Silent treatment

Q I have a child in school with elective mutism? Can you clarify what this is?

A Selective mutism (a term now preferred to elective mutism, which has connotations of free choice) is a condition where the child persists in not speaking in a range of social situations (for example, in school or among peers) even though he or she has no significant language disorder.

Communication often takes place by means of gesture, for example, by nodding or pointing. In more private, secure contexts, such as with close family members, there appears to be no problem and speech occurs freely.

This condition is rare, occurring in about one child per thousand. It affects more girls than boys. It is most common in 3 to 5- year-olds, and usually appears after speech has been acquired.

The condition is usually seen as a maladaptive response to anxiety.

Sometimes it represents a reaction to a traumatic event, or a painful injury to the mouth or throat, but often it is a symptom of extreme shyness.

The good news is that the situation usually resolves itself over time.

However, it is important that where the problem persists for several months the child is seen by a specialist. The usual treatment is some form of behaviour therapy.

In addition to ensuring that the child's learning is unaffected as much as possible, teachers need to seek to reduce the child's anxiety and to provide gentle reinforcement for any public speech.

* Please email questions to or write to TES Extra for Special Needs, Admiral House, Admiral House, 66-68 East Smithfield, London E1W IBX. Neither writer can enter correspondence with readers.

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