# What is the ICD-11 classification for Selective Mutism?

Canonical: https://pinnacleblooms.org/ask/what-is-the-icd-11-classification-for-selective-mutism
Publisher: Pinnacle Blooms Network / Bharath Healthcare Laboratories Private Limited

In ICD-11-MMS, Selective Mutism is coded 6B06 and classified within Anxiety or fear-related disorders — reframing it as an anxiety-driven condition marked by consistent failure to speak in specific social settings despite normal speech elsewhere.

*When a child speaks freely at home yet falls silent at school, the right code anchors the right care pathway.*

## In short
In the **ICD-11 for Mortality and Morbidity Statistics (ICD-11-MMS)**, Selective Mutism is classified under code **6B06**. It sits within the grouping of **Anxiety or fear-related disorders**, reflecting the contemporary understanding of selective mutism as anxiety-driven rather than a primary disorder of speech or oppositionality. The defining feature is a consistent failure to speak in specific social situations where speech is expected (typically school), despite speaking normally in other settings.

## The classification, briefly
Under ICD-11, **6B06 Selective mutism** is characterised by a marked, persistent selectivity in speaking — fluent expressive language in familiar contexts (usually the home) contrasted with consistent silence in defined social situations. For the diagnosis to hold, the disturbance should persist for at least one month (beyond the first month of school), is not attributable to a lack of knowledge of the spoken language required, and is not better accounted for by a communication disorder, an autism spectrum disorder, schizophrenia or another condition. Its placement among anxiety or fear-related disorders is the substantive shift from earlier nosology, which had located it among disorders with onset in childhood. This reframing is clinically meaningful: it directs assessment toward the child's social anxiety profile and away from interpreting silence as defiance or a speech impairment.

## Clinical note
Differentiate from a transient adjustment reaction (e.g. the first weeks at a new school or post-migration silent period), from a primary speech-language disorder, and from autism spectrum disorder where the communication pattern is pervasive rather than situation-bound. Co-occurring social anxiety is common and warrants direct enquiry. Hearing should be confirmed intact.

## The Pinnacle way
A clinical AbilityScore® and any formal diagnosis are established only at a Pinnacle Blooms Network centre, under qualified clinician care — never from a code lookup or an online form. Coding orients the pathway; structured clinician assessment determines it. Explore our [speech and language therapy](https://www.pinnacleblooms.org/top-speech-therapy-center-india-proven-improvement-rate) pathway, understand [how the AbilityScore is formed](/ask/what-is-the-abilityscore-and-how-is-it-calculated), or [begin with us](/).

## Trusted sources
WHO ICD-11 for Mortality and Morbidity Statistics — Selective mutism (6B06), within Anxiety or fear-related disorders.

**Next step —** For a child showing situation-specific silence, refer for a structured developmental and anxiety assessment at a Pinnacle Blooms Network centre.

This is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.

## Sources
- WHO ICD-11 — Selective mutism (6B06): https://icd.who.int/

## Connected topics and perspectives
- Conditions: https://pinnacleblooms.org/ask/conditions
- Doctor: https://pinnacleblooms.org/ask/lens/stakeholder/doctor
- Emotional: https://pinnacleblooms.org/ask/lens/domain/emotional
- Definition: https://pinnacleblooms.org/ask/lens/intent/definition
- Screen: https://pinnacleblooms.org/ask/lens/lifecycle/screen
- Speech Therapy: https://pinnacleblooms.org/ask/lens/route/speech-therapy
- Early Clarity: https://pinnacleblooms.org/ask/lens/empowerment/early_clarity

