Selective mutism

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Selective mutism is a condition in which a child who is fluent in a language frequently fails to speak in situations where language is expected.

It typically occurs in school or social settings. This pattern of mutism must be observed for at least one month. The first month of school does not count, because excessive shyness is common during this period.

Parents often think that the child is refusing to speak, but usually the child is truly unable to speak in particular settings.

Most experts believe that there are environmental, biological, interpersonal, and anxiety-related factors that cause selective mutism. Most children with this condition have some form of extreme social phobia (a phobia is extreme irrational fear).

Some affected children have a family history of selective mutism, extreme shyness, or anxiety disorders, which may increase their risk for similar problems. This condition is most common in children under age 5.

Review Date: 05/17/2006
Reviewed By: Paul Ballas, D.O., Department of Psychiatry, Thomas Jefferson University Hospital, Philadelphia, PA. Review provided by VeriMed Healthcare Network.