Selective mutism

A disorder characterized by consistent failure to speak in specific social situations, most commonly outside the home or at school, despite preserved ability to speak and understand language. In a safe, familiar environment (e.g. at home), the child communicates normally. The inability to speak is caused by anxiety and is not attributable to a speech or language disorder.

Symptoms

• Absence of speech in specific social situations despite ability to speak (also: Absence of speech in specific social situations despite ability to speak, failure to speak in specific situations, selective mutism, inability to speak in specific situations, absence of speech in social situation)
• Preserved speech in safe, familiar environment (e.g. at home) (also: Preserved speech in safe, familiar environment (e.g. at home), normal speech in safe environment, free speech at home, normal communication in safe surroundings, speech in comfortable environment)
• Anxiety as the cause of speech absence in social situations (also: Intense anxiety as the cause of speech absence in social situations, intense anxiety in social situations, social anxiety, fear in social contacts, intense social stress)
• Avoidance of verbal communication outside safe environment (also: Avoidance of verbal communication outside safe environment, avoidance of verbal communication, avoidance of speaking, avoidance of conversations, limiting verbal communication)
• Difficulties in school/social relationships (also: Difficulties in school or social relationships due to lack of speech, difficulties in school functioning, problems at school, educational difficulties, learning problems)
• Duration >=1 month (excluding first month of school) (also: symptoms >=1 month, duration of mutism, not limited to adaptation period, excluding first month of school, persistent silence)
• Fearfulness and withdrawal (also: Co-occurring fearfulness, withdrawal and excessive sensitivity, social anxiety, withdrawal, emotional hypersensitivity, shyness)
• No association with speech/language development disorders (also: normal speech development at home, no language deficits, differentiates from dysphasia, differentiates from communication disorders, motivational-anxiety problem)

ICD-11 diagnostic criteria

• brak mówienia w określonych sytuacjach społecznych
• prawidłowa zdolność mówienia w innych sytuacjach
• czas trwania co najmniej jeden miesiąc
• znaczące trudności w funkcjonowaniu społecznym lub szkolnym

How to recognise

In the ICD-11 framework, the core symptoms taken into account when recognising Selective mutism are:

• brak mówienia w określonych sytuacjach

Differential diagnosis

When diagnosing Selective mutism, the following ICD-11 disorders should be considered in the differential diagnosis:

• Zaburzenie ze spektrum autyzmu (6A02)
• Schizofrenia (6A20)
• Zaburzenie związane z lękiem przed separacją (6B05)
• Zaburzenie rozwojowe języka (6A01.2)

Synonyms and related terms

failure to speak in specific situations, selective mutism, inability to speak in specific situations, absence of speech in social situation, blocked speech, silence in specific contexts, no verbal communication in given situation, does not speak around people, silent at school, does not speak in certain places, cannot speak under stress, blocks and cannot speak, in some places does not speak, normal speech in safe environment, free speech at home, normal communication in safe surroundings, speech in comfortable environment, no speech problem at home, fluent communication in familiar environment, normal language functioning at home, speaks normally at home, converses freely with close ones, no problem speaking at home, converses normally with family, speaks normally in familiar places, Intense anxiety as the cause of speech absence in social situations, intense anxiety in social situations, social anxiety, fear in social contacts, intense social stress

Frequently asked questions

What are the symptoms of Selective mutism?

Symptoms associated with Selective mutism (ICD-11 6B06) include: Absence of speech in specific social situations despite ability to speak, Preserved speech in safe, familiar environment (e.g. at home), Anxiety as the cause of speech absence in social situations, Avoidance of verbal communication outside safe environment, Difficulties in school/social relationships, Duration >=1 month (excluding first month of school), Fearfulness and withdrawal, No association with speech/language development disorders.

How is Selective mutism diagnosed according to ICD-11?

According to ICD-11, the diagnostic criteria for Selective mutism (6B06) include: brak mówienia w określonych sytuacjach społecznych; prawidłowa zdolność mówienia w innych sytuacjach; czas trwania co najmniej jeden miesiąc; znaczące trudności w funkcjonowaniu społecznym lub szkolnym.

What disorders are in the differential diagnosis of Selective mutism?

The differential diagnosis of Selective mutism (6B06) includes: Zaburzenie ze spektrum autyzmu (6A02), Schizofrenia (6A20), Zaburzenie związane z lękiem przed separacją (6B05), Zaburzenie rozwojowe języka (6A01.2).

WHO ICD-11 source

View this entry in the official WHO ICD-11 browser: 6B06 – WHO ICD-11