What causes mutism?
Mutism is believed to arise from anxiety experienced in social situations where the child may be called upon to speak. Most experts believe that there are environmental, biological, interpersonal, and anxiety-related factors that cause selective mutism. Most children with this condition have some form of extreme social phobia. Refusing to speak, or speaking in a whisper, spares the child from the possible humiliation or embarrassment of "saying the wrong thing." When asked a direct question by teachers, for example, the affected child may act as if they are unable to answer.Some children may communicate via gestures, nodding, or very brief utterances. Additional features may include excessive shyness, oppositional behavior, and impaired learning at school. Some affected children have a family history of selective mutism, extreme shyness, or anxiety disorders that may increase their risk for similar problems. This condition is most common in children under age 5.