How Our Mental Health Questionnaire Can Help You

Congratulations on deciding to take our free Child Selective Mutism test.

Please note: this questionnaire was developed by Sullivan + Associates Clinical Psychology to provide a general overview of how much a particular problem or mental health issue impacts you. It is not meant to be diagnostic or replace a formal mental health assessment by a health care practitioner (i.e. Psychologist, Psychiatrist, etc.). However, feel free to use it as a starting point towards learning about improving a particular problem or mental health issue. If you choose to pursue psychotherapy/counselling or discuss your mental health with your Physician or Nurse Practitioner, sharing your results from this questionnaire would provide valuable information.

Benefits of Taking our Mental Health Questionnaire

  • Easy to Do – It’s a rating scale style questionnaire. Just click on the selection that best describes you.
  • Confidential – Your responses and results are 100% confidential.
  • Direction – Suggests helpful next steps, such as suggestions for resources and services based on your responses.
  • Cost Effective – It’s free to use as many times as you want.
  • Quick to Use – It takes approximately 5-10 minutes to complete the test.
  • Immediate Results – You will receive your results immediately upon completing the test.
  • Free Report – If you enter your email address, you will receive a copy of your results. If you chose to provide your email address, your responses and results will remain 100% confidential.
  • Anonymous – You don’t need to provide any identifying information to complete the test.

Selective Mutism Questionnaire

Answer each question, then click submit to see your results.

Child Selective Mutism Mini-Questionnaire : Parents/Guardians
Freezes in social situations
Gets quiet when someone they don't know enters the room
Being asked questions makes my child very anxious
Switches to using gestures when other people are around
Afraid of talking to new people
Will not engage with new people
Gets anxious when they are expected to talk in unfamiliar settings
Avoids/leaves situations where they will be expected to talk
Unable to talk to people outside of the home
Speaks in some circumstance but can't in others
I speak on behalf of my child when they can't
Becomes so anxious they cannot talk
Struggles to talk to their peers
Prefers it when I talk for them
Avoids people who try to talk to them