Selective Mutism

  • What is it?
    “Selective mutism (SM), formerly called elective mutism, is best understood as a childhood anxiety disorder characterized by a child or adolescent's inability to speak in one or more social settings (e.g., at school, in public places, with adults) despite being able to speak comfortably in other settings (e.g., at home with family).” (

    Basic suggestions for teachers in addressing students with possible selective mutism:

    • Work with families along with the school psychologist and/or school social worker. “Most cases of selective mutism are not referred for treatment due to the lack of understanding of of the disorder. Many children and adolescents can go years without speaking and, because their mutism is ingrained, it becomes much harder to overcome.” ( A school support team member along with the classroom teacher can encourage parents of children who appear to have selective mutism to seek diagnosis and treatment as soon as possible.

    • School interventions should assist the child in decreasing anxiety and teaching coping skills to use when confronted with anxious situations. The focus should not be getting the child to speak. Placing emphasis on speaking alone will put unnecessary pressure on a child and will often increase anxiety, leading to a lack of progress or regression.

    Selective mutism can be a complex disorder in the school setting because a child’s ability to communicate allows the teacher to assess where the student is academically and socially. Sometimes families have not sought psychological help outside of school as well, but these techniques can still be implemented to assist the child’s classroom and school functioning:

    • The goal is to gradually allow for decreased anxiety in social settings where speaking does not occur, and a progression from nonverbal to verbal communication. Children generally progress through a hierarchy of feared situations from using nonverbal communication such as nodding, pointing or writing to gradual approximations toward speaking such as whispering or initiating communication nonverbally.

    • Interventions should involve helping the child to increase awareness of his or her anxiety in a manner that is developmentally appropriate. Reading a story about selective mutism is one way to do that. “Lola’s Words” is an Ipad app that is very inexpensive that could be useful in raising the young child’s awareness. The website offers some tools such as books and workbooks that allow an adult to work directly with the child. See your support staff about these tools.

    • Preschool-aged children may be taught to recognize feelings including happy, sad, mad and scared and communicate whether they have a lot or a little of the feeling shown. They can also be taught to use progressive muscle relaxation and deep breathing techniques by telling them to squeeze lemons in their hands and release to make lemonade (make fists and relax them), turn their body from Jello to ice (tense and relax muscles) and to fill their tummies with air and slowly release it as if it were a big balloon (breathe slowly and deeply).

    • Older children and teens may be able to rate their feelings in various situations using a subjective unit of distress scale (SUDS) such as rating the feeling from 0 (not having this feeling at all) to 10 (experiencing the highest intensity of the feeling), creating a hierarchy of feared situations from easiest to most difficult, and apply anxiety reduction techniques through gradual exposure to the feared situations. Goals for desensitization and exposure should be in extremely small increments (often beginning with nonverbal communication goals before verbal goals) so that children may experience experiences of success rather than failure.

    • It is VERY common for children with SM to whisper; in fact, it is a good sign! The fact that the child was mute and now is whispering is progress. I would not ignore his success. Tell him how proud you are of him! Often, SM children will slowly begin to whisper, sometimes in a barely audible voice as they become more comfortable, and less anxious. Using VERBAL CUES with a child who is whispering is a great way to stimulate speaking louder Also, the use of the verbal intermediary with her friend...whispering at a set distance and increasing the distance. As he becomes more comfortable with his whispering, try and encourage him to speak a bit louder. Instruct his teacher to use the phrase; "I can't hear you ____". You will be surprised how well that works!!! Many SM children do not even realize they are whispering, so when you tell them that you cannot hear them, they will often speak a bit louder. Then, as time goes on, his speech will hopefully become more audible.

    • Most children with SM can perform academic work with minimal or no accommodations in the regular classroom. Some students may need a 504 plan or a special education evaluation. As you know, SM children often do not manifest many outward signs of true anxiety, some seem quite content and relaxed in their environment and are happily 'mute

    Parents of children with selective mutism should be encouraged to have playdates with other children and try and meet with their teacher during the summer before the school year if possible. Introduce the student to his or her next classroom as the fall approaches and let the child play with the toys and get comfortable in the room. He or she will most likely speak normally to you when you are in the classroom. Try to be patient and encourage his or her progress! Parents may try taping the child's assignment at home on a tape recorder. Tell the child what you are going to do, see how he or she reacts. This often works well. The child can then play the tape for the teacher alone (at first) and then to the class (if he or she is comfortable with this). When the child does do this, reward his or her efforts and let the child know how proud you are of him or her.