Selective mutism in teens & adults

People with selective mutism don’t choose where they can speak. When the fear response kicks in, speaking feels impossible in that moment.

For some people, selective mutism fades in childhood. For others, it carries on, or changes into another kind of anxiety, like social anxiety.

Selective mutism is not the same as autism, but they can happen together. Some people also have speech or language differences, or other kinds of anxiety.

Neurodiversity: the basics explains brain differences in a strengths-based way.

People described selective mutism as separate from who they really are. One woman said she only felt she could be herself with her parents.

Some described feeling stuck outside, looking in at social life. Loneliness was a strong theme.

Some people worried about things they hadn’t been able to do yet, like college, jobs or relationships. That sadness makes sense, and it can be talked about with a therapist.

One of the study’s authors, who had selective mutism himself, described being able to give lectures and handle everyday tasks. Recovery is possible.

In the U.S., students with selective mutism may get support through a Section 504 plan or an IEP. This might mean other ways to take part, like written answers or small groups.

Social anxiety at work, college & class has more ideas for speaking situations at school.

Small groups with people you already feel okay around are a good place to start. Shared activities, like gaming, art or sport, take the focus off talking.

Treatment for teens works best when everyone’s expectations shift, including the teen’s own. Being part of choosing goals helps you feel in charge of your progress.

Making calls, booking appointments or speaking at a counter can feel very hard. Online booking, email and text can help you get things done while you work on speaking.

Writing and other kinds of communication support can be used for a while, or longer term, alongside treatment.

You might ask about written updates instead of speaking in meetings, or chat tools instead of phone calls. You decide whether and how much to share with an employer.

Many people can talk freely with a few close people. A trusted partner, friend or family member can be a great practice partner when you’re ready.

Teens with selective mutism are more likely to also have social anxiety. Treatment for both has helped adults.

Social anxiety: understanding it explains this in depth.

Years of feeling unheard or left out can lead to low self-esteem and depression. These are treatable, and you deserve support for them too.

A new school, job, class or club, where people don’t have expectations of you yet, can be a good time to try small speaking steps. Plan them with a therapist if you can.

A good treatment plan changes everyone’s expectations, including your own. You might ask a trusted person to give you chances to answer, and to wait, without pushing.

Older children, teens and adults often benefit from CBT to work with anxious thoughts, plus gradual practice speaking with new people and in new places.

One clinic reports good results for older teens with intensive CBT of up to 30 hours in one week. Therapy can also happen in real places where speaking is hard.

Adults are ideally assessed by a mental health professional, with help from a speech and language therapist. Assessments can use writing or other ways of communicating, so you don’t have to speak to be understood.

Online therapy can make specialist help easier to reach. Talking about your goals online or in writing can be a comfortable first step.

Some people carry a card or phone note saying something like: “I have selective mutism. I understand you. I may write or point instead of speaking.” It can take the pressure off in shops or appointments.

Rewarding yourself for brave tries helps build confidence. Write down what you managed, however small it seems.

Setbacks happen. Speak to yourself the way you’d speak to a good friend who was trying something scary.

Social anxiety: a step-by-step practice plan has more ideas for building a practice ladder.

Try

• Accept writing, texting and gestures as real communication.
• Ask what helps them, in writing if that is easier.
• Give time to answer, without filling the silence.
• Respond naturally if they speak.

Avoid

• Answering or ordering for them
• Demanding that they speak
• Joking about their silence
• Making a big deal when they talk

You could say

• “I’m happy to text if that’s easier.”
• “No rush. I’m here when you’re ready.”
• “What would make this easier for you?”

The Selective Mutism Association (selectivemutism.org) lists treating professionals you can search by country, state, language, and in-person or online care.

Call or text 988, or chat at 988lifeline.org. It is free, confidential and open 24/7, and texting or chat means you don’t have to speak.

Find A Helpline (findahelpline.com) lists free, confidential helplines in more than 175 countries.

In the UK, the NHS suggests adults are assessed by a mental health professional, with support from a speech and language therapist.