Selective mutism is an acquired disorder of interpersonal communication in which the child refuses or withholds the speech in some circumstances while displays normal speech in other situations. It is a relatively rare disorder and it appears to be slightly more common in girls than boys. Different etiological explanations have been hypothesized and we often find comorbidity with other psychiatric pathology. However the most frequent association occurs with social phobia, with values of 90 to 100% of comorbidity being referred in some studies.

The authors undertook a review on this subject, focusing on different aetiology approaches, including genetics, temperamental, psychological, developmental and social conceptualizations. Issues concerning assessment and treatment were explored as well. They point out the importance of an integrative approach of the several theories described, in order to understand the complexity of the pathology and consequently achieve more accurate treatment strategies.

Although rare, selective mutism deserves particular attention because this condition can have dramatically negative effects on social and educational functioning in childhood reflecting later in adult life.