This is an English rendering of a Polish public-health reference. The care paths it names (112, night and holiday care NiŚOZ, primary care POZ) are Polish. This is not medical advice.

PL

This is not medical advice Life-threatening emergency (Poland): 112

Home › Speech

What to do when a child does not speak in preschool (przedszkole) or around strangers?

Applies to age: 24–60 months

In short

Selective mutism is an anxiety disorder: a child speaks freely with people close to them, but in some situations is unable to speak; this is not stubbornness. Do not pressure or bribe your child; if this worries you, consult a specialist.

Sources: NHS, Akty prawne w Dzienniku Ustaw, Portal PacjentaChecked: Report an error

What is normal

All claims: international norm

  • Selective mutism is an anxiety disorder in which a child is unable to speak in certain social situations, such as with classmates at school or with relatives they rarely see.
    Source: NHS – show the original wording (EN)

    Summarized and translated by the editors, not an official translation. Verbatim quote from the source, in its original wording:

    Selective mutism is an anxiety disorder where a person is unable to speak in certain social situations, such as with classmates at school or to relatives they do not see very often.

    NHS · open the source · accessed: 2026-10-16 · license [1]

  • Selective mutism most often starts in early childhood, between the 2nd and 4th year of life.
    Source: NHS – show the original wording (EN)

    Summarized and translated by the editors, not an official translation. Verbatim quote from the source, in its original wording:

    Selective mutism can start at any age, but most often starts in early childhood, between age 2 and 4.

    NHS · open the source · accessed: 2026-10-16 · license [1]

  • Selective mutism is often first noticed when a child starts contact with people outside the family, such as when starting daycare (żłobek) or preschool.
    Source: NHS – show the original wording (EN)

    Summarized and translated by the editors, not an official translation. Verbatim quote from the source, in its original wording:

    It's often first noticed when the child starts to interact with people outside their family, such as when they begin nursery or school.

    NHS · open the source · accessed: 2026-10-16 · license [1]

  • Children with selective mutism speak freely to some people, such as close family and friends, when nobody is nearby who triggers the freeze response.
    Source: NHS – show the original wording (EN)

    Summarized and translated by the editors, not an official translation. Verbatim quote from the source, in its original wording:

    However, people with selective mutism are able to speak freely to certain people, such as close family and friends, when nobody else is around to trigger the freeze response.

    NHS · open the source · accessed: 2026-10-16 · license [1]

  • A child with selective mutism does not refuse to speak or choose not to speak at a given moment; they are actually unable to speak.
    Source: NHS – show the original wording (EN)

    Summarized and translated by the editors, not an official translation. Verbatim quote from the source, in its original wording:

    A child or adult with selective mutism does not refuse or choose not to speak at certain times, they're literally unable to speak.

    NHS · open the source · accessed: 2026-10-16 · license [1]

  • Selective mutism affects about 1 in 140 young children.
    Source: NHS – show the original wording (EN)

    Summarized and translated by the editors, not an official translation. Verbatim quote from the source, in its original wording:

    Selective mutism affects about 1 in 140 young children.

    NHS · open the source · accessed: 2026-10-16 · license [1]

  • Do not pressure your child or bribe them to start speaking.
    Source: NHS – show the original wording (EN)

    Summarized and translated by the editors, not an official translation. Verbatim quote from the source, in its original wording:

    Do not pressurise or bribe your child to encourage them to speak.

    NHS · open the source · accessed: 2026-10-16 · license [1]

  • Reassure your child that non-verbal communication, such as smiling or waving, is fine until they feel better about talking.
    Source: NHS – show the original wording (EN)

    Summarized and translated by the editors, not an official translation. Verbatim quote from the source, in its original wording:

    Reassure your child that non-verbal communication, such as smiling and waving, is fine until they feel better about talking.

    NHS · open the source · accessed: 2026-10-16 · license [1]

  • Do not praise your child publicly for speaking, because this can cause embarrassment.
    Source: NHS – show the original wording (EN)

    Summarized and translated by the editors, not an official translation. Verbatim quote from the source, in its original wording:

    Do not praise your child publicly for speaking because this can cause embarrassment.

    NHS · open the source · accessed: 2026-10-16 · license [1]

  • Treatment of selective mutism does not focus on the speaking itself, but on reducing the anxiety associated with speaking.
    Source: NHS – show the original wording (EN)

    Summarized and translated by the editors, not an official translation. Verbatim quote from the source, in its original wording:

    Treatment does not focus on the speaking itself, but reducing the anxiety associated with speaking.

    NHS · open the source · accessed: 2026-10-16 · license [1]

  • In daycare or preschool, it helps to praise every attempt to join in and interact with others, such as passing and taking toys, nodding and pointing.
    Source: NHS – show the original wording (EN)

    Summarized and translated by the editors, not an official translation. Verbatim quote from the source, in its original wording:

    praising all efforts the child makes to join in and interact with others, such as passing and taking toys, nodding and pointing

    NHS · open the source · accessed: 2026-10-16 · license [1]

When to worry

All claims: international norm

  • The main warning sign is a marked contrast in how a child engages with different people, with sudden stillness and a frozen facial expression when expected to talk to someone outside their comfort zone.
    Source: NHS – show the original wording (EN)

    Summarized and translated by the editors, not an official translation. Verbatim quote from the source, in its original wording:

    The main warning sign is the marked contrast in the child's ability to engage with different people, characterised by a sudden stillness and frozen facial expression when they're expected to talk to someone who's outside their comfort zone.

