Selective Mutism Description/Definitions • • Characterised by the inability to speak in a specific social situation e.g. during class Normal development of language and speak Epidemiology • Usually before 5 years but might not become clinically relevant until the child is required to perform verbally until the child can verbally perform. Diagnosis DSM-V • • • • • Consistent inability to speak in specific social settings where speaking is expected. - E.g. not speaking in class but speaking at home. Interferes with academic or professional performance and social interaction For at least a month. Inability to speak is not due to difference or discomfort with the spoken language expected in the social situation. The inability to speak is not attributable to schizophrenia spectrum disorder or another psychotic disorder, autism spectrum disorder or a communication disorder. Management • • Psychotherapy - CBT at all ages ➔E.g. exposure therapy - Children ➔Family therapy and parent child interaction therapy. Pharmacotherapy - May co-exists with social anxiety disorder and may also result in school refusal.