Selective mutism
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Synopsis

Symptoms tend to be pronounced at the start of school or on introduction to new social settings. Patients typically have symptoms for at least 1 month, with most patients presenting with 6-7 months of persistent symptoms. Affected individuals often have poor outcomes in their respective learning environments due to poor engagement and participation.
Management options include psychotherapy, parent-child interaction therapy (PCIT), cognitive behavior therapy, and antidepressant therapy if major depressive disorder or generalized anxiety disorder are present. There are mixed results for all therapeutic options.
Codes
ICD10CM:F94.0 – Selective mutism
SNOMEDCT:
71959007 – Elective mutism
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Generalized anxiety disorder
- Social anxiety disorder
- Panic disorder
- Agoraphobia
- Separation anxiety disorder
- Major depressive disorder
- Deafness (see sensorineural deafness)
- Autism
- Rett syndrome
- Aphasia
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Therapy
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References
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Last Reviewed:06/07/2019
Last Updated:02/28/2020
Last Updated:02/28/2020