Selective mutism is a condition in which a child who can speak well stops speaking, usually in school or social settings.

Most experts believe that the causes of selective mutism involve the following factors:

• Anxiety
• Biological
• Environmental
• Social

Most children with this condition have some form of extreme social phobia.

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

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.

This syndrome is not the same as mutism. In selective mutism, the child has the ability to both understand and speak, but fails to speak in certain settings or environments. Children with mutism never speak.

• Ability to speak at home with family
• Failure to speak in certain social situations
• Fear of people
• Shyness

This pattern of mutism must be observed for at least 1 month. (The first month of school does not count, because shyness is common during this period.)

Teachers and counselors should consider cultural issues, such as recently moving to a new country and speaking another language. Children who are uncomfortable with a new language may not want to use it outside of a familiar setting. This is not necessarily selective mutism.