SM: What Is It?

Selective mutism (SM) is an anxiety disorder in which a child is unable to speak in some settings and to some people. A child with SM may talk normally at home, for instance, or when alone with her parents, but cannot speak at all, or speak above a whisper, in other social settings—at school, in public, or at extended family gatherings. Parents and teachers often think the child is willful and refuses to speak, orspeak loud enough to be heard, but the child experiences it as an inability. It can cause severe distress—she can’t communicate even if she is in pain, or, say, needs to use the bathroom—and prevents her from participating in school and other age-appropriate activities. It should not be confused with the reluctance to speak a child adapting to a new language might exhibit, or shyness in the first few weeks at a new school.