ABSTRACT
This chapter describes our thinking about selective mutism in the light of research findings, our clinical experience and the views of international experts in the field. Selective mutism (SM) is classified as an anxiety disorder, characterised by being able to speak in some situations but not others. But this description tells us very little about the nature of SM. SM is easy to recognise when children speak to some people, or in some places, but not in others. However, things are rarely this clear cut because the individual's ability to speak is entirely context-dependent. In an Association of Child and Adolescent Mental Health (ACAMH) occasional paper, the chapter describes how SM meets the criteria for specific phobia, as defined by DSM-5, but accrues additional complications over time. A phobic reaction to an imaginary threat is exactly the same as the body's automatic reaction to real danger.
