Selective mutism is a severe form of anxiety disorder where a person is unable to speak in certain situations. They are not mute; they can speak.

Neither are they shy nor aloof. There is no refusal on their part to speak. They’re also not the “usually quiet” type.  

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

If you’re a fan of the TV comedy series, The Big Bang Theory, Raj, the Indian guy, has selective mutism around women. It’s quite funny because he really can’t speak in front of women but converses normally with men, which is the exact example of this disorder. He was able to conquer the disorder in the end, though, and was able to speak to women normally.

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.

Since selective mutism usually starts at a young age, parents may not recognize it until they go to school. This post will discuss what selective mutism is, how it develops, and what parents can do to deal with the situation. It will also talk about selective mutism in adults and what they can do about it.

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 say)
  • Speech or language problems such as stuttering (a stuttering child may experience bullying because of it, causing shyness in speaking, which may lead to selective mutism)
  • Traumatic experiences like physical or sexual abuse
  • Family history of selective mutism or anxiety disorders
  • Communication disorders like autism

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.
  • Appearing to be anxious or depressed in certain settings
  • Social withdrawal (not wanting to go to school, being scared in social situations, avoiding playgrounds with many children)
  • Seeming to be extremely shy
  • Developmental delays; may have difficulties in communicating or speech and language delays
  • Pooping or peeing when in an uncomfortable social situation
  • Using non-verbal cues to communicate
  • Appearing nervous, uneasy, rude, sulky, stiff, tense, or stubborn; clingy to parents or avoiding eye contact

The Difference Between Selective Mutism and Traumatic Mutism

Selective mutism is an anxiety disorder that manifests in certain social situations only, such as 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.

In contrast, traumatic mutism occurs when a child develops mutism in all situations because of a trauma experienced, like when the child was physically abused or witnessed an accident. The child is unable to process the traumatic event and becomes 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 and ask relevant questions like:

  • What are your child’s signs and symptoms?
  • When did it start?
  • Are there any signs of a communication disorder or anxiety disorder?

It will help a lot 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, if they pee or poop in certain situations).

Your doctor may ask you to record videos of your child for at least one month and share your own observations when the social anxiety started. It will help if you bring your child’s academic reports and gather teacher comments for the appointment.

During the diagnosis, the doctor will also check the presence of physical conditions. The doctor will conduct a series of hearing 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.

What Should a Parent Do If Their Child Has Selective Mutism?

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 conscious of what your child is going through at this difficult time.

Praise your child for the accomplishments and milestones they achieved. At this time, it is best to speak with a trained specialist or doctor to know the best treatment approach.

Treating selective mutism is possible, but it does not happen overnight. 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 used to treat a child’s selective mutism, even in adults. The treatment philosophy for selective mutism is called SMart Center, which stands for 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 in the treatment of selective mutism:

1. 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.

2. Behavioral Therapy

In 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.

You can bring your 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 add more so your child can play with a small group.

3. 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.

4. 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 girl dolls and observing how she plays with them. The therapist will understand the child’s mute behavior through the way she plays with the dolls. Play therapy reenacts situations at home, helps make sense of her experience at school, or recreates through play what the child found stressful.

5. Frequent Socialization Even If Your Child Is Unable to Speak

Even if your child has selective mutism, 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.

6. Involvement of the Parents, Family, and the School

Aside from the speech language therapist or counselor, parents, family members, and teachers at school should also be involved too. Educate the people in your child’s life on selective mutism and the right approaches to dealing 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 currently advised to stay at home during this pandemic, and visiting a counselor with your child can be challenging. That’s no problem. You can book an appointment at KCC Direct Services for online mental health counseling. Let KCC offer you the solution that you and your child need.

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