Chapter 11 - Selective Mutism

Abstract

Selective mutism (SM) is a relatively rare condition in childhood characterized by a consistent failure to speak in some social situations where speaking is expected (e.g., kindergarten and school) despite speaking in other situations (e.g., at home). If left untreated, the muteness may last for years with serious consequences academically and socially. The lack of speech in specific situations is currently understood as an expression of anxiety in contrast to previous literature describing the muteness as a deliberate act. Correspondingly, the last decade anxiety treatment programs have been developed for children with SM. However, compared to other anxiety disorders in childhood, the current knowledge base on SM is still sparse. This chapter on SM provides an update on important issues such as prevalence, comorbidity, etiology, assessment, and treatment with an emphasis on how to work clinically with children with SM, their families, and school staff.