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Children Who are Anxious in Silence: A Review on Selective Mutism, the New Anxiety Disorder in DSM-5

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Abstract

Selective mutism (SM) is a relatively rare childhood disorder characterized by a consistent failure to speak in specific settings (e.g., school, social situations) despite speaking normally in other settings (e.g., at home). The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists SM among the anxiety disorders. This makes sense as the current review of the literature confirms that anxiety is a prominent symptom in many children suffering from this condition. Further, research on the etiology and treatment of SM also corroborates the conceptualization of SM as an anxiety disorder. At the same time, critical points can be raised regarding the classification of SM as an anxiety disorder. We explore a number of such issues in this review. Recommendations for dealing with this diagnostic conundrum are made for psychologists, psychiatrists, and other mental health workers who face children with SM in clinical practice, and directions for future research are highlighted.

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Acknowledgments

We thank R. Lindsey Bergman, UCLA Department of Psychiatry and Biobehavioral Science, Los Angeles, USA, for providing us with the table of her intervention for children with selective mutism.

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The authors have no potential conflicts of interest to disclose.

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  1. Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands

    Peter Muris

  2. Stellenbosch University, Stellenbosch, South Africa

    Peter Muris

  3. Virginia Polytechnic Institute and State University, Blacksburg, VA, USA

    Thomas H. Ollendick

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Muris, P., Ollendick, T.H. Children Who are Anxious in Silence: A Review on Selective Mutism, the New Anxiety Disorder in DSM-5. Clin Child Fam Psychol Rev 18, 151–169 (2015). https://doi.org/10.1007/s10567-015-0181-y

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