Selective Mutism

What is Selective Mutism?

Selective Mutism is an anxiety disorder in which a child is not able to speak in certain settings (e.g., school, public venues) or to certain people (e.g., extended family, teachers, classmates, strangers). Children with selective mutism usually feel intense anxiety about speaking and might fear that others will judge them or reject them if they do speak. As such, they feel unable to speak in certain situations even though they can comfortably speak at other times, such as when they are at home with their parents and siblings. Parents might not realize their child has trouble speaking around others since talking is not a problem at home. About 1% of children suffer from selective mutism. Selective mutism usually begins before the age of 5.

Individuals with Selective Mutism (SM):

  • Can be talkative, outgoing, and gregarious at home, but completely or mostly nonverbal at school or around strangers or other unfamiliar people or places.
  • Might seem frozen with fear or “shut down” when asked to speak outside the home or with strangers. However, some children don’t actually look anxious and might instead appear outwardly calm when expected to speak outside the home or with strangers.
  • Might use gestures, facial expressions, and nodding to communicate. Alternatively, some children with selective mutism also struggle with and avoid nonverbal communication and interaction with individuals other than their immediate family.
  • Might be able to speak in a whisper to teachers or peers.

SM Treatment:

The earlier children with selective mutism are treated, the better the outcomes they tend to have. Treatment for selective mutism involves a combination of behavior therapy (specifically, exposure therapy) and contingency management (i.e., prompting children using techniques that increase the likelihood of speech and reinforcing successful speaking experiences). Treatment helps children face situations that make them anxious instead of avoiding them, and it aims to increase the child’s confidence in their ability to speak in anxiety-provoking situations. Treatment involves the child, parents, and, whenever possible, school personnel and teachers.

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