Children with selective mutism fail to speak in certain situations outside of their home, although they may speak normally with more familiar individuals (i.e., close family members). The failure to speak most often occurs in the presence of teachers, same-aged peers, relatives outside of the immediate family, and unfamiliar people. As such, symptoms are often observed before the age of five years, but may also occur upon school entry. The failure to speak interferes with school functioning and friendships, and often results in significant stress and upset within the family.
Selective mutism may be associated with excessive shyness, fear of social embarrassment, clinginess, and disruptive behavior, and is often seen in combination with other conditions such as social phobia, separation anxiety, specific phobia, and oppositional defiant disorder. Roughly 0.03% to 1.0% of children suffer from symptoms associated with selective mutism.
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