What is Selective Mutism?
A guide for professionals supporting children and young people
Selective mutism is an anxiety-based communication difficulty where a child is able to speak in some situations but is unable to speak in others.
It is most commonly observed in environments such as school, where expectations and social demands are higher.
Understanding selective mutism
Selective mutism is a recognised anxiety condition that affects a child’s ability to speak in specific social situations, despite having the ability to speak comfortably in others (such as at home).
Children with selective mutism are not choosing not to speak. Their silence is linked to a heightened anxiety response, which can significantly impact communication, participation and daily functioning.
How selective mutism may present
Professionals may observe:
- consistent silence in specific environments (e.g. school)
- speaking freely in familiar or low-pressure settings
- difficulty initiating or responding verbally
- reliance on non-verbal communication (gestures, nodding, pointing)
- physical signs of anxiety (freezing, avoidance, reduced eye contact)
Presentation can vary depending on context, relationships and levels of perceived safety.
UNDERLYING MECHANISMS
Selective mutism and anxiety
Selective mutism is closely linked to social anxiety and the body’s threat response.
In situations where a child feels unsafe or overwhelmed, their nervous system may trigger a freeze response, making speech feel impossible rather than simply difficult.
Understanding this is essential for professionals, as approaches that increase pressure to speak can reinforce anxiety rather than reduce it.
COMMON MISUNDERSTANDINGS
What selective mutism is not
- shyness that a child will “grow out of”
- oppositional or defiant behaviour
- a lack of understanding or language ability
- a simple refusal to speak
Misunderstanding the nature of selective mutism can lead to approaches that unintentionally increase anxiety and maintain the difficulty.
IMPACT ON THE CHILD
Impact on communication and participation
- access to learning
- social interaction and peer relationships
- participation in school activities
- emotional wellbeing and confidence
Over time, this can lead to increased anxiety, reduced opportunities for communication, and a widening gap between the child’s abilities and their ability to express them.
SUPPORTING CHILDREN
Supporting children with selective mutism
Effective support focuses on reducing anxiety and creating the conditions for communication to emerge gradually.
This includes:
- reducing direct pressure to speak
- building trust and predictability
- supporting communication in non-verbal and low-demand ways
- working collaboratively with families and school staff
- introducing gradual, supported steps towards verbal communication
A consistent, informed approach across environments is key.
Are you a parent or carer?
If you are looking for support for your child, please visit my dedicated parent website:
There you’ll find guidance, resources and information about next steps.
Evaluation of your child
I have a lovely therapy room where you can come and feel relaxed with your child, and my aim is to play and make your child feel at home because this will help your child to find it easier to transfer skills they were learning in therapy
My approach is to provide families with structured, individualized, step-by-step treatment. This will involve looking at all the various stages of social communication and mapping the speaking habits for a child with Selective Mutism.
A complete evaluation is provided consisting of:
- Parent and teacher assessment forms
- Parent and child interviews
- Evaluation and understanding of which stage the child is at during particular social encounters.
For useful network and further information on Selective Mutism see:
