Table of ContentsView AllTable of ContentsWhen Does It Begin?SymptomsTestingSelf-SoothingSupportWays to CommunicateSeeking Medical Care
Table of ContentsView All
View All
Table of Contents
When Does It Begin?
Symptoms
Testing
Self-Soothing
Support
Ways to Communicate
Seeking Medical Care
Selectivemutismoccurs when a person who speaks verbally in some situations or settings does not speak in others. This is a medical condition, not a behavioral concern. It affects 1% to 2% of people, making it rare.
It can occur in childhood and adulthood. Undiagnosed or ongoing symptoms into adulthood can increase the risk of effects such asanxietyand other mental health concerns.
Learn about selective mutism in adults, the link to trauma, possible triggers, testing, and how to cope.
Does Selective Mutism Begin in Childhood or Adulthood?
Selective mutism often starts during childhood, around the time that children learn verbalcommunication(between ages 2 and 4). However, it can develop at any age, including adulthood.Sometimes, it is present in childhood but goes undiagnosed or untreated into adolescence and adulthood.
Complex Trauma Link
Studies have shown a link between trauma and selective mutism.People withcomplex traumamay be at an increased risk for this condition. It is also possible to experience selective mutism without a history oftrauma.
Additional Risk Factors
Other risk factors for selective mutism include:
People who speak multiple languages or are in environments with people speaking languages other than their first language are more likely to experience selective mutism, even when they can speak the language.
Being multilingual doesn’t cause selective mutism, but for children who are anxious, having to speak a language they are less familiar with may put them more at risk for selective mutism.
How Selective Mutism Presents in Adults
Selective mutism is similar in adults and children. However, adults experience more significant adverse life effects after many years of decreased communication andsocial interaction.Examples of adverse effects include completing fewer years of school or a lower salary, regardless of intelligence.
Symptoms of selective mutism include:
Situational Triggers
Selective mutism is more likely to happen in any situation or environment where thenervous systembecomes activated, or the person feelsunsafe.
Each person’s experience is different. Examples of possible situational triggers include:
Testing for Selective Mutism as an Adult
If you think that you or someone you care for has selective mutism, follow up with a healthcare provider. When untreated, it can affect many areas of life, such as career and financial security, relationships, and overall quality of life. It can occur alongside other mental health concerns, such asanxiety disorder.
Getting diagnosed can bring understanding and lead to additional support and treatment, coping strategies, and symptom improvement. The diagnostic process may include an appointment with a medical professional, an evaluation of the symptoms, and a screening questionnaire.
Self-Soothing With Selective Mutism
Selective mutism is linked to fear, anxiety, and discomfort in different environments and situations. Learningmindfulnesstechniques and buildingconfidenceand comfort can help to improve selective mutism symptoms. Other self-soothing methods for selective mutism include:
Professional Help and Coping
The goal in treatment for selective mutism is to reduce the stress associated with speaking rather than focusing on the speaking itself.
It is crucial to seek the support of a mental health provider for selective mutism—and other mental health concerns. People who experience selective mutism are at an increased risk of other mental health conditions. For example, anxiety disorder affects 80% of people with selective mutism, and up to 41% of people with selective mutism also experience socialphobia.
How to Find a Therapist or Counselor
Mental health professionals can help people with selective mutism.Cognitive behavioral therapy, or CBT, is a type oftalk therapy (psychotherapy)that has been found effective in treating selective mutism and has shown long-term benefits.
Speech-language therapymay also be helpful. Check with your health insurer to locate mental health professionals, such as psychologists, therapists, and counselors, who accept health insurance.
A Word From VerywellAlthough it can be frustrating to be unable to communicate how you want to, be patient with yourself. Reward yourself for taking small steps that will lead to your desired changes in the future.—DAKRARI QUIMBY, PHD, MEDICAL EXPERT BOARD
A Word From Verywell
Although it can be frustrating to be unable to communicate how you want to, be patient with yourself. Reward yourself for taking small steps that will lead to your desired changes in the future.—DAKRARI QUIMBY, PHD, MEDICAL EXPERT BOARD
Although it can be frustrating to be unable to communicate how you want to, be patient with yourself. Reward yourself for taking small steps that will lead to your desired changes in the future.
—DAKRARI QUIMBY, PHD, MEDICAL EXPERT BOARD
Ways to Communicate With Selective Mutism
People with selective mutism may feel embarrassed and find it difficult to ask for help, but it may be comforting to know that this is a treatable medical condition.
Tips for communicating with people who have selective mutism include:
Understanding Different Types of Social Cues
If Someone You Know Needs Help
If you or someone you know is showing signs of selective mutism, help is available. This condition is treatable through talk therapy, mental health interventions, coping strategies, and more. Reach out to a healthcare provider, such as a primary care provider or therapist, for evaluation and support.
Summary
Selective mutism is a mental health condition that involves not speaking in certain environments or social settings despite the ability to speak. For example, people with selective mutism may be very vocal at home or with trusted friends and family members but not speak in large groups.
While it often begins in childhood, it can happen at any age and may go undiagnosed for years. It is essential to seek the support of a healthcare provider when you suspect selective mutism, as it can affect many areas of life and increase the risk of other mental health concerns such as anxiety.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Koskela M, Ståhlberg T, Yunus WMAWM, Sourander A.Long-term outcomes of selective mutism: a systematic literature review.BMC Psychiatry. 2023;23(1):779. doi:10.1186/s12888-023-05279-6
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Oerbeck B, Overgaard KR, Stein MB, Pripp AH, Kristensen H.Treatment of selective mutism: a 5-year follow-up study.Eur Child Adolesc Psychiatry. 2018;27(8):997-1009. doi:10.1007/s00787-018-1110-7
Selective Mutism Association.How to help a child with selective mutism in the classroom: 9 tips.
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