My child talks at home but not at school. Is it selective mutism?

What is selective mutism?

Selective mutism is an anxiety disorder in which a child can't speak in certain social situations, such as with classmates at school, while speaking easily in others.¹ "Disorder" is just the name of the diagnosis. It doesn't describe your child.

The NHS is clear that a child with selective mutism isn't refusing or choosing to stay silent. They're unable to speak, because the expectation to talk sets off a freeze response with anxiety and panic.¹ The RCSLT describes it as a phobia of speaking in certain situations.² So it isn't rudeness or defiance, and it isn't something to blame yourself for.

For a diagnosis the silence has to have lasted at least a month (two months in a new setting) and to get in the way of the child's day, and it can't be better explained by another communication or behavioural difficulty.¹ Only a professional who has met your child can say whether that fits.

How is it different from shyness, or from a quiet spell in a new language?

A shy child is usually nervous but can talk, perhaps quietly or slowly, and warms up with time. A child with selective mutism may stay silent for months in the same classroom, even with people they'd love to talk to, and may chat freely with the same classmates once they're outside the school gates. The NHS advises against accepting that a child will "grow out of it" or is "just shy".¹

Children who've just started English as a new language often go quiet for a while. SMIRA, the UK charity for selective mutism, describes this as a developmental stage of language learning and not selective mutism, although bilingual children can have selective mutism too.³ It describes the quiet period as a time of inner language rehearsal.⁴

If you can't tell which it is, that's a reason to ask and not to wait. Growing up with more than one language doesn't cause selective mutism, and my guide to bilingual children says more.

What might I notice?

The pattern matters more than any single sign, and it's the contrast between settings that stands out. You might see that your child:

• talks easily at home and not at all at nursery, school or clubs
• freezes, looks away or goes very still when someone outside the family speaks to them
• whispers to one friend but not to the teacher
• nods, points or waits for a brother or sister to answer
• comes home exhausted, or bursting with words after a day of holding them in

Some autistic children and children with language difficulties are also silent in some places, which is why a proper look matters. The approach can differ.

What helps at school and at home?

What helps is lowering anxiety, with no demand to speak. The NHS says treatment doesn't focus on the speaking itself. It starts by removing the pressure to speak, then moves gradually from simply relaxing in the nursery, school or social setting to saying single words and sentences to one person, and eventually to speaking freely to everyone.¹

In practice, with the school, that tends to mean:

• staff accept every way of answering: nodding, pointing, drawing, writing, a card
• nobody waits for an answer in front of the class, and the register can be answered with a wave
• a trusted friend joins in first, then an adult, one step at a time
• games where talking is optional, so your child can enjoy being with others

At home, you can tell your child that you understand talking feels scary, that they can take small steps when they're ready, and that smiling and waving are fine for now.² Warn them about changes of routine and rehearse new situations by playing them through.⁵ And if they do speak somewhere new, try to carry on as though they always have. SMIRA's advice is that making a fuss can raise the stakes.⁵

What can make it worse?

Pressure does, even when it's kindly meant. The RCSLT advises parents not to pressurise or bribe a child to speak, and SMIRA says that asking questions and putting on pressure makes it worse.²⁵

• Bribes and rewards for talking, because they put a price on something your child can't yet do.
• Putting a child on the spot with "go on, say hello" or "tell Miss what you did".
• Praising speech in public. The RCSLT says it can cause embarrassment and suggests waiting until you're alone with your child.²
• Telling other people, within your child's hearing, that they "can't" or "won't" talk. SMIRA suggests saying instead that when they're worried, the words won't come out.⁵

The RCSLT also suggests that families keep going to parties and family visits, and think about what would make them more comfortable for the child.²

Will my child grow out of it?

The NHS says not to accept the opinion that a child will grow out of it,¹ and I can't predict how any child will do or promise a result. The RCSLT says early intervention is associated with better outcomes in a shorter time.²

The research is small. A trial in Norway randomised 24 children aged 3 to 9 to three months of a home and school programme or to a waiting list. Speech at school increased in the treatment group and didn't change in the waiting list group, and younger children improved more.⁶ A year after a six-month course of treatment for those 24 children, 12 no longer had a diagnosis, 4 were in remission and 8 still met the criteria, and the younger children (aged 3 to 5) were more likely to be free of selective mutism than those aged 6 to 9.⁷

A 2023 review of 25 studies found combined behavioural approaches promising, with a large effect on speaking against waiting lists, but only five randomised trials could be pooled and the authors call for much more research.⁸ So the evidence is encouraging and still thin. Those studies used structured programmes run by research teams, and I can't say any one child would respond the same way.

Who should I ask, and when?

Start with the free NHS routes: your child's class teacher or the school SENCO (the special educational needs coordinator), and your GP. For a younger child, your health visitor is another way in. The NHS says that if you suspect selective mutism you can ask your GP for a referral to a local specialist service, or contact a speech and language therapy clinic directly, and that your child may also need to see a mental health professional or the school's educational psychologist.¹

If the silence has lasted a month or two, I'd ask now and not wait for next term. If your child seems to struggle to understand instructions or follow routines, the NHS says to speak to a GP.¹ And if your child has stopped speaking everywhere or lost words they used to have, ask for an urgent GP appointment or call NHS 111.

What happens if I get in touch?

Book the free 15-minute call and tell me what you're seeing at home and at school. You don't need a GP referral, and seeing me doesn't take your child off an NHS waiting list. The usual first step after the call is an assessment at my Wanstead clinic for £270 where nobody asks your child to talk, and I can visit their school too. There's more on my selective mutism page, how school visits work and the fees page.