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Vol. 25 - Num. 98

Clinical Reviews

Selective mutism: when shyness becomes extreme

Nieves Silva Caparrósa, Manuel Bergara de la Fuenteb, Cristóbal Coronel Rodríguezb

aMIR-Pediatría. Servicio de Pediatría. Hospital Universitario Virgen del Rocío. Sevilla. España.
bPediatra. CS Amante Laffón. Sevilla. España.

Correspondence: N Silva. E-mail:

Reference of this article: Silva Caparrós N, Bergara de la Fuente M, Coronel Rodríguez C. Selective mutism: when shyness becomes extreme . Rev Pediatr Aten Primaria. 2023;25:e49-e51.

Published in Internet: 23-05-2023 - Visits: 8768


Selective mutism is a less frequent disorder, often underdiagnosed, which negatively affects the child’s development and school performance. This disorder takes place before the age of five. It is characterized with the incapacity to speak in places where the child does not feel comfortable, as school, but at home they speak without problem. In fact, the detection occurs at school, and generates family distress due to their surprise for their child’s attitude. The treatment is based on cognitive-conductive therapy, and just in severe cases pharmacotherapy is needed. A case diagnosed 6 months ago and under treatment since then is described below.


Anxiety Children Cognitive behavorial therapy Psychopharmacology Selective mutism


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