Free article: Selective mutism: Seen but not always heard - part one

Published: Wednesday, 19 February 2014

In the first of two articles, Liz Tucker explains selective mutism and what the implications can mean for the child.


  • Reasons for silence in the transition to school.
  • Definition of the selective mutism disorder.
  • Major indicators for selective mutism.
  • Other characteristics to look out for.
  • How selective mutism contrasts with shyness.
  • How selective mutism affects academic progress and attendance.

It is not unusual for some children to enter a setting or school and display a preference not to talk or join in with the daily routine. Starting school for the first time or simply moving from one class to another can be a daunting experience both socially and emotionally for many children, which is why the best schools take the transition process very seriously and put the appropriate steps in place to minimise children’s stress and anxiety.

Some children are naturally shy and need a great deal of support in building relationships and developing the confidence and interpersonal skills to sustain friendships with their peers and the adults they encounter in their daily routine. Other children just need a little bit of time to become comfortable with a change in their surroundings; experienced staff in school understand that this is the case and persist with gentle patience and a little TLC until such pupils in their care become confident and begin to participate.

Similarly, silent periods during the fledgling months of an EAL (English as an additional language) learner in the classroom are natural and form part of their language acquisition process. Children for whom English is an additional language are most likely to spend a lengthy amount of time just getting to grips with their new surroundings; they spend almost all of their time listening to the interactions around them and observing the patterns of the language used in their new environment.

SENCos may find themselves in a position whereby a child in their school is presenting him or herself as either virtually or totally silent. Staff may share their concerns, expecting the support and interventions necessary to help a child make progress. When other natural traits such as shyness have been ruled out and it has been established that this behaviour falls outside the normal parameters of an EAL learner, it can be a daunting process to establish the best pathway of support for the child and their family. It may be helpful to consider the possibility that a child is selectively mute in these circumstances, in order to begin a dialogue with the appropriate professionals who will be able to assist in a possible diagnosis and treatment pathway.

What is selective mutism?

Selective mutism (SM) is often referred to as a childhood anxiety disorder. It usually presents itself before a child reaches their fifth birthday. Children with SM do not speak at all in certain situations and environments but they do speak freely in other circumstances such as in their home (which is familiar to them) or amongst their closest friends and family.

It often goes unnoticed until a child starts nursery or school because the onset of schooling puts them in an extremely social environment with an entirely different set of expectations, and the larger groupings make their selective mutism noticeable in their vocal absence from routine daily interactions.

Selective mutism is not a social choice on the part of a child. Children with SM often wish to speak, but where there is an expectation to do so in certain situations then they find themselves unable to.

The disorder was formerly referred to as elective mutism because it was believed that it was a child’s free choice whether to speak or remain silent in given situations. However, the involuntary nature of this disorder is now widely accepted and since 1994 it has been referred to as selective mutism.

Characteristics of a child with selective mutism

In simple terms, a child with SM can present themselves as almost two entirely different social personalities with regard to their apparent willingness and ability to communicate with others depending on the situation.

For some children it can be purely the environment that causes the disorder to appear or disappear and for others it could be the expectations of the people around them. During home visits prior to entry, practitioners may have absolutely no concerns about SM as the child appears to be confident and sociable towards them, yet when they arrive at school there is a dramatic change in their personality. Of course, for some children, both environment and people’s expectations can influence the extent of their disorder, which is why it remains one of the least understood conditions affecting childhood and consequently one of the most frustrating disorders to treat.

The child with SM may display completely normal and chatty behaviour at home in accordance with their age and stage of development. During interactions with siblings, parents and other close family members there is likely to be no obvious indication that the condition is present, and even when newcomers enter the home or family friends are encountered on a trip out, for example in the supermarket, a child with SM may be referred to as shy or just not in a sociable mood.

On entry to an educational setting such as a nursery or school the child can present with a range of characteristics, but the overriding factor is that they are silent and fail to speak whenever there is any kind of expectation to do so. For example, a child may refuse to join a group of children on the carpet for a direct teaching session and insist on just watching what is going on from a distance. Refusals will be of a silent nature, with closed body language, little or no eye contact and an assertive effort to remain disengaged from the group.

Occasionally, a child with SM may interact with selected peers during independently chosen play but this is usually confined to limited talk and unlikely to cross the boundary of personal interaction with the majority of other children.

The silence of an SM child lasts beyond the first month of nursery or school, provided there have been no other influencing factors such as the child being newly exposed to and learning the English language. After a settling in period has occurred, in line with the usual social and emotional development expectations, a child with SM will have made little or no progress in their ability to interact with adults and the majority of their peers.

The child with SM does not lack the knowledge of what or how to express themselves with speech. By contrast, they are likely to be articulate and comfortable in other situations, with a vocabulary equal to or in advance of that of similar aged children. They understand what other children and adults are saying and are capable of taking in and processing the information and interaction displayed by others, but they cannot join in themselves.

Other indicators

Although prolonged and consistent silence in situations outside their familiar environment where there is an expectation to speak is the main and most obvious indicator, a selectively mute child is likely to show a range of other characteristics or behaviours which will help you complete the jigsaw before seeking professional guidance.

The SM child will appear shy and uncomfortable in the setting, possibly showing a reluctance to separate from their parent or carer. As SM is a social anxiety disorder, it may manifest itself in other ways, such as in a reluctance to eat or participate in similar activities which are normal, everyday experiences for children at school. Activities that other children find exciting and interesting can cause an SM child to freeze up with anxiety and have feelings of extreme self-consciousness and fear of social embarrassment. This is particularly difficult for the child, as they want to participate but feel helpless and unable to do so, regardless of the encouragement that may be shown by adults and peers alike.

You are very unlikely to catch the eye of a child with SM as this kind of interaction is socially painful; they will not look for or maintain any eye contact but instead favour looking down or away in order to avoid this social expectation. Again, this behaviour is difficult for the child, as eye contact is the very fabric of good interpersonal communication (note, however, that some children from a minority ethnic background will also adopt this behaviour as it is in line with their culture). In the most part, a child with SM will know that looking at the person who is talking to them is an expectation, yet they will avoid doing so at all costs.

It is not unusual for an SM child to appear to not experience any joy in everyday activities at school. Observations on SM children recall that such children present with an expressionless demeanour and a reluctance to smile, in addition to a stiffness and awkwardness of movement in a situation that they deem as threatening.

Selective mutism and shyness

The SM child may be shy but this condition is far outside than the natural tendencies of children to be conventionally introverted or extroverted in their interaction with others.

Although shyness and SM can and often do co-exist, it is important to understand that shyness itself is not an anxiety disorder. Every child and adult can experience different levels of shyness in certain situations, but the trait mostly fluctuates and will change with maturity and experience, and it does not usually interfere with their ability to function within society. Shyness does not require treatment but SM does require some level of professional intervention in order for the child to overcome their symptoms and function at a level that will allow social progress and fulfil their academic potential.

Academic progress and attendance

Although a child with SM may be processing and attaining academic information, their progress may be limited. This is largely due to the reliance on oral assessment in the early years, which provides practitioners with the necessary information to plan the next steps in a child’s learning. If you can’t glean what a child does or does not know then it can be very difficult to move their learning forward or to make the provision to address any gaps in their knowledge.

It is not unusual for the attendance of the SM child to be very poor, and in some cases this can be the first indicator that arises during data analysis to prompt a discussion between school staff and the parents/carers of the child. Parents may find that this is the first time that they have become aware of their child’s patterns of non-attendance. Some report that their child has appeared anxious or has been sick in the morning before school and this is the reason they have kept them from attending that day. Some parents may report that their child has actually been sick on the way to school or that they became poorly as soon as they entered the classroom and spoke with the teacher, and consequently they took their child back home. These situations are unsurprising when you consider that an anxiety disorder like SM can cause physical symptoms such as vomiting, stomach aches, headaches, shaking, nausea and panic attacks.

Selective mutism is complex; for example, it displays many symptoms and characteristics of other conditions. It is therefore vital that early intervention strategies are identified with a multi-agency approach which includes and supports the child’s parents/carers, the SM child and the staff working with that child.

Further information

A second article by Liz Tucker looks at the ways in which staff can work with selectively mute children in the classroom, and is available to Premium Plus subscibers.

About the author

Liz Tucker is an experienced educational consultant and early education specialist who has supported SENCos in a wide variety of settings and schools for ten years in her role as a local authority education advisor. She has worked with Forum as a consultant editor and co-author of EY publications. She is currently a phase leader in an inner-city school.

This article was first published in the April 2013 edition of SEN Leader magazine.