apparent around three years of age, the condition is often not diagnosed until much later (e.g., early to mid primary school). The delayed referrals of children to appropriate services is often due to the perception that the child will ‘grow out of it’ and eventually start talking. However, this is often not the case, as improvements tend to occur very slowly (if at all) if it is left untreated. Preschool workers, early childhood carers, and speech therapists play a key role in early detection of the condition and in ensuring that steps are taken before the mutism becomes firmly established.

In the past ten years or so, the recognition that selective mutism is a form of social anxiety has led to the development of effective treatment programs, such as cognitive-behaviour therapy (CBT). CBT programs aim to gradually expose the child to anxiety-provoking social situations and assist them to build up nonverbal, and later verbal communication.

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