Elective Mutism

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) notes that social phobia, commonly known as pathological shyness, often is associated with elective mutism. Frequently there is also a family history of anxiety disorder. Psychologists once considered elective mutism a rare disorder, but in the early 2000s it was known to affect more than 6 children in 1,000, about the same prevalence as autism, a disorder with which it may be confused.

Elective mutism usually begins under the age of five, though it may not become apparent until the child starts school. Affected children may communicate readily in settings where they are relaxed and comfortable, such as the family home, only to become mute in more demanding situations, such as at school or with strangers. The condition prevents children from communicating and learning and so, if undiagnosed and untreated, interferes with their education.

Children with elective mutism are not being difficult or rude. The underlying cause of the condition is not well understood, but often other anxiety symptoms are also present. An additional factor may be difficulties in processing sensory information, which adds to their anxiety in situations in which they are expected to speak. Elective mutism also may result from these individuals having experienced some kind of psychological trauma.

See also Autism.