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Back to Health A to Z Selective mutism Selective mutism is a severe anxiety disorder where a person is unable to speak in certain social situations, such as with classmates at school or to relatives they do not see very often. It usually starts during childhood and, if left untreated, can persist into taalk.

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Staff in early years settings and schools may receive training so they're able to provide appropriate support. In time, the person will learn to anticipate the situations that provoke this distressing reaction and do all they can to avoid them.

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But the older they are when the condition is diagnosed, the longer it will take. If you suspect your child has selective mutism and help is not available, or there tto additional concerns — for example, the child struggles to understand instructions or follow routines — seek a formal diagnosis from a qualified speech and language therapist.

And adults may lack qualifications because they're unable to participate in college life or subsequent interviews. Diagnosis in adults It's possible for adults to overcome selective mutism, although they may continue to experience the psychological and practical effects of spending years without social interaction or not being able to reach their academic or occupational potential.

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For example, they may encourage with selective mutism to communicate through their parents, or suggest that older children or adults write down their responses or use a computer. When mutism occurs as a symptom of post-traumatic stressit follows a very different pattern and the child peson stops talking in environments where they ly had no difficulty.

Tall expectation to talk to certain people triggers a freeze response with feelings of panic, like a bad case of stage fright, and talking is impossible. The most effective types of treatment are cognitive behavioural therapy CBT and behavioural therapy. Do not praise your child publicly for speaking because this can cause embarrassment. Advice for parents Do not pressurise or bribe your child to encourage them to speak.

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Do not avoid parties or family visits, but consider what environmental changes are necessary to make the situation more comfortable for your. Younger children can also benefit from CBT-based approaches deed to support their general wellbeing. However, antidepressants may be used alongside a treatment programme to decrease anxiety levels, particularly if attempts to engage the individual in treatment have failed. For example, or instant messaging could progress to an exchange of voice recordings or voic messages, then more direct communication, such as telephone or Skype conversations.

This means: not letting the child know you're anxious reassuring them that they'll be able to speak when they're ready concentrating on having fun praising all efforts the child makes to in and interact with others, such as passing and taking toys, nodding and pointing not showing surprise when the child speaks, but responding warmly as you would to any other child As well as these environmental changes, older children may need individual support to overcome their anxiety.

And adults may lack qualifications because they're unable to participate in college life or perskn interviews.

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You can contact a speech and language therapy clinic directly or speak to a health visitor or GP, who can refer you. Diagnosis guidelines Selective mutism is diagnosed according to specific guidelines. Another person is introduced into the situation and, once fo included in talking, the parent withdraws. It can continue into adolescence and adulthood if not managed.

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There are several techniques based on CBT and behavioural therapy that are useful in treating selective mutism. It's more common in girls and children who are learning a second language, such as those who've recently migrated from their country tzlk birth.

Back to Health A to Z Selective mutism Selective mutism is a severe anxiety disorder where a person is unable to speak in certain social situations, such as with classmates at school or to relatives they do not see very personn. Wait until you're alone with them and consider a special treat for their achievement.

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Adults will ideally be seen by a mental health professional with access to support from a speech and language therapist or another knowledgeable professional. Do not avoid parties or family visits, but consider what environmental changes are necessary to make the situation more comfortable for your.

Graded exposure In graded exposure, situations causing the least perosn are tackled first. This can make them "shut down" and be unable to speak when overwhelmed in a busy environment. Though some health professionals recommend using a combination of medicine and behavioural therapies in adults with selective mutism.

For example, or instant messaging could progress to an exchange of voice recordings or voic messages, then more direct communication, such as telephone or Skype conversations. Stimulus fading In stimulus fading, the person with selective mutism communicates at ease with someone, such as their parent, when nobody else is present. The need for individual treatment can be avoided if family and staff in early years settings work together to reduce the child's anxiety by creating a positive environment for them.

Find out more about anxiety in children. Stimulus fading In stimulus fading, the person with selective mutism communicates at ease with someone, such as their parent, when nobody else is present.

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Positive and negative reinforcement Positive and negative reinforcement involves responding favourably to all forms of communication and not inadvertently encouraging avoidance and silence. The clinician may initially want to talk to you without your child present, so you can speak freely about any anxieties you have about your child's development or behaviour. Desensitisation Desensitisation is a technique that involves reducing the person's sensitivity to other people hearing their voice by sharing voice or video recordings.

It's important for selective mutism to be recognised early by families and schools so they can work together to reduce 's anxiety.

Some children may manage to respond with a few words, or they may speak in an altered halk, such as a whisper. Children may have difficulty with homework asments or certain topics because they're unable to ask questions in class. Older children and adults are encouraged to work out how much anxiety different situations cause, such as answering the phone or asking a stranger the time.

With realistic targets and repeated exposure, the anxiety associated with these situations decreases to a manageable level. There's no evidence to suggest that children with selective mutism are more likely to have experienced abuse, neglect or trauma than any other. Tell them they can take small steps when they feel ready and reassure them that talking will get easier.