Selective mutism
A child may talk freely at home and find words unavailable at school or with unfamiliar people. If you are trying to understand this difference, start with where they feel comfortable and how they can communicate without pressure.
When speaking depends on the situation.
Selective mutism is an anxiety disorder involving a persistent difficulty speaking in some expected situations, despite speaking in others. It can affect participation in education and relationships.
It usually begins in childhood and can continue later in life. This page focuses on supporting a child; an adult with speaking difficulties can also seek professional help.
Based on NHS · American Speech-Language-Hearing Association
Communication has a context.
- People
Familiar and unfamiliar communication partners
- Places
Where communication feels more or less comfortable
- Ways to respond
Speech, gestures, drawing or writing
- Shared support
A coordinated plan around the child
Communication is more than spoken answers.
An assessment considers where and with whom communication is easier, language experience and hearing or other communication needs. Difficulty speaking in a setting should not be treated as deliberate refusal.
Ways of communicating
Gestures, writing or other responses may help the child participate.
Language context
The professional needs to understand the child’s languages and opportunities to use them.
Comfort and access
Ask how the appointment can reduce pressure to speak.
Based on ASHA
Look at the setting, not just the silence.
These observations can help you describe a concern; they cannot establish a diagnosis.
Who is there
Who the child can speak with comfortably.
Where it happens
Where speaking becomes difficult or unavailable.
Ways to communicate
Whether writing, gestures or another response feels easier.
Everyday impact
How communication affects learning, friendships or asking for help.
Based on NHS · American Speech-Language-Hearing Association
Make the appointment accessible before it starts.
Ask the service how a child who cannot speak at an appointment can take part. A speech and language professional and a child mental health professional may contribute different expertise.
Assessment considers communication across people and settings, hearing and language, development and anxiety. Learning a new language needs its own context; silence in an unfamiliar language alone does not establish selective mutism.
- 1Comfortable communication
Where, with whom and in which language can the child communicate comfortably?
- 2Joining the appointment
Can they write, point, draw or respond in another way while you get to know them?
- 3One shared plan
How can home, education and professionals make communication feel less pressured?
Support communication without turning it into a performance.
Ask which age-appropriate support fits, how the young person will be involved and who can help with the next step.
Based on NHS · American Speech-Language-Hearing Association
Coordinate support rather than testing the child in public.
Ask the child’s clinician or speech and language professional how home and education can support a shared plan. Avoid surprising the child with demands to demonstrate speech or turning progress into a public performance.
Find support. Prepare your next step.
Find care or prepare a conversation. You can ask for help before you have a diagnosis.
Your first sentence does not need to be perfect.
You might ask your child's healthcare professional or an appropriate school contact for advice. Explain the difference you notice and ask who can assess both anxiety and communication needs.
Based on NHS · American Speech-Language-Hearing Association
“My child can speak comfortably in some situations but finds it difficult in others. How can we understand this and make support accessible without pressuring them to speak?”Prepare for the appointment
Your questions, with room for nuance.
You can read just the answer you need.
Should I make my child answer to prove they can?
Pressure to demonstrate speech is not a diagnostic assessment. Ask a qualified professional about communication access and an appropriate plan.
Based on ASHA
Where this information comes from.
Use this hub to learn and prepare questions. It does not diagnose you or recommend a personal treatment plan. By Selfmora editorial; sources checked . Updated .
Additional explanations and examples: sources consulted . Examples illustrate ideas; they do not assess your personal health. Your questions
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