What is situational (selective) mutism?
Situational mutism means a person cannot speak in certain situations, even though they can speak in others.
This might include talking easily at home but not at school or work, speaking with some people but not others, or being able to speak one moment and not the next.
Different words are used to describe this. ‘Selective mutism’, ‘elective mutism’ and ‘situational mutism’ are often used to describe the same experience. Some people feel the words ‘selective’ and ‘elective’ give the idea the person is choosing whether to speak, but this is not the case.
So terms like ‘situational mutism’ or ‘speech shutdown’ may also be used. The word ‘mutism’ can feel outdated or negative for some people, but it is still widely used and can help people find support and information. It is always best to check with the person what words they prefer to use to describe their communication.
Why this happens
We cannot always know exactly why someone develops SM, but there are some factors that may make it more likely, such as earlier speech and language differences or having family members with SM or high anxiety. There are also factors that can cause SM to continue such as difficult experiences, or negative reactions from other people. For example, if someone has been pressured or criticised for not speaking, this can make it even harder the next time.
Autistic people may process information in a different way. Social situations can take a lot of effort, and things like noise, bright lights, or busy spaces can feel overwhelming. This can increase anxiety and make it harder to speak in some situations.
This can lead to a freeze response (see more in meltdowns and shutdowns here). This means the body feels unsafe or overwhelmed, and speech shuts down. This can happen when there is too much noise, too many people, or pressure to speak. It can also happen when someone is tired, unwell, or stressed.
It can help to think about how much is being asked of the person, and how much energy and support they have at that time. If there are lots of demands, like noise, social pressure, or needing to think quickly, and the person is already tired or overwhelmed, speaking can become much harder.
How it may look
Situational mutism can look different for each person. A person might go quiet in certain places, freeze when asked a question, or seem unable to get words out even when they know what they want to say. They may use gestures, writing, or typing on a phone instead of talking.
For example, someone may talk easily with close family at home, but be unable to speak at school, at work, or in a busy shop. They may want to answer a question but find that their body will not let them speak.
This is not a choice. It is a body response.
Supporting someone with situational mutism
The most important thing to understand is that the person is not choosing to stay silent. Their body has gone into a freeze response. Pressure will make it harder, not easier, for them to speak.
Reduce pressure to speak. Do not tell the person to “just talk” or “use your words” and avoid putting them on the spot. Instead, give them different ways to respond. You can ask yes or no questions, offer simple choices, or encourage them to nod, point, or gesture.
Give the person time. Wait longer than you think you need to, and do not rush or interrupt. It can help to say, “Take your time. There is no rush.”
Accept other ways of communicating. This might include writing, typing, signing, pointing, or using a phone or communication app. Communication is more important than speech.
Stay calm. Use a relaxed and friendly tone and avoid sounding frustrated or demanding. Even if the situation feels awkward, staying calm helps the person feel safe.
Asking for more help
If you are a parent or carer of a child with selective mutism and feel they need support, it can help to know where to go. In Leicester, Leicestershire and Rutland, speech and language therapy services do not support children for difficulties with selective mutism. Instead, support sits with the local authority educational psychology service. If your child is struggling in school because of selective mutism, you or the school can make a referral to this service, although referral criteria may vary.
Selective mutism is an anxiety disorder. Support from CAMHS (Child and Adolescent Mental Health Services) or adult mental health services is usually only offered if the person meets their criteria for anxiety support. If you are seeking this type of support for a child or for yourself as an adult, you would usually need to ask your GP to make a referral.
You can also contact the Selective Mutism Information and Research Association (SMIRA) for advice, information, and support. They support people of all ages, including children, young people, and adults.
Website: www.selectivemutism.org.uk
Email: info@selectivemutism.org.uk
Making situations easier
Try to lower demands where possible. (Link to familiarity article) Reduce noise, crowds, or pressure, and move to a quieter place if you can.
Be clear and predictable. Let the person know what will happen next and keep instructions short and simple. For example, you might say, “We’re going to the desk, then we can leave.” A written or visual list (using pictures) of what is happening can be helpful.
Building trust over time
Focus on building a sense of safety and trust, rather than expecting speech. Use activities where there is no pressure to talk, such as games, drawing, or shared tasks.
Be open and understanding. You can say that you know speaking is difficult and that they do not have to talk. Make it clear there is no pressure.
Offer tools to support communication, such as pen and paper, pictures, or a phone. You can model using these yourself so it feels normal and accepted.
Use simple choices rather than open questions. For example, “Do you want this or that?” is easier than asking “What do you want?”
What to avoid
Avoid forcing the person to speak and avoid showing any frustration. Do not draw attention to their silence or make it the focus. Avoid praising them if they do speak, as this can add pressure. Do not speak for them without checking what they want.
Important messages
Situational mutism is not a behaviour problem. It is not refusal or stubbornness. It is a response to anxiety or feeling overwhelmed.
Some autistic people will experience this, especially in stressful or busy situations. Others will not. For those who do, it may happen sometimes rather than all the time.
Key points
- Some people cannot speak in certain situations
- This is called situational or selective mutism
- Selective mutism is an anxiety disorder
- Autistic people are more likely to experience this
- It is not a choice, but a body and brain response
- Communication can change depending on the situation
- Anxiety, sensory overload, and demand can all affect a person’s ability to speak
- Communication can happen in many ways, not just speech
- The best support is to reduce pressure and help the person feel safe
- Supporting other ways to communicate can make things easier
Resources
For more sources of information about SM – and links to resources, click the following link:
www.leicspart.nhs.uk/autism-space/general-resources/other-resources/
For more articles about autism and communication, click the following link:
www.leicspart.nhs.uk/autism-space/relationships/
References
Autism and increased likelihood of selective mutism
Reference: Steffenburg, H., Steffenburg, S., Gillberg, C. and Billstedt, E. (2018) Children with autism spectrum disorders and selective mutism. Neuropsychiatric Disease and Treatment. Available at: www.tandfonline.com/doi/pdf/10.2147/NDT.S154966
Key message:
- A large proportion of children with selective mutism also meet criteria for autism (around 63% in this study).
- This shows a strong overlap, meaning autistic people are more likely than average to experience SM.
Selective mutism is an anxiety disorder
Reference: American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (DSM‑5). Arlington, VA: APA.
(Accessible overview explanation): Muris, P. and Ollendick, T.H. (2015) Children who are anxious in silence: a review on selective mutism. Available at: embrace-autism.com/selective-mutism-and-autism/
Key message:
- Selective mutism is classified as an anxiety disorder.
- The inability to speak is due to high anxiety and a freeze response, not choice or refusal.
Best support strategies (reduce pressure and support communication)
Reference (Harvard):
Carroll, C. (2019) Selective Mutism and Autism: Similarities, differences and overlap. SMiRA (Selective Mutism Information & Research Association). Available at: www.selectivemutism.org.uk/wp-content/uploads/2019/04/Autism-vs-SM-similarities-differences-and-overlap.pdf
Key message:
- Effective support focuses on reducing anxiety and pressure to speak.
- People should be supported to communicate in other ways (e.g. gesture, writing, visuals).
- Forcing speech or showing frustration increases anxiety and makes speech harder.