Table of ContentsView AllTable of ContentsSymptomsCausesTreatmentComplications and Risk FactorsDiagnosisWhen to Seek HelpFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Treatment
Complications and Risk Factors
Diagnosis
When to Seek Help
Frequently Asked Questions
Mutism is the state of being unable to or unwilling to speak to an extent that interferes with daily life.This article discusses the symptoms and causes of mutism, its risk factors, how it’s diagnosed, and when to get help.
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Types of Mutism
Types of mutism include:
Symptoms of Mutism
The most common symptoms of selective mutism include:
Other symptoms of mutism include:
Selective Mutism vs. Autism
Children withautismcan exhibit selective mutism,and at times, selective mutism can be confused for autism. However, while both selective mutism and autism can include social anxiety, living with autism can also include:
How Selective Mutism Affects Adults
Causes of Mutism
The most common causes of selective mutism are:
Other types of mutism, including organic mutism, have physical causes or result from health issues, such as:
What Medications Can Cause Mutism?
Some medications and drugs can causecatatonia, which is a condition that includes mutism and an inability to move parts of the body. These medications include:
How to Treat Mutism
For children with selective mutism, treatment can include:
Other treatments for selective mutism might include:
Treatment for organic or cerebellar mutism can include:
Complications and Risk Factors Associated With Mutism
With children, it’s advised to treat mutism as early as possible so it doesn’t result in social and developmental delays. Mutism that is not addressed could lead to:
Factors that can increase the likelihood of living with mutism include:
For other types of mutism, contributing factors include:
Are There Tests to Diagnose the Cause of Mutism?
Diagnosing selective mutism is usually a team effort between caretakers, school workers, healthcare providers, and possibly social workers. The process most likely entails:
Other ways to diagnose selective mutism include:
For adults, a healthcare provider might ask about the following when diagnosing selective mutism:
Organic muteness can be a symptom of conditions like psychosis, a brain tumor, or stroke. Diagnosis can include screening for the suspected condition with brain scans and observing other symptoms.
When to See a Healthcare Provider
With children, mutism could interfere with developing social skills at a crucial time, while for adults, mutism can interfere with overall well-being. A healthcare provider’s help is encouraged if mutism:
Organic or cerebellar mutism usually require the assistance of speech and physical therapists to help the person return to communicating verbally.
If mutism occurs along with symptoms of psychosis, like hallucinations, decline in self-care, and intense emotional fluctuations, getting treatment as early as possible is highly advised.
If you would like to address mutism with the help of a professional but cost is an issue, consider sliding scale therapists or online help. The Substance Abuse and Mental Health Administration (SAMHSA) also has an online clinic finder that could help you get started with finding free or low-cost federally funded mental health care.
Summary
Selective mutism is when social anxiety causes a person to stop speaking to an extent that interferes with daily life. Organic mutism occurs because of causes like accidents or health issues like stroke, psychosis, or drug use. Cerebellar mutism is a type of mutism that can occur after removal of a brain tumor from around the cerebellum.
Symptoms of selective mutism include only speaking in private, using signs and symbols to speak, and feeling intense social anxiety. Other types of mutism occur despite wanting to speak and might also include difficulty controlling movements.
Antipsychotic and antianxiety drugs, along with recreational drugs, can increase the chances of living with organic mutism.
Treatment for mutism can includesocial skills therapy, cognitive behavioral therapy, and exposure therapy. For organic mutism, speech therapy and physical therapy could be necessary.
Diagnosing mutism includes ruling out hearing issues, language barriers, and developmental disorders, including autism. If mutism interferes with speech or social development for children or with daily life and well-being for children and adults, it is advised to see a healthcare professional.
Learn MoreWhat Is Social Anxiety?
Selective mutism can be treated with cognitive behavioral therapy, which addresses the ideas behind certain behaviors in order to modify them. This might include mindfulness exercises (letting scary emotions pass through the body without judgment) or breathing exercises. For children, using different methods of communication, like art therapy or focusing on sounds before full words and conversations, can also help.
Giving positive feedback for social successes while creating a socially supportive environment can also help. Exposure therapy, in which a person gradually faces their fears, can also help with the social anxiety behind selective mutism.
Learn MoreWhat Is Cognitive Behavioral Therapy?
Selective mutism can include being able to socialize privately but finding it impossible to speak in public. Adults and children with the disorder might prefer if others spoke for them or use signals to communicate. Debilitating social anxiety and social phobias can also be a part of selective mutism.
