top of page
  • Writer's pictureDr. Elena Duong

Struggle Speaking in Certain Settings? Maybe It is Selective Mutism...

Updated: Dec 18, 2022

Have you heard of selective mutism? It is not as well-known as social anxiety disorder (you can read more by clicking here). Some may mistake shyness with selective mutism since they have some similar surface symptoms, but there are some differences. An individual with shyness might not want to talk in class but can if need be, while an individual with selective mutism cannot.

What is Selective Mutism?

According to the Diagnostic and Statistical Manual of Mental Disorder-5 (American Psychiatric Association, 2013), the following are the criteria for selective mutism:

  • Not being able to speak in specific social situation when expected to speak despite speaking in other situations

  • Not speaking interferes with an individual’s achievement or social communication

  • An individual has the knowledge or comfort with the spoken language required in social setting and is not speaking

This condition tends to be diagnosed in childhood. Other signs can include behavioral inhibitions such as: being able to talk freely at home but not in other settings, feeling fear and shutting down after being asked to speak, relying on nonverbal communications, and/or struggling with eye contact (Selective Mutism Association [SMA], n.d.).

What Causes This Condition?

There is not a singular cause for selective mutism. Some factors include: genetics, a reinforcing environment of avoidance behaviors (through observing others or being isolated from others), having another anxiety disorder, and/or already having a shy/timid temperament (American Speech-Language-Hearing Association, n.d.).

I May Have Selective Mutism. What is Next For Treatment?

  • We encourage you to go to a mental health professional for a diagnosis and treatment plan

  • The following are treatments found to be helpful with selective mutism (SMA, n.d.):

    • For selective mutism and other anxiety disorders, research suggests cognitive behavioral therapy (CBT) can be helpful

    • Behavioral Strategies:

      • Examples include integration of relaxation skills and gradual exposure as well as social skills training (i.e., skills to move through social situations)

    • Cognitive Strategies:

      • These strategies examine the anxious thoughts contributing to the selective mutism

    • Medication

      • You can consult a medical doctor on what type of medication

      • Studies have shown selective serotonin reuptake inhibitors (SSRIs) have been helpful with those with anxiety conditions

    • Speech-Language Therapy

      • Speech-language pathologists will work with individuals working on nonverbal social engagement skills, communication skills in activities, and may integrate speech articulation therapy

It is never too late to seek help with selective mutism, especially if it is causing significant disturbance to your life or preventing you from being where you want to be. It is already a struggle to reach out for therapy, and having selective mutism may make it more difficult due to the nature of the disorder.

If you want therapeutic support with your mental health struggles, feel free to contact us through our site.

Stay tuned. The next topic is "Coping Through The Holidays."


American Speech-Language-Hearing Association. (n.d.). Selective Mutism. American Speech-Language-Hearing Association. (n.d.).

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Selective Mutism Association. (n.d.). What is SM? Selective Mutism Association.

Selective Mutism Association. (n.d.). FAQs. Selective Mutism Association.

Written by Elena Duong, Psy.D.

Edited by Susanna La, Ph.D.

Recent Posts

See All


Les commentaires ont été désactivés.
Post: Blog2_Post
bottom of page