# When should I worry that my 18-to-24-month-old might have Selective Mutism?

Canonical: https://pinnacleblooms.org/ask/when-should-i-worry-that-my-18-to-24-month-old-might-have-selective-mutism
Publisher: Pinnacle Blooms Network / Bharath Healthcare Laboratories Private Limited

At 18–24 months it is too early to diagnose selective mutism, which is normally recognised only once a verbal child consistently and persistently goes silent in specific settings, usually after age 3. At this age, focus on whether communication is growing — babbling, gestures, words and understanding. Shyness with strangers is common and not selective mutism. A general developmental check is warranted if words or understanding seem delayed.

*If your toddler chatters happily at home but falls silent elsewhere — and you're wondering whether to worry yet — your attentiveness is exactly the right instinct.*

## In short
At 18 to 24 months, it is far too early to label [Selective Mutism](/selective-mutism) — and you do not need to worry about that diagnosis yet. Selective mutism is a pattern where a child who *can* speak consistently doesn't speak in specific social settings (often nursery or with unfamiliar people) while speaking freely where they feel safe — and it's normally only recognised once a child is regularly in those settings, usually closer to or after age 3. What matters at this age is simply that your toddler is *developing* communication: babbling, gestures, first words and understanding. Shyness and slow-to-warm temperament are very common and are not the same as selective mutism.

## What is appropriate to watch at 18–24 months
At this stage, focus on whether communication is *growing*, not on where your child chooses to talk. Encouraging signs to look for:

- **Understanding** — follows simple instructions, points to things when named, responds to their name.
- **Words** — a handful of words by 18 months, growing toward many more and beginning to combine words by around 24 months.
- **Communicating any way they can** — pointing, gesturing, showing, making sounds, leading you by the hand.
- **Warming up** — being quiet or clingy with strangers, then relaxing into themselves at home, is typical toddler behaviour.

What would warrant a general developmental check now is *not* selective mutism, but signs that communication itself may be delayed: very few or no words by 18–24 months, not responding to their name, no pointing or gesturing, or losing words they once used. Selective mutism becomes a meaningful question later — when a verbal child consistently and persistently goes silent in particular settings for a month or more (beyond the first settling-in weeks of nursery).

## The Pinnacle way
Developmental measurement supports care planning; diagnosis requires an appropriately qualified healthcare professional., under qualified clinician care — never from an online description or a single worry. If your concern is that words are slow to come, our [speech therapy](https://www.pinnacleblooms.org/top-speech-therapy-center-india-proven-improvement-rate) team can gently support early communication, and a structured, clinician-administered [AbilityScore®](/ask/what-is-the-abilityscore-and-how-is-it-calculated) builds your child's own developmental baseline so support fits *them*. For most warm, quiet toddlers, the answer is simply reassurance and a clear picture of how they're growing.

## Trusted sources
WHO ICD-11 framework (selective mutism, 6B06); American Academy of Pediatrics developmental surveillance guidance; CDC developmental milestones and 'Learn the Signs, Act Early' resources.

**Next step —** If your toddler's words seem slow to arrive, [book a developmental check](https://www.pinnacleblooms.org/enroll-autism-speech-aba-therapies-india) with a Pinnacle clinician — and rest assured that quietness with strangers, at this age, is usually just a child taking their time.

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/browse11/l-m/en
- CDC — Developmental milestones: https://www.cdc.gov/child-development
- AAP HealthyChildren — Toddler development: https://www.healthychildren.org/English/ages-stages/toddler/Pages/default.aspx

## Connected topics and perspectives
- Conditions: https://pinnacleblooms.org/ask/conditions
- Parent: https://pinnacleblooms.org/ask/lens/stakeholder/parent
- Toddler-18-24: https://pinnacleblooms.org/ask/lens/age/toddler-18-24
- Emotional: https://pinnacleblooms.org/ask/lens/domain/emotional
- Concern: https://pinnacleblooms.org/ask/lens/intent/concern
- Screen: https://pinnacleblooms.org/ask/lens/lifecycle/screen
- Special Education: https://pinnacleblooms.org/ask/lens/route/special-education
- Early Clarity: https://pinnacleblooms.org/ask/lens/empowerment/early_clarity

