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Selective mutism is a condition in which a child who can speak well stops speaking, usually in school or social settings.
The cause of selective mutism is unknown. Most experts believe that children with the condition inherit a tendency to be anxious and inhibited. Most children with this condition have some form of extreme social phobia.
Parents often think that the child is refusing to speak, but usually the child is truly unable to speak in certain settings.
Some affected children have a family history of selective mutism, extreme shyness, or anxiety disorders, which may increase their risk for similar problems. This condition is most common in children under age 5.
This syndrome is not the same as mutism. In selective mutism, the child has the ability to both understand and speak, but fails to speak in certain settings or environments. Children with mutism never speak.
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Simms MD, Schum RL. Language development and communication disorders. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 32.2.
Victor AM, Bernstein GA. Anxiety disorders and posttraumatic stress disorder update. Psychiatr Clin North Am. 2009;32:57-69.
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