In simple words: Selective mutism is a condition where a child who can normally speak is unable to talk in certain places or situations, like school or social events, due to anxiety or fear. They can talk just fine at home or other comfortable settings. It's not that they're being stubborn or defiant, but rather they physically can't speak because of their anxiety. Treatment usually involves therapy and support to help them manage their anxiety and communicate more freely.

Selective mutism is a complex childhood anxiety disorder where a child is unable to speak in certain social settings, such as school, despite demonstrating normal speech and communication abilities in comfortable environments. It often coexists with social anxiety disorder (social phobia). Affected children understand language and can speak freely in familiar settings, but experience a "freeze" response and become silent when expected to speak in specific social situations. This silence isn't a choice, but a symptom of anxiety, often coupled with shyness, social isolation, fear, school phobia, and anxiety in unfamiliar surroundings or groups. Diagnosis typically involves assessing the patient’s history, a physical examination to exclude other medical causes, and interviews with parents, teachers, or other relevant individuals. Treatment often includes behavioral therapy, family and school support, and possibly mild anti-anxiety medication considered safe for children.

Example 1: A 5-year-old girl attends kindergarten but does not speak to her teacher or classmates, although she communicates freely at home with her family., A 7-year-old boy whispers occasionally to a single friend at school but remains silent during class discussions and interactions with other children and teachers., A 10-year-old child speaks to some adults at school in one-word answers but never initiates conversation and avoids all communication with peers.

Documentation should include detailed observations of the child's communication patterns in various settings, reports from parents and teachers, and assessment of the child's anxiety levels. A physical examination and other relevant evaluations should rule out alternative medical or developmental causes of the mutism. The duration and severity of the mutism should be noted, along with any associated symptoms, such as social withdrawal or avoidance behaviors.