Selective Mutism

Part of the Current Clinical Psychiatry book series (CCPSY)


Selective mutism (SM) is an impairing behavioral disorder of childhood characterized by persistent failure to speak in specific social situations despite the ability to speak in other situations. SM typically begins during the preschool years but is usually not identified until the early school years. The disorder occurs in 0.11–2 % of children and persists for most children if untreated. SM is most often conceptualized as an anxiety disorder and is considered by many to be an early-onset or developmental variant of social phobia. The treatment literature is dominated by case reports and a few controlled studies. The most common treatments are those that are also used for pediatric anxiety, namely, cognitive, behavioral, and pharmacological interventions. Cognitive and behavioral strategies are recommended as the first-line treatment. Selective serotonin reuptake inhibitors are suggested in cases of treatment resistance and/or high symptom severity or impairment. It is often necessary to involve the child’s teacher or other school personnel in the treatment plan.


Selective mutism Anxiety Social phobia Speech problem Language problem Exposure treatment SSRI treatment 


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© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent PsychiatryJohns Hopkins Medical InstitutionBaltimoreUSA

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