## Related question paths

### Understand the subject
- What is Selective Mutism, and what are its ICD-11 features in early childhood?: https://pinnacleblooms.org/ask/what-is-selective-mutism-and-what-are-its-icd-11-features-in-early-childhood
- What is Selective Mutism?: https://pinnacleblooms.org/ask/what-is-selective-mutism
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- What is Selective Mutism in Early Childhood?: https://pinnacleblooms.org/ask/what-is-selective-mutism-and-what-does-it-look-like-in-early-childhood
- How Selective Mutism Affects a Child's Daily Life: https://pinnacleblooms.org/ask/how-does-selective-mutism-affect-a-child-s-daily-life
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- What Causes Selective Mutism in Children?: https://pinnacleblooms.org/ask/what-causes-selective-mutism-in-children
- Early Intervention Outcomes for Selective Mutism Under 7: https://pinnacleblooms.org/ask/what-does-current-research-show-about-early-intervention-outcomes-for-selective-mutism-in-children-under-7
- What other conditions often occur alongside Selective Mutism?: https://pinnacleblooms.org/ask/what-other-conditions-often-occur-alongside-selective-mutism

### Recognise signs & concerns
- Early Indicators of Selective Mutism for Paediatricians: https://pinnacleblooms.org/ask/what-early-indicators-of-selective-mutism-should-a-paediatrician-watch-for
- Selective Mutism red flags warranting referral in young children: https://pinnacleblooms.org/ask/what-clinical-red-flags-for-selective-mutism-warrant-referral-in-a-young-child
- When should a doctor refer suspected selective mutism for therapy?: https://pinnacleblooms.org/ask/when-should-a-doctor-refer-a-child-with-suspected-selective-mutism-for-developmental-therapy
- Can Selective Mutism Be Cured?: https://pinnacleblooms.org/ask/can-selective-mutism-be-cured
- Can Selective Mutism Be Prevented?: https://pinnacleblooms.org/ask/can-selective-mutism-be-prevented
- Do Boys Show Selective Mutism Differently?: https://pinnacleblooms.org/ask/do-boys-show-selective-mutism-differently
- Selective Mutism in Girls: https://pinnacleblooms.org/ask/do-girls-show-selective-mutism-differently
- How a frontline health worker can spot possible Selective Mutism early: https://pinnacleblooms.org/ask/how-can-a-frontline-health-worker-spot-a-child-with-possible-selective-mutism-early
- Should I be worried my child might have Selective Mutism?: https://pinnacleblooms.org/ask/should-i-be-worried-my-child-might-have-selective-mutism
- Early Signs of Selective Mutism: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-selective-mutism
- Early Signs of Selective Mutism in a 1-Year-Old Boy: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-selective-mutism-in-a-1-year-old-boy
- Early signs of selective mutism in a 1-year-old girl: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-selective-mutism-in-a-1-year-old-girl

### Explore causes & influences
- Contributing Factors for Selective Mutism: https://pinnacleblooms.org/ask/what-are-the-known-contributing-factors-for-selective-mutism-in-early-childhood
- Are boys more likely to have selective mutism?: https://pinnacleblooms.org/ask/are-boys-more-likely-to-have-selective-mutism
- Are girls more likely to have Selective Mutism?: https://pinnacleblooms.org/ask/are-girls-more-likely-to-have-selective-mutism
- Early Intervention for Selective Mutism: Advancing UNCRPD and the SDGs: https://pinnacleblooms.org/ask/how-does-early-intervention-for-selective-mutism-advance-un-child-rights-uncrpd-and-the-sdgs
- What Causes Selective Mutism in Young Children?: https://pinnacleblooms.org/ask/what-causes-selective-mutism-in-young-children
- Cost-effectiveness of early therapy for Selective Mutism: https://pinnacleblooms.org/ask/what-is-the-cost-effectiveness-of-early-therapy-for-selective-mutism-in-young-children
- What is the prevalence and public-health burden of Selective Mutism among young children in India?: https://pinnacleblooms.org/ask/what-is-the-prevalence-and-public-health-burden-of-selective-mutism-among-young-children-in-india

