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SM is often not recognised because a child’s behaviour is attributed to shyness or embarrassment. In the past, there was a tendency to perceive SM children as stubborn and oppositional. More recent research, however, indicates that in most cases SM is the result of crippling anxiety. Stressful early experiences, a clash of cultures between home and school, language difficulties, and/or unaccustomed expectations at school, may predispose a child to SM.
When under stress, children may become physically rigid and eye-contact increases their discomfort. Children may have the desire to speak but are over-come by ‘stage-fright’ and hence remain silent. In some cases, SM is known to be preceded by delayed milestones and speech and language difficulties. A psychological assessment may be useful to exclude the presence of learning problems. The usual onset of SM is around three years when the child enters a play-group. SM may commence later after a trauma or post-operatively and is then known as ‘traumatic mutism.’
What are the symptoms?
| How is it treated? 
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