What's elective mutism?Elective mutism is a condition in which children do not speak because they do not want to. Typically, children with elective mutism will speak when they are on their own, with their friends and sometimes with their parents, but they do not speak in school, in public situations or with strangers. The condition occurs somewhat more frenquently in girls than boys.
A significant proportion of children with elective mutism also have articulatory or language deficits. True elective mutism may be a reaction to a traumatic event, the aftermath of an injury to the mouth or throat, particularly if it is painful, or a symptom of extreme shyness.
In some cases, the lack of speech is eventually found not to be volitional, but a sign of damage or deformity of the speech apparatus, or a feature of infantile autism. It is a rare condition, diagnosed in less than 1% of children who attend child psychiatric clinics. The cause is unknown. Often speech is normal at home but lacking at school. There is no organic cause of the mutism, just a refusal to speak in certain situations. There is often negative behaviour associated with this condition, e.g. refusing to sit down or play when invited to do so. This condition usually occurs in 3-5 years olds, i.e. after speech has normally been acquired. The condition may last for months or years. However, the long-term prognosis is good and the condition usually resolves. There is no evidence that treatment interventions are effective in this condition.