Home » Online Therapy » Anxiety » Selective mutism

If you or your child are unable to speak in certain situations but talk fine in others, you may have selective mutism, a condition more common in children. Here we explain what selective mutism is and how to get help.

What is selective mutism?

Selective mutism is an anxiety disorder usually affecting children. It is present in individuals who have the ability to speak but cannot speak in certain social situations or with certain people. It is important to note that selective mutism is not an inability to speak, but rather an inability to speak in certain contexts or with certain people.

What causes the diagnosis?

It is a combination of several factors that cause the condition and it can be linked to genetic, biological and environmental factors. If you suffer from social anxiety, this can be an underlying factor.

What set our therapist apart was her genuine empathy and personal insight. Not only did she possess a deep understanding of neurodiversity, but she also shared personal experiences that resonated with us, creating an instant connection and fostering a sense of trust!

Benedetta Osarenk


Our counsellors

Click here to view all psychologists, therapists, and coaches.

Selective mutism in children

The diagnosis affects around 0.7 – 0.8% of children. It is a real problem and cannot be controlled at will. The child can sometimes communicate by nodding, using gestures or writing notes. It can be triggered by stressful events such as a move or a change in preschool, and is more common in cases of autism, cognitive difficulties, and if a child is multilingual.

As selective mutism is considered an anxiety disorder, it may coincide with social anxiety, generalised anxiety disorder (GAD), separation anxiety, agoraphobia, panic disorder or specific phobias.

Selective mutism and social anxiety

Selective mutism has a lot in common with the anxiety disorder, social phobia. What distinguishes the two are physical symptoms, with social phobia having more. The diagnosis also means that people are more likely to have language disorders. Situations that trigger anxiety also differ between the syndromes, with social phobia causing anxiety in more situations and the onset often occurring at a later age. But there are definite similarities between the syndromes.

Autism and selective mutism

Similarities exist between selective mutism and autism, but the difference is that people with autism have difficulties in all social situations, whereas someone who does not speak can function socially in some social situations. With autism, you may have difficulty understanding social situations, but not in selective mutism.

Selective mutism language disorder

Selective mutism can sometimes be interpreted as difficulties with speech, but it is not a language disorder. You can speak in some contexts while remaining silent in others. School staff may need support from a speech therapist to deal with these children or students.

Help with selective mutism

Anxiety disorder is a common and treatable problem. Seek help today to help reduce your symptoms.


Book a meeting

Fill in the form, choose a counsellor and proceed to payment.

Symptoms of selective mutism

The diagnosis can develop at an early age and is often noticed in preschool. You might think that the child is just shy, but they do not improve after a month, it could be selective mutism. Some of the symptoms are:

  1. Silence in specific situations: People with the diagnosis are silent or communicate by nodding or using body language in certain social situations or with certain people.
  2. Often visible in childhood: Symptoms usually appear in childhood, often at school.
  3. Related to anxiety: Selective mutism is closely linked to anxiety.
  4. Speech in familiar or safe environments: At home or with close friends and family, people with selective mutism often do not have difficulty speaking.

Selective mutism treatment

The symptoms can sometimes go away on their own, but a person may need more support. The earlier help is received, the better. Treatment may include speech therapy, relaxation exercises, and social skills training. There is little scientific support for drug treatment.

Speech therapy for selective mutism

If you are a parent of a child, you can seek help from a speech therapist. The treatment involves changing the attitude towards an environment and gradually getting the child used to talking to others and taking the initiative to speak.

How therapy can help with anxiety

Talking to a licensed psychologist can give you tools to understand and manage symptoms. This can help you overcome the condition and improve your quality of life.

First steps to change

Consider booking an initial session with one of Lavendla’s therapists or psychologists. We are here, ready to make the difficult easier.


Why Lavendla?

USP 1

Lorem ipsum

USP 2

Lorem ipsum

USP 3

Lorem ipsum


12 common questions and answers about selective mutism

What is selective mutism?

Selective mutism is an anxiety disorder usually affecting children, where people who otherwise have the ability to speak do not speak in certain social situations or with certain people.

What are the most common symptoms of selective mutism?

The symptoms often develop in childhood and are similar to anxiety disorders. You may talk to people with whom you feel more comfortable but become silent in other contexts.

How is selective mutism different from social phobia?

Social phobia has more physical symptoms, anxiety in more contexts, and a later age of onset, while someone who doesn’t speak often has a language disorder.

Is selective mutism a language disorder?

Selective mutism can sometimes be interpreted as having difficulty with speech, but it is not a language disorder.

How common is selective mutism?

The diagnosis affects around 0.7 – 0.8% of all children.

What is the difference between autism and selective mutism?

There are similarities between selective mutism and autism, but what distinguishes them is that autistic people have difficulties in all social situations, whereas someone who does not speak functions socially in some social contexts.

How can selective mutism be treated?

Treatment may include speech therapy, relaxation exercises, and social skills training.

What are the long-term effects of untreated anxiety?

Untreated anxiety can lead to depression and other mental health problems.

Can a speech therapist help with selective mutism?

You can seek help from a speech therapist. The treatment involves changing the attitude of the environment and gradually getting the child used to taking up space, talking to others, and taking the initiative to speak.

Can you have other mental health problems at the same time?

Selective mutism is considered an anxiety disorder and often it coincides with social anxiety, generalised anxiety disorder (GAD), separation anxiety, agoraphobia, panic disorder, or specific phobias.

How much does a treatment at Lavendla cost?

Sessions with Lavendla therapists cost between €30 – €100 per session, depending on their experience level and the session length. Book an initial session with one of our therapists through our website for an initial discussion.

Where can I go if I need help?

At Lavendla, we have experienced psychologists and therapists working with CBT who can help you feel better.

What does treatment for selective mutism involve?

Seeking help is a big step towards better health and a very a positive thing to decide to take control of how you feel. Here is an overview of the steps usually involved in CBT treatment.

Step 1: Initial assessment session

During the first meeting with a psychologist, an assessment is made to review the client’s mental and physical health and how the symptoms manifest themselves.

Step 2: Goal setting

This is where you set concrete goals for the therapy, both short- and long-term.
Goals can define which areas of your life are most affected by your well-being and how you would like to change them.

Step 4: Treatment with different techniques and tools

This is the start of the actual treatment phase, which involves exercises aimed at providing tools for overcoming and working through a problem.

Step 5: Monitoring and evaluation

Treatment is monitored regularly to see how well the therapy is working. If necessary, the treatment plan can be adjusted or renewed.

Step 6: Reflection

As the therapy comes to an end, it is time to reflect on the progress made. It is also important to monitor the results over time.

If you or someone close to you is seeking professional help, do not hesitate to book a session with one of our licensed psychologists or therapists.

Lavendla – Making the difficult easier

Written by dominic

Dominic is a Cape Town-based copywriter and editor with a background in psychology.