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Treatment for Selective Mutism
Selective mutism is an anxiety disorder. It's when a child can’t speak in certain settings but can speak fine in others. For example, a child may not be able to speak at school but can speak with no problem at home. It's called selective mutism because the child is only mute in certain situations. It’s a rare childhood condition. It can cause problems with school and social situations. Selective mutism often begins in very young children, usually around ages 3 to 6. It may not be noticed until a child starts school.
Types of treatment
Treatment varies based on the needs of your child, and may include:
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Stimulus fading. This is done by slowly introducing a new person into the room when your child is relaxed.
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Shaping. This is done by encouraging your child’s attempts to communicate with gestures and whispers until they speak out loud.
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Self-modeling. This is done by having your child watch a video of themself communicating well at home.
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Speech therapy. This can be done for any underlying speech problems, if needed.
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Family and behavioral therapy. These can help with emotional issues.
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Medicines. Some medicines can be used to lower anxiety.
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Speaking with your child’s teachers. Your child’s teachers can help make communication at school less scary. For example, a teacher may have your child only speak in small groups at first, instead of to the whole class.
With treatment, a child is likely to stop having selective mutism. With no treatment, the speaking problems are more likely to continue.
How you can help your child
It’s important to be patient with your child. Remember that your child is not choosing not to speak. Your child is too anxious to be able to speak. For the best outcome, stay closely involved with your child’s therapy. You may be able to find ways to structure situations outside the home that can increase your child’s communication. Work closely with your child’s teachers.
Online Medical Reviewer:
Daphne Pierce-Smith RN MSN
Online Medical Reviewer:
Rita Sather RN
Date Last Reviewed:
6/1/2025
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