Overview
Children with selective mutism want to talk but freeze in certain places because of anxiety.
It often starts when a child begins school.
Symptoms
Common signs:
- Not speaking at school
Less common
- Shyness
- Avoiding eye contact
When to get medical care
Call 911This isn't an emergency by itself. Call 911 for trouble breathing, chest pain, or fainting.
Get care todayNew or worse symptoms, or symptoms with fever.
See a doctor soonSymptoms that last or keep coming back.
Causes
Anxiety.
Does it spread or run in families?
- It isn't contagious. You can't catch it from someone else.
Who is more likely to get it
- Shy temperament
Diagnosis
A clinician asks about your symptoms and may order tests.
The exam
A physical exam.
Treatment
Treatment depends on the cause and how severe it is.
Self-care
- Don't pressure speech
- Praise small steps
- Don't force speech or praise only talking
- Let the child respond with nods or writing at first
Prevention
To lower your risk or prevent problems:
- Early help
Which doctor treats this
- Start with your primary care provider (family doctor or internist).
- They may send you to a speech-language pathologist (speech therapist).
Children, pregnancy, and older adults
- Children 2 to 5: Often starts then.
Pregnancy and breastfeeding
- If you're pregnant or planning to be, tell your prenatal provider about this condition.
- Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
- Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
- Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.
Outlook
Most improve with behavior therapy.
Getting ready for your visit
Bring a list of your symptoms and medicines.
What to bring
- A list of your medicines and supplements
- Notes on when symptoms started and what makes them better or worse
Questions to ask
- What's causing this?
- What treatment do you recommend?
Research studies
Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.
Sources
Last updated 2026-11-12.