Characteristics of person, place, and activity that trigger failure to speak in children with selective mutism

Eur Child Adolesc Psychiatry. 2022 Sep;31(9):1419-1429. doi: 10.1007/s00787-021-01777-8. Epub 2021 Apr 24.


Selective Mutism (SM) is an anxiety disorder with predictable and circumscribed situations in which children remain silent while they speak unaffectedly in others. However, core features of anxiety inducing stimuli have rarely been studied so far. Parents of children with elevated SM symptomatology participated in an online-based study and answered open ended questions about specific characteristics of a person, place, and activity that elicit failure to speak in their child. The final sample consisted of n = 91 parents with children aged between 3 and 17 years (M = 8.02 years, SD = 3.94). Answers were analyzed by qualitative content analysis. Characteristics of a person were assigned to five categories with lack of distance as the most frequently reported feature. With respect to a place, the majority of parents mentioned unknown places as a silence trigger. The most frequently mentioned feature of an activity that was designated to be associated to silence was new activity. There were only few associations between the designation of these features, age, and gender. For the first time, anxiety inducing triggers related to person, place, and activity were comprehensively assessed in children with SM. This allows a differentiated and deeper understanding of an understudied disorder. The majority of characteristics can be associated with proposed etiological factors such as increased behavioral inhibition, conditioning processes, social anxiety, and a strong need for control. Implications for effective treatments are discussed.

Keywords: Online study; Qualitative research; Selective mutism; Triggers for failure to speak.

MeSH terms

  • Adolescent
  • Anxiety / therapy
  • Anxiety Disorders / therapy
  • Child
  • Child Behavior Disorders*
  • Child, Preschool
  • Humans
  • Mutism* / therapy
  • Parents