    NHS · open the source · accessed: 2026-10-16 · license [1]

  • One of the criteria for diagnosing selective mutism is an inability to speak to certain people that lasts at least a month (2 months in a new setting) and interferes with the child's ability to function in that setting.
    Source: NHS – show the original wording (EN)

    Summarized and translated by the editors, not an official translation. Verbatim quote from the source, in its original wording:

    Selective mutism is diagnosed according to specific guidelines.

    NHS · open the source · accessed: 2026-10-16 · license [1]

    their inability to speak to certain people has lasted for at least 1 month (2 months in a new setting)

    NHS · open the source · accessed: 2026-10-16 · license [1]

    their inability to speak interferes with their ability to function in that setting

    NHS · open the source · accessed: 2026-10-16 · license [1]

  • Do not accept the opinion that your child will grow out of it or that they are just shy.
    Source: NHS – show the original wording (EN)

    Summarized and translated by the editors, not an official translation. Verbatim quote from the source, in its original wording:

    Do not accept the opinion that your child will grow out of it or they are "just shy".

    NHS · open the source · accessed: 2026-10-16 · license [1]

  • If you suspect selective mutism and help is not available, or there are additional worrying signs, such as the child having difficulty understanding instructions or following a routine, it is worth seeing a doctor for a specialist diagnosis.
    Source: NHS – show the original wording (EN)

    Summarized and translated by the editors, not an official translation. Verbatim quote from the source, in its original wording:

    If you suspect your child has selective mutism and help is not available, or there are additional concerns – for example, the child struggles to understand instructions or follow routines – speak to a GP and ask them to refer you to a local specialist service for a formal diagnosis.

    NHS · open the source · accessed: 2026-10-16 · license [1]

  • When mutism is a symptom of post-traumatic stress, it follows a different pattern than selective mutism; the child suddenly stops talking in places where they previously had no difficulty with it.
    Source: NHS – show the original wording (EN)

    Summarized and translated by the editors, not an official translation. Verbatim quote from the source, in its original wording:

    When mutism occurs as a symptom of post-traumatic stress, it follows a very different pattern and the child suddenly stops talking in environments where they previously had no difficulty.

    NHS · open the source · accessed: 2026-10-16 · license [1]

See a doctor

  • Polish care pathway: the Ministry of Health (MZ) regulation on guaranteed services in primary care (POZ) (consolidated text published in the Journal of Laws, Dz.U. 2023 item 1427, Annex 1, Part III, No. 5) provides, as part of the well-child checkup (bilans zdrowia) at 2 years of age, for a hearing response development test and an assessment of speech development. This is the timing of the checkup and an indication of what is assessed then; it does not directly concern selective mutism.
    Source: Akty prawne w Dzienniku Ustaw – show the quote

    Verbatim quote from the source:

    Polish original

    2 lata profilaktyczne badanie lekarskie (bilans zdrowia) obejmuje

    Akty prawne w Dzienniku Ustaw · open the source · accessed: 2026-10-16 · license [2]

    Polish original

    przeprowadzenie testu rozwoju reakcji słuchowych oraz ocenę rozwoju mowy

    Akty prawne w Dzienniku Ustaw · open the source · accessed: 2026-10-16 · license [2]

  • If a child is developing differently from peers, it is worth consulting a specialist about what worries you and making use of the advice of a midwife, nurse or pediatrician.
    Source: Portal Pacjenta – show the quote

    Verbatim quote from the source:

    Polish original

    Warto jednak skonsultować ze specjalistą to, co Cię zaniepokoiło i korzystać z rad położnej, pielęgniarki czy pediatry.

    Portal Pacjenta · open the source · accessed: 2026-10-16 · license [3]

  • A child's well-child checkup is carried out by a family doctor, pediatrician or nurse.
    Source: Portal Pacjenta – show the quote

    Verbatim quote from the source:

    Polish original

    Badanie przeprowadza lekarz rodzinny, pediatra lub pielęgniarka.

    Portal Pacjenta · open the source · accessed: 2026-10-16 · license [3]

  • You do not need a referral to see a psychiatrist, psychologist or psychotherapist for children and adolescents up to 18 years of age.
    Source: Portal Pacjenta – show the quote

    Verbatim quote from the source:

    Polish original

    Nie potrzebujesz skierowania do lekarza psychiatry, psychologa i psychoterapeuty dla dzieci i młodzieży do 18 roku życia.

    Portal Pacjenta · open the source · accessed: 2026-10-16 · license [3]

international norm “International norm” next to a section heading means its claims come from a non-Polish source, because no Polish source in our registry covers this topic. When this applies to only some of the claims, the foreign ones carry the same label next to their source.

International norm

“International norm” next to a section heading means its claims come from a non-Polish source, because no Polish source in our registry covers this topic. When this applies to only some of the claims, the foreign ones carry the same label next to their source.

Sources

  1. NHS (nhs.uk, Anglia)
    License: Open Government Licence v3.0. Source: NHS (nhs.uk, Anglia). Content summarized and translated by the editors; changed relative to the original. Contains public sector information licensed under the Open Government Licence v3.0. The summary is ours and is not attributed to the NHS.
  2. Akty prawne w Dzienniku Ustaw (ELI: eli.gov.pl, api.sejm.gov.pl)
    License: Akt normatywny, art. 4 pkt 1 ustawy o prawie autorskim (nie podlega ochronie). Source: Akty prawne w Dzienniku Ustaw (ELI: eli.gov.pl, api.sejm.gov.pl).
  3. Portal Pacjenta (pacjent.gov.pl)
    License: CC BY 3.0 PL. Source: Portal Pacjenta (pacjent.gov.pl). Content summarized and translated by the editors; changed relative to the original.

See an error or outdated information? Report an error in this answer. Answer checked against the sources on October 16, 2026.

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