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This pattern of mutism must be observed for at least 1 month. (The first month of school does not count, because shyness is common during this period.)
Teachers and counselors should consider cultural issues, such as recently moving to a new country and speaking another language. Children who are uncomfortable with a new language may not want to use it outside of a familiar setting. This is not necessarily selective mutism.
Stafford B, Boris NW, Dalton R. Anxiety disorders. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 24.
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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