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Selective mutismA complete absence of speech despite the physical ability to speak.Read more → matters because the child can speak perfectly normally in one setting, usually at home, yet consistently fails to speak in another, usually school, and that setting-specific pattern is the clue that it is anxiety-based, not a language problem. It is diagnosed as a consistent failure to speak in specific social situations where speech is expected, despite speaking normally in other situations. For example, imagine a girl who chats freely with her family at home but has not spoken a single word at school in over a year, despite understanding everything asked of her. In practice, that intact ability to speak elsewhere is exactly what rules out a primary language or speech disorder.

The mutismA complete absence of speech despite the physical ability to speak.Read more → must persist for at least one month, not counting the first month of school, which can cause normal shyness, and cause significant impairment in education or social communication. It is closely linked to social anxiety, and many children with selective mutism also meet criteria for social anxiety disorder. The child understands language normally and speaks fluently in comfortable settings, which is what separates it from a language disorder, where speech difficulty would appear everywhere. Say the same girl's vocabulary and grammar are tested informally at home, where her language skills prove entirely age-appropriate. In practice, that normal language ability at home confirms the problem is situational anxiety, not a language impairment.

• Which duration rule does ICD-11 apply before selective mutismA complete absence of speech despite the physical ability to speak.Read more → can be diagnosed in a child starting school?
• Which disorder most often coexists with selective mutismA complete absence of speech despite the physical ability to speak.Read more → in children?
• A teacher plans to insist that a child with selective mutismA complete absence of speech despite the physical ability to speak.Read more → answers aloud in class before being allowed to leave. What is the likely effect?

• Language disorder, speech and understanding difficulty across all settings, unlike selective mutism'sA complete absence of speech despite the physical ability to speak.Read more → normal speech in comfortable settings.
• Autism spectrum disorder, broader social-communication difficulty present everywhere, rather than selective mutism'sA complete absence of speech despite the physical ability to speak.Read more → sharp setting-specific silence.
• Shyness in the first month of school, expected and short-lived, whereas selective mutismA complete absence of speech despite the physical ability to speak.Read more → persists beyond a month and causes real impairment.
• Social anxiety disorder, closely linked, and often co-occurs, but centres on fear of scrutiny generally rather than a specific speaking-versus-silent split between settings.

• Silence in every setting would suggest a language or developmental disorder rather than selective mutismA complete absence of speech despite the physical ability to speak.Read more →.
• A few days of silence does not meet the duration requirement.
• One week is too short and would capture normal adjustment to a new school.
• The disorder typically presents in early childhood, so an age-twelve threshold is wrong.
• Tic disorders are associated with obsessive-compulsive symptoms rather than with selective mutismA complete absence of speech despite the physical ability to speak.Read more →.

• Extract the defining phenomenology, duration, severity and functional-impact clues.
• Match the pattern to the most specific diagnostic or assessment construct.
• Actively test the closest look-alike against the missing or contradictory clue.
• Choose the precise term rather than a broader category that is merely compatible.