Selective mutism

Also called Situational mutism

Selective mutism is an anxiety disorder where a person is unable to speak in certain social situations, such as with classmates at school or with relatives they do not see often. It usually starts in childhood, often when a child starts nursery or school. It is not a choice or refusal to speak, and the child usually speaks freely at home.

Last updated Nov 9, 2026

What it is

Without support it can continue into adulthood, so early help is important.

Treatment uses small, gradual steps to reduce anxiety about speaking, with support from family, school and therapists such as speech and language therapists or psychologists.

Common signs

  • Speaking freely at home but not at school or with others
  • Freezing or looking blank when expected to speak
  • Avoiding eye contact
  • Using gestures instead of words
  • Seeming shy or anxious in social situations

How it is usually diagnosed

  • Assessment by a speech and language therapist, psychologist or other specialist
  • Information from family and school

Records worth keeping

Keeping these together makes each appointment easier, especially when you see a new doctor:

  • Speech and language therapy reports
  • Psychology letters
  • School support plans

Questions to ask your doctor

  • How can we support speaking at home and school?
  • Which professionals should be involved?
  • How long does progress usually take?

When to get help right away

Call 112 or go to the nearest emergency department if you have:

  • A child or adult with thoughts of harming themselves: get urgent help, call 112 if in danger

This page is general information. It is not a diagnosis and does not replace a doctor who knows your history. Medfold keeps your records organised; it does not interpret them.

Sources