Learn MoreUnderstanding Nonverbal Autism
21 SourcesVerywell 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.National Library of Medicine.Mutism.MedlinePlus.Selective mutism.Mount Sinai.Posterior fossa tumor.Stroke Association.Aphasia and its effects.American Speech-Language-Hearing Association.Selective mutism.Steffenburg H, Steffenburg S, Gillberg C, Billstedt E.Children with autism spectrum disorders and selective mutism[published correction appears inNeuropsychiatr Dis Treat. 2018;14:2305].Neuropsychiatr Dis Treat. 2018;14:1163-1169. doi:10.2147/NDT.S154966NHS.Signs of autism in adults.NHS.Signs of autism in children.Grover S, Naskar C, Sharma P.Treatment-resistant non-catatonic mutism in schizophrenia: A case report and review of literature.Asian Journal of Psychiatry. 2022;71:103067. doi:10.1016/j.ajp.2022.103067Rasmussen SA, Mazurek MF, Rosebush PI.Catatonia: Our current understanding of its diagnosis, treatment and pathophysiology.World J Psychiatry. 2016;6(4):391-398. doi:10.5498/wjp.v6.i4.391Takacs R, Milan F, Ungvari GS, Faludi G, Gazdag G.Catatonia in disulfiram intoxication - a case report and a brief overview of the literature.Neuropsychopharmacol Hung. 2016;18(2):110-114.Mekala H, Malik Z, Lone J, Shah K, Ishaq M.Cannabis-induced catatonia: A case series.Cureus. 2020;12(6):e8603. doi:10.7759/cureus.8603McLaughlin S.Expressive arts therapy and therapeutic relationship with a child with selective mutism: development of a method.Expressive Therapies Capstone Theses. Published online May 21, 2022.NHS.Selective mutism.NHS.Aphasia.Noris A, Zicca A, Lenge M, et al.The medical therapy for cerebellar mutism syndrome: a case report and literature review.Childs Nerv Syst. 2021;37(9):2727-2734. doi:10.1007/s00381-021-05233-5Dar MA, Rather YH, Shah MS, Wani RA, Hussain A.Rapid response of long-standing, treatment-resistant non-catatonic mutism in paranoid schizophrenia with single ECT session.N Am J Med Sci. 2014;6(11):591-594. doi:10.4103/1947-2714.145480Kent Community Health NHS Foundation Trust.Selective mutism.Hua A, Major N.Selective mutism.Curr Opin Pediatr. 2016;28(1):114-120. doi:10.1097/MOP.0000000000000300Selective Mutism Association.Do I have selective mutism?National Alliance on Mental Illness.Encouraging people to seek help for early psychosis.
21 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.National Library of Medicine.Mutism.MedlinePlus.Selective mutism.Mount Sinai.Posterior fossa tumor.Stroke Association.Aphasia and its effects.American Speech-Language-Hearing Association.Selective mutism.Steffenburg H, Steffenburg S, Gillberg C, Billstedt E.Children with autism spectrum disorders and selective mutism[published correction appears inNeuropsychiatr Dis Treat. 2018;14:2305].Neuropsychiatr Dis Treat. 2018;14:1163-1169. doi:10.2147/NDT.S154966NHS.Signs of autism in adults.NHS.Signs of autism in children.Grover S, Naskar C, Sharma P.Treatment-resistant non-catatonic mutism in schizophrenia: A case report and review of literature.Asian Journal of Psychiatry. 2022;71:103067. doi:10.1016/j.ajp.2022.103067Rasmussen SA, Mazurek MF, Rosebush PI.Catatonia: Our current understanding of its diagnosis, treatment and pathophysiology.World J Psychiatry. 2016;6(4):391-398. doi:10.5498/wjp.v6.i4.391Takacs R, Milan F, Ungvari GS, Faludi G, Gazdag G.Catatonia in disulfiram intoxication - a case report and a brief overview of the literature.Neuropsychopharmacol Hung. 2016;18(2):110-114.Mekala H, Malik Z, Lone J, Shah K, Ishaq M.Cannabis-induced catatonia: A case series.Cureus. 2020;12(6):e8603. doi:10.7759/cureus.8603McLaughlin S.Expressive arts therapy and therapeutic relationship with a child with selective mutism: development of a method.Expressive Therapies Capstone Theses. Published online May 21, 2022.NHS.Selective mutism.NHS.Aphasia.Noris A, Zicca A, Lenge M, et al.The medical therapy for cerebellar mutism syndrome: a case report and literature review.Childs Nerv Syst. 2021;37(9):2727-2734. doi:10.1007/s00381-021-05233-5Dar MA, Rather YH, Shah MS, Wani RA, Hussain A.Rapid response of long-standing, treatment-resistant non-catatonic mutism in paranoid schizophrenia with single ECT session.N Am J Med Sci. 2014;6(11):591-594. doi:10.4103/1947-2714.145480Kent Community Health NHS Foundation Trust.Selective mutism.Hua A, Major N.Selective mutism.Curr Opin Pediatr. 2016;28(1):114-120. doi:10.1097/MOP.0000000000000300Selective Mutism Association.Do I have selective mutism?National Alliance on Mental Illness.Encouraging people to seek help for early psychosis.
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.
