Selective Mutism

About 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.

Selective Mutism (SM) symptoms include:

  • Being talkative, outgoing, and gregarious at home, but completely or mostly nonverbal at school or around strangers or other unfamiliar people or places.
  • Appearing frozen with fear or “shutting 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.
  • Using 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.
  • Speak only in a whisper or with an unconventional voice or tone to teachers or peers.

Selective Mutism Treatment:

Selective Mutism treatment for children is best started as early as possible to get better the outcomes. Treatment for selective mutism involves a combination approaches, including Parent-Child Interactive Treatment for Selective Mutism (PCIT-SM), 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). PCIT-SM is the research-documented treatment approach developed to help therapists, parents, and teachers working with children to overcome selective mutism (SM). PCIT-SM has been tested and found to be effective in both the individual/family format and the intensive group format.

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.

The clinicians at Anxiety Specialists of Atlanta, including Dr. Josh Spitalnick, Dr. Shannan Edwards, Dr. John Mohammadioun, and Dr. Megan Faye were trained by and consult regularly with Dr. Shelley Avny, Clinical Director at CAAP, a nationally recognized SM expert.

For More Information: