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Selective Mutism

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Selective Mutism

Contents

What selective mutism is
Signs and characteristics
Causes and contributing factors
Getting assessed and diagnosed
Support in education
Strategies and interventions
Related guidance

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What selective mutism is

Selective mutism is an anxiety-based condition where a person is physically able to speak but consistently unable to do so in specific situations, such as at school or with unfamiliar people.
 It is not defiance or a speech delay — the silence is caused by intense fear of speaking.

Early recognition and gentle, anxiety-reducing support can help children regain confidence to communicate.

Related guidance

  • Anxiety Disorders
  • Speech and Language
  • Autism Spectrum Disorder (ASD)
  • Social Communication Difficulties
  • SEN Wellbeing
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    Signs and characteristics

    Children with selective mutism may:

    • talk freely at home but remain silent at school or in public

    • appear frozen, blank or expressionless when expected to speak

    • communicate through gestures, nodding or whispering

    • become distressed when pressured to talk

    • experience physical symptoms of anxiety, such as trembling or nausea

    Check signs of selective mutism
    Learn how to recognise when silence is linked to anxiety rather than choice.

    Causes and contributing factors

    Selective mutism is often linked to:

    • social anxiety or extreme shyness

    • genetic or family predisposition to anxiety

    • past negative experiences around speaking

    • speech and language difficulties

    • environmental pressures, such as new settings or high expectations

    Learn what causes selective mutism
    Understand the role of anxiety, temperament and environment.

    Getting assessed and diagnosed

    Assessment is carried out by:

    • a Speech and Language Therapist (SLT)

    • a psychologist or CAMHS professional

    • input from parents and teachers

    Diagnosis is based on observed patterns of speech across different settings, lasting at least one month (beyond normal shyness).

    Find out how selective mutism is assessed and supported

    Support in education

    Support focuses on reducing pressure and creating a sense of safety. Schools can help by:

    • avoiding direct demands to speak

    • using alternative communication methods (gestures, cards, technology)

    • building trust through predictable routines

    • providing one-to-one support and gradual exposure to speaking situations

    • involving SLTs and educational psychologists

    If the condition affects learning, an EHCP can include therapy-based targets and classroom strategies.

    Read about SEN and anxiety support for selective mutism

    Strategies and interventions

    Helpful approaches include:

    • Desensitisation – gradual exposure to speaking in low-stress settings

    • Stimulus fading – slowly introducing new listeners

    • Cognitive Behavioural Therapy (CBT) for older children

    • Parent and teacher training in supportive communication

    • Speech and language therapy to encourage relaxed verbal interaction

    External resources:

    NHS: Selective Mutism overview
    SMIRA: Selective Mutism Information & Research Association
    YoungMinds: Anxiety and selective mutism

    Get support for selective mutism

    Search for therapists, tutors and psychologists experienced in anxiety and selective mutism support.

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