National Library of Medicine.Mutism.MedlinePlus.Selective mutism.Mount Sinai.Posterior fossa tumor.Stroke Association.Aphasia and its effects.American Speech-Language-Hearing Association.Selective mutism.Steffenburg H, Steffenburg S, Gillberg C, Billstedt E.Children with autism spectrum disorders and selective mutism[published correction appears inNeuropsychiatr Dis Treat. 2018;14:2305].Neuropsychiatr Dis Treat. 2018;14:1163-1169. doi:10.2147/NDT.S154966NHS.Signs of autism in adults.NHS.Signs of autism in children.Grover S, Naskar C, Sharma P.Treatment-resistant non-catatonic mutism in schizophrenia: A case report and review of literature.Asian Journal of Psychiatry. 2022;71:103067. doi:10.1016/j.ajp.2022.103067Rasmussen SA, Mazurek MF, Rosebush PI.Catatonia: Our current understanding of its diagnosis, treatment and pathophysiology.World J Psychiatry. 2016;6(4):391-398. doi:10.5498/wjp.v6.i4.391Takacs R, Milan F, Ungvari GS, Faludi G, Gazdag G.Catatonia in disulfiram intoxication - a case report and a brief overview of the literature.Neuropsychopharmacol Hung. 2016;18(2):110-114.Mekala H, Malik Z, Lone J, Shah K, Ishaq M.Cannabis-induced catatonia: A case series.Cureus. 2020;12(6):e8603. doi:10.7759/cureus.8603McLaughlin S.Expressive arts therapy and therapeutic relationship with a child with selective mutism: development of a method.Expressive Therapies Capstone Theses. Published online May 21, 2022.NHS.Selective mutism.NHS.Aphasia.Noris A, Zicca A, Lenge M, et al.The medical therapy for cerebellar mutism syndrome: a case report and literature review.Childs Nerv Syst. 2021;37(9):2727-2734. doi:10.1007/s00381-021-05233-5Dar MA, Rather YH, Shah MS, Wani RA, Hussain A.Rapid response of long-standing, treatment-resistant non-catatonic mutism in paranoid schizophrenia with single ECT session.N Am J Med Sci. 2014;6(11):591-594. doi:10.4103/1947-2714.145480Kent Community Health NHS Foundation Trust.Selective mutism.Hua A, Major N.Selective mutism.Curr Opin Pediatr. 2016;28(1):114-120. doi:10.1097/MOP.0000000000000300Selective Mutism Association.Do I have selective mutism?National Alliance on Mental Illness.Encouraging people to seek help for early psychosis.
National Library of Medicine.Mutism.
MedlinePlus.Selective mutism.
Mount Sinai.Posterior fossa tumor.
Stroke Association.Aphasia and its effects.
American Speech-Language-Hearing Association.Selective mutism.
Steffenburg H, Steffenburg S, Gillberg C, Billstedt E.Children with autism spectrum disorders and selective mutism[published correction appears inNeuropsychiatr Dis Treat. 2018;14:2305].Neuropsychiatr Dis Treat. 2018;14:1163-1169. doi:10.2147/NDT.S154966
NHS.Signs of autism in adults.
NHS.Signs of autism in children.
Grover S, Naskar C, Sharma P.Treatment-resistant non-catatonic mutism in schizophrenia: A case report and review of literature.Asian Journal of Psychiatry. 2022;71:103067. doi:10.1016/j.ajp.2022.103067
Rasmussen SA, Mazurek MF, Rosebush PI.Catatonia: Our current understanding of its diagnosis, treatment and pathophysiology.World J Psychiatry. 2016;6(4):391-398. doi:10.5498/wjp.v6.i4.391
Takacs R, Milan F, Ungvari GS, Faludi G, Gazdag G.Catatonia in disulfiram intoxication - a case report and a brief overview of the literature.Neuropsychopharmacol Hung. 2016;18(2):110-114.
Mekala H, Malik Z, Lone J, Shah K, Ishaq M.Cannabis-induced catatonia: A case series.Cureus. 2020;12(6):e8603. doi:10.7759/cureus.8603
McLaughlin S.Expressive arts therapy and therapeutic relationship with a child with selective mutism: development of a method.Expressive Therapies Capstone Theses. Published online May 21, 2022.
NHS.Selective mutism.
NHS.Aphasia.
Noris A, Zicca A, Lenge M, et al.The medical therapy for cerebellar mutism syndrome: a case report and literature review.Childs Nerv Syst. 2021;37(9):2727-2734. doi:10.1007/s00381-021-05233-5
Dar MA, Rather YH, Shah MS, Wani RA, Hussain A.Rapid response of long-standing, treatment-resistant non-catatonic mutism in paranoid schizophrenia with single ECT session.N Am J Med Sci. 2014;6(11):591-594. doi:10.4103/1947-2714.145480
Kent Community Health NHS Foundation Trust.Selective mutism.
Hua A, Major N.Selective mutism.Curr Opin Pediatr. 2016;28(1):114-120. doi:10.1097/MOP.0000000000000300
Selective Mutism Association.Do I have selective mutism?
National Alliance on Mental Illness.Encouraging people to seek help for early psychosis.
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