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Warning-sign checks

Selective mutism: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Get emergency help if the person has immediate breathing difficulty, is in danger, cannot communicate an urgent medical need, or may harm themselves or someone else.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Seek urgent medical assessment if speech changes suddenly, particularly with weakness, facial drooping, confusion, a severe headache, a head injury, or difficulty understanding language.

  3. 3

    Does any of this apply?

    Book an appointment

    Arrange a routine assessment if you or your child regularly speaks in some settings but cannot speak in others, especially when this affects school, work, friendships, healthcare, or daily needs.

    Support is also appropriate if the pattern lasts beyond an initial adjustment to a new school, language, or environment.

    Seek an earlier appointment if anxiety is increasing, attendance is falling, eating or toileting is affected, or the person cannot report pain, bullying, or other important concerns.

The article also says

A sudden loss of speech in every setting is not the usual pattern of selective mutism.

Every sign above is quoted from the sofidex article on Selective mutism. If you are not sure, err upward — it is always reasonable to be checked.