Complaints & connections · borters.ch
Mutismus electivus
Selective mutism is anxiety, not defiance — the child wants to speak and cannot, and pressure only deepens the silence.
Also known as: selective mutism · elective mutism · not speaking at school · situational mutism · speech anxiety
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Selective mutism means this: a child speaks freely, fluently and happily at home — often loudly and at length with parents and siblings — and cannot get a word out in kindergarten or school. That contrast is what defines the condition. It is an anxiety disorder, not defiance, stubbornness, manipulation or a parenting failure. The child wants to speak and cannot in that moment; those affected later describe a feeling of freezing or a lump in the throat. About one child in 140 is affected, slightly more often girls; it usually becomes visible on starting kindergarten or school. Multilingualism raises the risk — though the silent phase when learning a new language normally lasts only a few months. What makes it worse: pressure, demands to speak, rewards for speaking, expectant watching and well-meant questions in front of the whole class. What helps: removing the expectation entirely, allowing non-verbal communication — nodding, pointing, cards, writing, voice recordings — building trust, then moving in small planned steps: first with a trusted person in an empty room, then with one classmate present, then in the classroom. Starting early works best; the longer silence becomes habit, the harder it is to shift. Selective mutism is not shyness: shy children thaw after a few weeks, here the silence stays stable for months and years. In Switzerland assessment runs via the paediatrician, speech therapy, the school psychology service and child psychiatry. How this is worked on in speech therapy — amount, duration, limits and the signs that are urgent — is ordered by age at logopaedie.borters.ch.
No demands, no waiting for an answer, no “say hello now”. As fear drops, speech comes closer by itself.
Cards, hand signs, writing or a voice recording are not an excuse but the bridge speech later returns over.
From whispering with one person in an empty room to one classmate and then the class — each step is planned, not forced.
“She’ll grow out of it” rarely holds here. The shorter the silence has lasted, the more easily it resolves.
Rewards and public praise turn speaking into a test with an audience — exactly what triggers the fear.
An agreed plan prevents being called on in front of the class and stops staffroom remarks like “she’s just rude”.
Speech therapy, the school psychology service and child psychiatry use proven step-by-step behavioural plans — guided is faster.
A hearing test and a look at language development belong at the start — some silence has an additional cause.
Selective mutism is an anxiety disorder — it is not speech that is missing, but speaking in certain situations. SSRIs are used when the anxiety is very marked and need six to twelve weeks; they do not do the speaking, they lower the threshold. What works is a stepwise approach that widens in small steps from one person to the next — pressure and demands to speak make things measurably worse.
About one to seven in a thousand children are affected, girls somewhat more often. It usually begins between two and five and becomes noticeable when the child starts kindergarten. For the diagnosis it must last at least a month, not counting the first month in a new environment. The earlier support starts, the better — after several years the silence becomes a habit and therapy takes longer.
The same child talks non-stop at the kitchen table and has not said a word at kindergarten for months.
After settling in, shy children speak. If silence lasts beyond a month, that is a topic in its own right.
When addressed the child looks frozen: no smile, no eye contact, barely any movement — a sign of fear, not sulking.
Pointing, nodding, drawing, writing all work — proof that it is neither ability nor willingness.
They will not use the school toilet, never raise a hand, avoid birthday parties and introduction rounds.
Morning tummy aches, nausea before school and Sunday-night sleep trouble often come with it.
A lack causes exhaustion, problems concentrating, low mood and forgetfulness — and it is one of the few causes that can be found and put right with a single blood draw.
Low values are common with low mood. Whether correcting it lifts the mood is not settled; that it makes sense in winter at our latitudes is.
An empty store causes tiredness, lack of drive and problems concentrating long before any anaemia becomes visible. In women of childbearing age the most common single reason.
A building block of the cell coverings in the brain. The studies on mood are inconsistent; as part of a good diet it belongs there anyway.
Needed for making the messengers in the brain. It runs short with alcohol and under certain medicines — and it is always judged together with B12.
Selective mutism is an anxiety disorder, and what works is the careful, graded building up of speaking in the feared setting — not pressure and not a preparation. Waiting costs time: the longer the silence is practised, the harder it comes undone.
Clearly worthwhile and well supported when deficient — vegan, older adults, certain drugs. No energy boost without a deficiency.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
Clearly effective with proven deficiency, useless without. Take only with a documented deficiency — excess is harmful.
Effects on inflammation and triglycerides established; cardiovascular prevention is mixed. Watch quality and freshness.
In pregnancy clearly established against neural-tube defects, otherwise mainly with deficiency. Can mask a B12 deficiency — watch both.
The silence is not refusal but a fear reaction — the body is in the same alarm state as with a threat. This is why pressure does not help, and why the first step is to take the pressure away.
In a child who suddenly falls silent and at the same time becomes nervous, shaky and thinner, the thyroid belongs checked once. Rare — but it is a value, not a suspicion.
Some children barely eat outside the family because eating in front of others is also hard. This is part of the picture and not an eating disorder — it resolves along with speaking.
In children age-appropriate relaxation exercises are used. They do not replace behavioural support — pressure to speak regularly makes the picture worse.