### Understand assessment
- Selective Mutism Screening & Diagnostic Pathway in Under-7s: https://pinnacleblooms.org/ask/what-is-the-recommended-screening-and-diagnostic-pathway-for-selective-mutism-in-children-under-7
- How AbilityScore Tracks Progress in Selective Mutism: https://pinnacleblooms.org/ask/how-does-abilityscore-track-progress-in-a-child-with-selective-mutism
- How Selective Mutism Is Assessed in a Young Child: https://pinnacleblooms.org/ask/how-is-selective-mutism-assessed-in-a-young-child
- How Is Selective Mutism Assessed in Children Under 7?: https://pinnacleblooms.org/ask/how-is-selective-mutism-assessed-in-children-under-7
- What an AbilityScore of 0–100 Means for a Child with Selective Mutism: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-0-100-mean-for-a-child-with-selective-mutism
- AbilityScore® 100–200 in Selective Mutism: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-100-200-mean-for-a-child-with-selective-mutism
- What does an AbilityScore of 200–300 mean for a child with Selective Mutism?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-200-300-mean-for-a-child-with-selective-mutism
- What an AbilityScore of 300–400 Means in Selective Mutism: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-300-400-mean-for-a-child-with-selective-mutism
- What an AbilityScore® of 400–500 means in Selective Mutism: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-400-500-mean-for-a-child-with-selective-mutism
- What an AbilityScore of 500–600 means for Selective Mutism: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-500-600-mean-for-a-child-with-selective-mutism
- What does an AbilityScore of 600-700 mean for a child with Selective Mutism?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-600-700-mean-for-a-child-with-selective-mutism
- What does an AbilityScore of 700–800 mean for a child with Selective Mutism?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-700-800-mean-for-a-child-with-selective-mutism

### Explore therapy & support
- Supporting a Child with Selective Mutism Day to Day: https://pinnacleblooms.org/ask/as-a-grandparent-or-caregiver-how-can-i-support-a-child-with-selective-mutism-day-to-day
- Can a child with Selective Mutism attend a mainstream school?: https://pinnacleblooms.org/ask/can-a-child-with-selective-mutism-attend-a-mainstream-school
- Can a Child with Selective Mutism Attend a Regular School?: https://pinnacleblooms.org/ask/can-a-child-with-selective-mutism-attend-a-regular-school
- Can a Child with Selective Mutism Grow Up to Live Independently?: https://pinnacleblooms.org/ask/can-a-child-with-selective-mutism-grow-up-to-live-independently
- How can a classroom teacher help a child with Selective Mutism take part and learn?: https://pinnacleblooms.org/ask/how-can-a-classroom-teacher-help-a-child-with-selective-mutism-take-part-and-learn
- Selective Mutism in District Early Intervention Programmes: https://pinnacleblooms.org/ask/how-can-a-district-early-intervention-programme-identify-and-support-children-under-7-with-selective-mutism
- How can a teacher include and support a young child with Selective Mutism?: https://pinnacleblooms.org/ask/how-can-a-teacher-include-and-support-a-young-child-with-selective-mutism-in-a-mainstream-classroom
- How can we support emotional development in a child with Selective Mutism?: https://pinnacleblooms.org/ask/how-can-we-support-emotional-development-in-a-child-with-selective-mutism
- How does therapy help a child with Selective Mutism make progress?: https://pinnacleblooms.org/ask/how-does-therapy-help-a-child-with-selective-mutism-make-progress
- How Is Selective Mutism Diagnosed in a Child?: https://pinnacleblooms.org/ask/how-is-selective-mutism-diagnosed-in-a-child
- How Therapy Supports a Child with Selective Mutism: https://pinnacleblooms.org/ask/how-is-selective-mutism-supported-through-therapy
- Selective Mutism AbilityScore — what to do next: https://pinnacleblooms.org/ask/my-child-with-selective-mutism-has-an-abilityscore-of-0-100-what-should-we-do-next

### At home & in everyday life
- How can I support my child with Selective Mutism at home?: https://pinnacleblooms.org/ask/how-can-i-support-my-child-with-selective-mutism-at-home