## Related question paths

### Understand the subject
- How Selective Mutism Affects a Child's Daily Life: https://pinnacleblooms.org/ask/how-does-selective-mutism-affect-a-child-s-daily-life
- Is Selective Mutism considered a disability?: https://pinnacleblooms.org/ask/is-selective-mutism-considered-a-disability
- Is Selective Mutism Genetic or Hereditary?: https://pinnacleblooms.org/ask/is-selective-mutism-genetic-or-hereditary
- What are common myths about Selective Mutism?: https://pinnacleblooms.org/ask/what-are-common-myths-about-selective-mutism
- What are the types or levels of Selective Mutism?: https://pinnacleblooms.org/ask/what-are-the-types-or-levels-of-selective-mutism
- What Causes Selective Mutism in Children?: https://pinnacleblooms.org/ask/what-causes-selective-mutism-in-children
- What is Selective Mutism?: https://pinnacleblooms.org/ask/what-is-selective-mutism
- What is Selective Mutism in Early Childhood?: https://pinnacleblooms.org/ask/what-is-selective-mutism-and-what-does-it-look-like-in-early-childhood
- What other conditions often occur alongside Selective Mutism?: https://pinnacleblooms.org/ask/what-other-conditions-often-occur-alongside-selective-mutism
- 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 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 the ICD-11 classification for Selective Mutism?: https://pinnacleblooms.org/ask/what-is-the-icd-11-classification-for-selective-mutism

### Recognise signs & concerns
- When to Worry About Selective Mutism at 12–18 Months: https://pinnacleblooms.org/ask/when-should-i-worry-that-my-12-to-18-month-old-might-have-selective-mutism
- Early Signs of Selective Mutism in a 12-to-18-Month-Old: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-selective-mutism-in-a-12-to-18-month-old
- Early signs of Selective Mutism in an 18–24-month-old: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-selective-mutism-in-a-18-to-24-month-old
- When to Worry About Selective Mutism at 9–12 Months: https://pinnacleblooms.org/ask/when-should-i-worry-that-my-9-to-12-month-old-might-have-selective-mutism
- When should I worry about Selective Mutism at 6–9 months?: https://pinnacleblooms.org/ask/when-should-i-worry-that-my-6-to-9-month-old-might-have-selective-mutism
- When should I worry that my 2-year-old might have Selective Mutism?: https://pinnacleblooms.org/ask/when-should-i-worry-that-my-2-year-old-might-have-selective-mutism
- 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
- 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

### Explore causes & influences
- 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
- What Causes Selective Mutism in Young Children?: https://pinnacleblooms.org/ask/what-causes-selective-mutism-in-young-children
- 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
- Contributing Factors for Selective Mutism: https://pinnacleblooms.org/ask/what-are-the-known-contributing-factors-for-selective-mutism-in-early-childhood
- 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
- 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
- What does an AbilityScore of 800–900 mean for a child with Selective Mutism?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-800-900-mean-for-a-child-with-selective-mutism

### Explore therapy & support
- 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 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 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
- Selective Mutism: AbilityScore 100–200 — What To Do Next: https://pinnacleblooms.org/ask/my-child-with-selective-mutism-has-an-abilityscore-of-100-200-what-should-we-do-next
- Selective Mutism AbilityScore 200–300: Next Steps for Parents: https://pinnacleblooms.org/ask/my-child-with-selective-mutism-has-an-abilityscore-of-200-300-what-should-we-do-next
- Selective Mutism: AbilityScore 300–400 Next Steps: https://pinnacleblooms.org/ask/my-child-with-selective-mutism-has-an-abilityscore-of-300-400-what-should-we-do-next
- Selective Mutism with an AbilityScore of 400–500: what to do next: https://pinnacleblooms.org/ask/my-child-with-selective-mutism-has-an-abilityscore-of-400-500-what-should-we-do-next
- Selective Mutism AbilityScore 500–600: Next Steps: https://pinnacleblooms.org/ask/my-child-with-selective-mutism-has-an-abilityscore-of-500-600-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