{"h1":"Selective Mutism: ICD-11 Features in Early Childhood","faq":[{"a":"No. Under ICD-11 it sits within anxiety and fear-related disorders. The child has intact speech and language ability but is unable to speak in specific anxiety-provoking situations.","q":"Is Selective Mutism a speech disorder?"},{"a":"Onset is usually between 2 and 5 years, and it is frequently first recognised when the child begins nursery or formal schooling and the contrast with home speech becomes apparent.","q":"At what age does Selective Mutism typically present?"},{"a":"The failure to speak in specific settings should persist for at least one month and extend beyond the normal initial settling-in period of starting school.","q":"How long must symptoms persist for the ICD-11 pattern?"}],"lang":"en","slug":"what-is-selective-mutism-and-what-are-its-icd-11-features-in-early-childhood","title":"What is Selective Mutism, and what are its ICD-11 features in early childhood?","entity":{"key":"selective-mutism","kind":"condition","name":"Selective Mutism","slug":"selective-mutism"},"lenses":[{"kind":"stakeholder","label":"Doctor","value":"doctor"},{"kind":"domain","label":"Emotional","value":"emotional"},{"kind":"intent","label":"Definition","value":"definition"},{"kind":"lifecycle","label":"Screen","value":"screen"},{"kind":"route","label":"Special-Education","value":"special-education"},{"kind":"empowerment","label":"Early Clarity","value":"early_clarity"}],"parent":{"key":"conditions","label":"Conditions"},"related":[{"lang":"en","slug":"what-does-current-research-show-about-early-intervention-outcomes-for-selective-mutism-in-children-under-7","title":"Early Intervention Outcomes for Selective Mutism Under 7"},{"lang":"en","slug":"what-is-selective-mutism-and-what-does-it-look-like-in-early-childhood","title":"What is Selective Mutism in Early Childhood?"},{"lang":"en","slug":"what-are-the-known-contributing-factors-for-selective-mutism-in-early-childhood","title":"Contributing Factors for Selective Mutism"},{"lang":"en","slug":"what-is-selective-mutism","title":"What is Selective Mutism?"},{"lang":"en","slug":"what-early-indicators-of-selective-mutism-should-a-paediatrician-watch-for","title":"Early Indicators of Selective Mutism for Paediatricians"},{"lang":"en","slug":"what-is-the-icd-11-classification-for-selective-mutism","title":"What is the ICD-11 classification for Selective Mutism?"}],"summary":"Selective Mutism (ICD-11 6B06) is an anxiety and fear-related disorder defined by consistent failure to speak in specific social situations despite normal speech elsewhere, persisting beyond one month with functional impact, and not explained by language unfamiliarity or a communication disorder.","answer_md":"*A child who speaks freely at home yet falls silent at school is not being defiant — they are caught in a specific, treatable anxiety pattern.*\n\n## In short\nSelective Mutism (ICD-11 **6B06**) is a consistent failure to speak in specific social situations where speech is expected — typically school or with unfamiliar adults — despite speaking normally in other settings, usually the home. It is classified within anxiety and fear-related disorders, not as a communication or language disorder. The child *can* speak; situational anxiety blocks it.\n\n## The clinical picture\nUnder ICD-11, the core features in early childhood are:\n- **Selectivity** — fluent, age-appropriate speech in comfortable settings (home, with close family) but consistent muteness in specific contexts.\n- **Duration and persistence** — the pattern endures at least one month, extending beyond the normal settling-in period of starting nursery or school.\n- **Functional impact** — interference with educational participation, social interaction or daily functioning.\n- **Exclusions** — not better explained by a lack of familiarity with the spoken language required, and not attributable to a communication disorder (e.g. childhood-onset fluency disorder) or to a neurodevelopmental or psychotic disorder.\n\nOnset is typically between ages 2 and 5, often first identified when formal schooling begins. High comorbidity with social anxiety and behavioural inhibition is well documented. Differentiate from transient situational reticence, hearing impairment, and language-exposure effects in multilingual children.\n\n## The Pinnacle way\nDevelopmental measurement supports care planning; diagnosis requires an appropriately qualified healthcare professional., under qualified clinician care — never from an online tool. Our pathway combines graded-exposure behavioural work with [speech therapy](https://www.pinnacleblooms.org/top-speech-therapy-center-india-proven-improvement-rate) and family coaching across [selective mutism](/selective-mutism) support, anchored by the clinician-administered [AbilityScore®](/ask/what-is-the-abilityscore-and-how-is-it-calculated).\n\n## Trusted sources\nWHO ICD-11 Mortality and Morbidity Statistics (6B06); ASHA guidance on selective mutism; AAP developmental and behavioural resources.\n\n**Next step —** Refer the family for a structured developmental and anxiety assessment at a Pinnacle centre.\n\nThis is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.","canonical":"https://pinnacleblooms.org/ask/what-is-selective-mutism-and-what-are-its-icd-11-features-in-early-childhood","editorial":{"reviewed_at":"2026-06-11T20:12:18.613642+00:00","reviewed_by":null,"developed_by":"SETU Consortium · Pinnacle Blooms Network"},"alternates":[{"href":"https://pinnacleblooms.org/ask/what-is-selective-mutism-and-what-are-its-icd-11-features-in-early-childhood","lang":"en","indexable":true},{"href":"https://pinnacleblooms.org/ask/what-is-selective-mutism-and-what-are-its-icd-11-features-in-early-childhood-te","lang":"te","indexable":true}],"dimensions":[{"key":"conditions","label":"Conditions"}],"meta_title":"Selective Mutism (ICD-11 6B06): Definition","meta_robots":"index, follow, max-image-preview:large","everyday_tip":"Reassure parents not to pressure the child to speak; reduced demand and graded, low-anxiety exposure support speech far better than coaxing.","published_at":"2026-06-10T10:42:00.172548+00:00","reading_paths":[{"key":"understand","items":[{"lang":"en","slug":"what-is-selective-mutism","title":"What is Selective Mutism?","reason":"Linked from this answer"},{"lang":"en","slug":"what-is-selective-mutism-and-what-does-it-look-like-in-early-childhood","title":"What is 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