Selective mutism (SM) is a specific anxiety disorder characterized by difficulty speaking in some situations despite having the capacity for age-appropriate speaking in comfortable situations. Some misunderstand the term "selective" to suggest that the individual willfully chooses to withhold their voice, but the term references that speaking occurs in select situations (for example, at home versus at school or with a specific friend versus a group of peers) based on relative distress or comfort. SM tends to onset in the preschool years, and is not the result of a traumatic life experience. Unlike some children who show shyness or initial and temporary reluctance to speak (such as at the beginning of a school year), children with SM experience ongoing failure to adjust and speak and, as a result, there is interference in different parts of their life. SM, for instance, may interfere with a child's ability to self-advocate, participate meaningfully and adequately in learning settings, and/or engage in social situations.
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