Help for Selective Mutism in the UK

The NHS says it most often starts between ages 2 and 4, and is often first noticed when a child starts nursery or school. The main sign is a marked contrast: a child speaks freely with close family but freezes, with a still face, when expected to talk to someone outside their comfort zone. They may seem shy, tense, clingy or even sulky, and some use nods, gestures or a whisper.

It is not the same as autism, though a person can have both. Source: NHS: selective mutism (read 10 November 2026).

The NHS advises not to accept that a child will grow out of it or is just shy. You can speak to a GP and ask for a referral to a local specialist service, or contact a speech and language therapy clinic directly. Your GP or local integrated care board should be able to give you the number of your nearest NHS speech and language therapy service. A child may also see a mental health professional or school educational psychologist.

Adults are ideally seen by a mental health professional with support from a speech and language therapist. The NHS says the Royal College of Speech and Language Therapists and ASLTIP can help you find professionals with experience of selective mutism.

The NHS says treatment starts by removing pressure to speak, then moves in small steps from relaxing in a setting, to single words with one person, to speaking freely with everyone. Approaches it describes include CBT, behavioural therapy, graded exposure, stimulus fading (gradually bringing a new person into a comfortable conversation), shaping and desensitisation. Family and school staff can use these together, often guided by a speech and language therapist or psychologist.

From the NHS advice for parents:

• do not pressure or bribe your child to speak
• tell them you understand speaking is hard and that it will get easier, in small steps
• praise efforts privately rather than in public
• reassure them that smiling, waving and other non-verbal communication is fine for now
• ask friends and relatives to let your child warm up at their own pace, focusing on fun rather than talking

See also which professional for my child and school anxiety and avoidance.

Speech and language therapist and practitioner psychologist are protected titles regulated by the HCPC; check the HCPC register. Ask about their experience with selective mutism and how they will work with home and school. For children, see questions to ask a child's therapist.

Whoever you choose, check their register and ask about fees, session length and how you will review progress together. See questions to ask a private allied health professional and how much therapy costs. On Therapist Circle, each practitioner's registration is checked when they join, and their profile shows the register and number so you can check it yourself.