Selective mutism

This code represents a rare anxiety disorder characterized by a consistent failure to speak in specific social situations where speech is expected, despite speaking in other situations. It can significantly interfere with educational or occupational achievement, or with social communication.

Assign this code when documentation clearly indicates a child or adult consistently fails to speak in particular social settings (e.g., school, work, with non-familial adults) for at least one month, and this is not attributable to a lack of knowledge or comfort with the spoken language. The diagnosis requires the disturbance to interfere with educational or occupational achievement or with social communication.

• Differentiate from other communication disorders; ensure the mutism is selective to specific social contexts.
• Review documentation to rule out pervasive developmental disorders (F84.-) or schizophrenia (F20.-) as the primary cause.
• Do not use for transient mutism associated with separation anxiety (F93.0) in young children.