Selective mutism may start during childhood and, if left untreated, can persist until adulthood. The inability to speak in certain situations may affect a person’s social relationships, academic performance, and for adults, work performance. 

What is selective mutism?

It is a severe form of anxiety disorder where a person is unable to speak in certain situations. They are not mute; they can speak. It’s not being ‘shy or keeping quiet’; there is no refusal to speak or just ‘usually quiet’

The main reason is, they’re too stressed, or anxiety levels are too high in that social setting that no word is coming out from their mouth. People with selective mutism literally can’t speak in certain settings. The disorder literally means ‘being mute in selective situations’.

Since selective mutism usually starts at a young age, parents may not recognize it until they go to school. That is why in this post, we’ll discuss what selective mutism is, how it develops, and what parents can do to deal with the situation. For adults with selective mutism, this article will be helpful for you too. 

How Do You Get Selective Mutism? Causes of Selective Mutism

Selective mutism has no known cause. Further research is needed to determine what mainly causes selective mutism. However, there are risk factors that can be linked to the development of selective mutism:

  • Anxiety disorders or being too anxious because of stress
  • Poor home and family relationships
  • Early psychological problems that were not addressed properly
  • Low self-esteem issues 
  • Difficulties with hearing (affected children may not correctly understand what other people says)
  • Speech or language problems such as stuttering (a child who stutters may experience bullying because of the stuttering, causing the shyness to speak and may lead to selective mutism)
  • Traumatic experiences like physical or sexual abuse
  • Family history of anxiety disorders or selective mutism
  • Communication disorders like autism

Related: How Bottling Up Your Emotions is Bad for You

Signs and Symptoms in Children With Selective Mutism

  • Main symptom: Failure to speak for one month (or more) in certain social situations. Granting all other factors were ruled out like verbal communication problems, autism, or not knowing the language spoken.
  • Appears to be anxious or depressed in certain settings 
  • Social withdrawal (for example, the child does not want to go to school, seems to be scared in social situations, avoids playgrounds with many children)
  • Seems to be extremely shy
  • Developmental delays: The child may have difficulties in communicating or speech and language delays
  • When in an uncomfortable social situation, may pee or poop. 
  • Uses non-verbal cues to communicate
  • Other symptoms of selective mutism: When in a social situation, the child may appear as nervous, avoiding eye contact, uneasy, rude, sulky, clingy to parents, stiff, tensed, or stubborn

The Difference Between Selective Mutism and Traumatic Mutism

Selective mutism is an anxiety disorder for certain social situations only. For example, at school, in front of a particular person, or at a family gathering. Mutism is a way for the child to avoid the anxious feeling of being in that social situation. 

On the other hand, traumatic mutism is when a child develops mutism in all situations because of a trauma experienced. For example, the child was physically abused or witnessed an accident. The child is unable to process the traumatic event and became mute in all settings. 

Diagnosis of Selective Mutism

If you suspect that your child has selective mutism, seek help from a doctor right away. Your child’s doctor may assess your child’s medical history. For example, what are the signs and symptoms shown by your child, when it started, any signs of a communication disorder or anxiety disorder.

It helps if you talk to your child’s teachers about their observations and comments (the first month of school, how your child interacts with other kids, pees, or poops in certain situations). 

You may be asked to record videos of your child for at least 1 month and share your own observations when the social anxiety started. It may help to bring your child’s academic reports and gather teacher comments to the appointment. 

During the diagnosis, the doctor will also check the presence of physical conditions. The doctor will conduct a series of hearing tests and speaking tests to determine the presence of any disorder. If any condition is diagnosed, you will be endorsed to a specialist like a Speech and Language Pathologist or Psychiatrist. The doctor will rule out medical and mental health conditions to diagnose selective mutism.

For a Child With Selective Mutism, What Should the Parent Do?

A child with selective mutism should not be pressured to speak. The child may act out, and this will just worsen the situation. As a parent, be there for your child, accept the situation, and be there for your child at this difficult time. 

Praise your child for the accomplishments and milestones achieved. At this time, it is best to speak with a trained specialist or doctor to know the best treatment approach. Treating selective mutism does not happen overnight but is possible. Selective mutism does not go away on its own and may reach adulthood if left untreated

How Are Children With Selective Mutism Treated?

Different types of therapy and approach are used to treat a child’s selective mutism, even in adults. The treatment philosophy for selective mutism is called SMart Center: Selective Mutism, Anxiety, and Related Disorders Treatment Center.

The SMart Center includes an individualized care plan for a child with selective mutism. People involved in the treatment are therapists, parents, teachers, and even school personnel. Here are some approaches utilized for the treatment of selective mutism:

Social Communication Anxiety Therapy

The first type of therapy is Social Communication Anxiety Therapy. Since selective mutism is a social anxiety disorder, the goal is to lower the child’s anxiety in social settings, boost self-esteem, and increase social confidence. The purpose of the treatment is to develop coping skills for proper emotional, social, and academic functioning. 

Behavioral Therapy

With Behavioral Therapy, Positive Reinforcement and Desensitization techniques are used to change a child’s behavior. Behavioral Therapy removes the pressure from the child to speak and acknowledge their feelings of anxiety. During Behavioral Therapy, the child is subtly introduced to social settings to help the child feel more comfortable and overcome anxiety. 

As for parents, you can bring the child to school when there are few people around. This can help the child to practice talking. Also, you can organize playdates at home, desirably the friends they’re comfortable with. Start with one friend and slowly adding more so your child can play with a small group. 

Cognitive Behavioral Therapy (CBT)

Therapists can help a child with selective mutism through Cognitive Behavioral Therapy to modify their behavior and turn their feelings of anxiety into positive ones. CBT incorporates acknowledgment of the presence of anxiety that leads to mutism. CBT focuses on emphasizing your child’s positive attributes, building confidence, and lessening their feelings of anxiety. 

Play Therapy

The purpose of Play Therapy for children with selective mutism is to learn how to process emotions, build self-confidence and learn healthy coping skills. An example of Play Therapy is giving a child dolls and observe how she plays with them. The therapist understands the child’s mute behavior through the play. To reenact situations at home, make sense of her experience at school, or recreate through play what they found stressful. 

Frequent Socialization Even if Your Child Is Unable to Speak

Even if your child has selective mutism, still encourage socialization in tiny doses to ensure you’re not pressuring your child. Arrange to have play dates with a small group of friends at first. When your child is comfortable, you’d be surprised that they start to speak up little by little. Up to such a point that selective mutism isn’t an issue anymore. 

Involvement of: Parents, Family & The School

Other than a Speech-Language therapist, or a counselor, parents, family members, and teachers at school should be involved too. Educate the people in your child’s life on what selective mutism is and what are the right approaches to deal with kids with selective mutism.

This ensures that your kid won’t be pressured to talk at school, or there are no judging eyes from your relatives. Awareness is essential, and be an advocate for your child. Children with selective mutism need understanding, and everyone can contribute to their treatment.  

Seek Professional Help

Your child can overcome selective mutism, and treatment is within your control. Start with seeking professional help from a therapist or counselor at Kentucky Counseling Center (KCC)

We are advised to stay at home during this pandemic, and visiting a counselor with your child may be challenging. That’s no problem. You can book an appointment at KCC Direct Services for online mental health counseling. Any challenge has a solution, and let KCC be a part of the solution. 

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