Selectvie Mutism in Children and Adolescents


ICD-10 code: F94.0

Selective mutism is part of a cluster of diagnoses called the anxiety disorders.  Anxiety disorders are a group of psychiatric conditions that include:

  • Separation anxiety disorder
  • Generalized anxiety disorder
  • Social anxiety disorder
  • Panic disorder
  • Agoraphobia
  • Specific phobia
  • Separation anxiety disorder

These disorders are characterized primarily by the experience of excessive fear and anxiety.  People with generalized anxiety disorder spend a lot of time worrying about a lot of different things.  People with social anxiety disorder feel very anxious around other people because they are afraid of embarrassing themselves or being disliked.  People with panic disorder have sudden rushes of intense fear or discomfort called panic attacks.  They often worry about having another panic attack and might avoid certain situations that might trigger a panic attack.  People with agoraphobia are afraid of going into certain situations because they are afraid it might be difficult to escape or because they might experience panic-like or other embarrassing symptoms.  Commonly avoided situations are using public transportation, being in open spaces like parking lots, being in enclosed places like movie theaters, or being in a crowd.  People with a specific phobia are afraid of a certain object or situation, such as flying, heights, animals, or seeing blood.  People with separation anxiety disorder are afraid of being away from a certain person, usually because they are afraid that something bad might happen to them or the other person if they are separated.

The anxiety disorders are characterized by excessive fear and anxiety, along with behavioral disturbances, like avoiding certain places, people, or situations.  The anxiety disorders differ from each other in the target or focus of the fear.  In some anxiety disorders, like specific phobia, the person is only excessively fearful of a very specific object or situation.  In other anxiety disorders, like GAD, the person may feel anxious a great deal of the time or about a lot of different things.

What is Selective Mutism?

Selective mutism is a relatively rare psychological disorder that affects approximately .7% of children. The mean age of onset varies between 2 and 5 years of age, but may become most apparent when the child enters school for the first time. There is some evidence that selective mutism is slightly more common in girls than boys.

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Understanding Selective Mutism

Children with selective mutism are persistently silent in some specific situations despite being able to speak freely at other times. Typically, children affected by the condition can speak at home with family members and but fail to speak in other places like in school settings and public places.

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How is Selective Mutism treated?

Selective mutism is treatable. The practice parameter for child and adolescent anxiety published by the American Academy of Child and Adolescent Psychiatry includes selective mutism. Additionally, the Selective Mutism Group has a position statement on evidence-based treatment strategies for selective mutism and the Aberdeenshire Council has practice guidelines for supporting children with selective mutism.

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