​Children or adolescents with selective mutism may avoid eye contact, freeze, blush, or stare blankly when addressed by people whom they are unfamiliar with. Some might refuse to follow the adult's directions, which might seem like they are being disobedient or defiant. They may withdraw, avoid or 'shut down' in social situations which makes them feel anxious or stressed. Hence, they may not respond to greetings outside of the home environment.  

​Psychological therapy:
Cognitive behavioural therapy is commonly used to help children with selective mutism overcome their anxiety of speaking in social settings. This is done by helping them identify their own levels of anxiety and learn strategies to cope with the anxiety. The therapist will work closely with parents and school to progressively introduce situations that encourage the child's communication with others, and setting up a rewards system to motivate and support progress.

Medications:
Depending on the severity of the condition, medications may be considered and prescribed to help reduce the symptoms of selective mutism. 

• Dr Chee Tji TJian
• Dr Tian Cheong Sing