What Is Selective Mutism and How Does It Impact Children?
Abby Barnes, M.S., CCC-SLP
As children get older and become more social, we witness their personalities start to shine. Some children (just like adults) are more outgoing and extroverted, while others tend to be shy and reserved.
But what if your child appears to be too shy to speak in certain situations?
Children with selective mutism may feel comfortable speaking with certain people and in certain places, but not others. For example, they may talk regularly at home or with friends, but once they get to school they seemingly lose the ability to speak. This happens time and time again in these situations.
If this sounds familiar, it may not be caused by shyness at all. It could be that your child has selective mutism.
What are the symptoms of selective mutism?
Selective mutism is diagnostically an anxiety disorder, not a communication disorder. Many children who have selective mutism are genetically predisposed to it, as well as to other anxiety disorders.
Symptoms of selective mutism often present themselves during early childhood, between ages 3 and 6 years old. Some common symptoms of selective mutism include:
Lack of eye contact
Crying
Freezing/appearing paralyzed
Hiding/running away
Speaking with some people but not others
Speaking in some situations but not others
Difficulty speaking with people they are usually comfortable with when in the presence of others (for example, not talking to their parents when their teacher is nearby)
Using gestures instead of verbal communication
Lack of a speech or language disorder that may affect their ability to speak or understand others
Some less affected children may whisper or gesture to communicate.
In selective mutism, these symptoms last for more than one month, and that time period doesn't include a situation when it may be expected that your child wouldn't talk right away, such as the beginning of a new school year.
Differences between selective mutism and a language or social language delay
It's not uncommon for selective mutism to be confused with other types of language or social disorders, which may look similar to an untrained eye. As much as parents, caregivers, and teachers should be aware of what selective mutism is, it's equally as important to know what selective mutism is not.
Let’s discuss some differences between selective mutism and a delay in expressive language or social language.
Selective mutism: A child with selective mutism wants to talk but freezes when placed in difficult communication settings. They are doing their very best but cannot force the words to come out.
Language delay: An expressive language delay is a child’s inability to use words and sentences at an age-appropriate level to express their wants and needs. It's a developmental delay of their language abilities.
Social language delay: A social language delay happens when a child has difficulty understanding how to interact in social situations, read nonverbal cues, and engage in conversation with ease. It's a developmental delay in understanding various social skills.
It's important to note that receptive and expressive language delays, as well as social language delays, can co-exist with selective mutism. However, they are separate disorders and not the cause of selective mutism.
Selective mutism is not disobedience
As a caregiver to a child with selective mutism, it can be upsetting to watch them struggle to speak in certain situations. You may even become frustrated at times.
However, it's important to remember that children with selective mutism are not intentionally choosing to not speak. This is a disorder, not disobedience. They are not being defiant or stubborn. Rather, they're simply unable to communicate in the presence of certain people or situations. The majority of children who have selective mutism also have an accompanying disorder of social phobia or social anxiety.
Therefore, it's not appropriate to reprimand children with selective mutism. Speaking negatively to them about their inability to talk, or assuming that they're purposefully choosing not to speak, can be very hurtful. In fact, it can even make it more challenging for them to communicate.
How does selective mutism affect children?
Imagine wanting to be able to communicate with those around you but being completely stuck. You'd likely feel extremely discouraged and probably embarrassed. Children with selective mutism experience these feelings daily.
While every child with selective mutism is different, many find it difficult to speak in school. When children can't properly communicate with teachers, it can lead to poor academic performance. For example, they may not raise their hand in class, ask for help, or request assistance for basic needs such as using the restroom.
These socially anxious feelings don't just affect interactions with adults. Some children with selective mutism have trouble speaking with kids their own age.
These socially anxious feelings don't just extend to their interactions with adults. Some children with selective mutism have trouble speaking with kids their own age. During early childhood and school-age, children play and socialize together in the classroom, on the playground, and during extracurricular activities. There is so much social learning that goes on during these times. When children can't speak and participate in these scenarios, it can negatively impact their social development as well as their mental health and well-being.
The importance of diagnosing selective mutism early
The earlier a child is diagnosed with selective mutism, the better. Children often respond positively to early intervention. The longer a child goes without a diagnosis, the later treatment starts.
Children should begin treatment as early as possible to help prevent selective mutism from persisting into adulthood, as well as to avoid symptoms becoming worse. According to The SMart Center, delayed intervention can cause:
Worsening anxiety
Depression and other anxiety disorders
Social isolation and withdrawal
Poor self-esteem and self-confidence
School refusal, poor academic performance, and the possibility of quitting school
Underachievement academically and in the workplace
What to do if you think your child has selective mutism
Sometimes children with selective mutism are simply labeled as “shy.” However, dismissing selective mutism as shyness can have serious implications for your child down the line.
If you believe your child has selective mutism, or if you notice the symptoms described in this article, be sure to speak with your child’s pediatrician. You may also need to seek the advice of a psychiatrist or psychologist. Either way, it's important to get a professional’s opinion in order to have a formal evaluation completed.
Treatment may consist of behavioral therapy or family therapy. In some cases, a psychiatrist may decide that medication is necessary, as well.
How can you communicate with a child who has selective mutism?
Apart from seeking professional help, there are simple communication techniques you and your child can use. Here are some tips:
Don't draw attention to your child's lack of speech. Also, try to avoid putting pressure on them. This only makes it more challenging to express themselves. Removing pressure may help your child relax and feel more comfortable, setting up a supportive environment in which they may be more likely to talk.
When speaking with your child, do not make eye contact. Eye contact can be overwhelming for children with selective mutism. They also may prefer that you sit next to them, instead of being face-to-face.
Continue the conversation even if your child doesn't respond. Provide plenty of time, and take intentional pauses, to allow your child the chance to answer. If they don’t answer, continue talking and providing more opportunities for conversation.
Select a task that your child really enjoys, perhaps even one that you frequently participate in together. Talk about the activity and provide several opportunities for your child to comment.
Always remember to offer encouragement and support for your child and their efforts to communicate. They're doing the very best they can, and they will greatly benefit from knowing you are their biggest advocate, cheering them on along the way!
