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Selective Mutism is a complicated childhood anxiety disorder in which a child is unable to speak in certain social situations, such as school. It is much more than just shyness, and it is not a child willfully refusing to speak. Children and adolescents with selective mutism have an intense fear of speaking in front of others, and although they may speak just fine within their home, they are unable to speak when they are in particular settings. Successful treatment focuses on cognitive behavioral methods to lower anxiety, increase self-esteem, and increase confidence and communication in social settings.