Many children are shy by nature. They might hug their parents’ legs and bury their faces when introduced to someone new or run off at a record pace to avoid the interaction altogether. This is not uncommon — but some children fail to speak in select (or all) social situations.
If your child doesn’t talk to other people or speak in certain settings, specifically at school, they might have selective mutism. This can be concerning, and your feelings are valid; however, know that your child can improve their behaviors through therapy.
What Is Selective Mutism?
Selective mutism is defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), as an anxiety disorder, “characterized by a consistent failure to speak in social situations in which there is an expectation to speak (e.g., school) even though the individual speaks in other situations. The failure to speak has significant consequences on achievement in academic or occupational settings or otherwise interferes with normal social communication.”
Children with selective mutism can display different behaviors, which sometimes makes it difficult to diagnose. For example, many children have confidence in other areas outside of speaking and progress normally in every other situation; conversely, other children may be totally withdrawn and don’t have the capacity to even communicate or respond non-verbally. Selective mutism can be debilitating. Most notably, it can stunt a child’s social development and prevent them from forming relationships with others.
Selective mutism in children is common. According to the Selective Mutism Association, 1 in 140 children has selective mutism, with signs typically showing around ages 2-4. And, importantly, in the majority of cases (90%), children with selective mutism also have social phobia, as reported by the Selective Mutism Center.
Selective Mutism Symptoms and Signs
What behavior characteristics does a child with selective mutism exhibit? As mentioned earlier, children with selective mutism can display different behaviors. Some are completely mute and unable to speak to anyone, anywhere; others are able to speak to a few loved ones; others can talk to a select number of people but only in a whisper. Additionally, some children freeze in social settings, while others appear relaxed and are able to socialize in their own way that doesn’t involve talking.
Here are a few specific signs of selective mutism to keep an eye out for:
- The child is usually talkative at home with his family but communicates differently with others – for example, they only use one-syllable words and make gestures to communicate.
- They are extremely attached to their parents and severely shy around others.
- The child doesn’t have contact with other individuals (social isolation).
- They suffer at school and/or in other areas of life as a result of the above behaviors.
What Is an Example of Selective Mutism?
Kirsty Heslewood didn’t utter a word until she turned seven years old. She was clingy and held onto her mother’s legs on her first day of preschool. Heslewood felt shy, scared, and lonely; she wanted to speak, but she didn’t. Her silence continued into elementary school — she refused to speak to her classmates and her teachers. The only way she communicated was with signs and gestures, such as nodding her head.
When Heslewood turned 23, she was crowned Miss Hertfordshire at an annual beauty pageant. She then went on to compete for Miss England in 2012. Exuding confidence and eloquently speaking on the stage with a packed audience listening, nobody would have thought that she suffered from selective mutism as a child.
What Is Selective Mutism Caused By?
Why does a child or adolescent develop selective mutism? As with most mental health conditions, the exact cause or causes of selective mutism aren’t well-understood. Many experts believe that children with the condition are innately anxious (remember: Many of these kids also suffer from social anxiety).
Risk factors for selective mutism include a family history of selective mutism, severe shyness, or anxiety disorders; subtle receptive language difficulties; and overprotective or controlling parents.
Is Selective Mutism Part of Autism?
Selective mutism and autism are not the same disorder; additionally, selective mutism is not a characteristic of autism and vice versa. However, children with autism may display some of the same symptoms of selective mutism.
Does Selective Mutism Go Away?
Selective mutism does go away with treatment (and sometimes on its own). It is not a lifelong condition — instead, it typically lasts from a few weeks (on the shorter end) to a few years (on the longer end). The sooner a child gets proper treatment, the sooner they can recover from their selective mutism and go on to develop healthy relationships with others.
Is There Treatment for Selective Mutism?
Selective mutism is highly treatable, with one of the most effective treatments for selective mutism being cognitive behavioral therapy (CBT). While there are many methods that can be utilized in CBT for selective mutism, it might involve gradual exposure, in which the therapist gradually exposes the child to anxiety-provoking situations and works with them to feel more comfortable — eventually, comfortable enough to speak in these situations.
When it comes to older kids in particular, CBT can also help them identify the thoughts that make them anxious and cause them to behave the way they do in social settings. The therapist can then work with the child to replace those thoughts with more positive ones and, in turn, correct the behaviors characteristic of selective mutism.
When a child with selective mutism is diagnosed early and a treatment plan is put in place, the better the prognosis is for them to overcome the condition. If you think that your child might have selective mutism, talk to a medical professional. You can start with your doctor who can refer you to a mental health professional, or you can reach out to a mental health professional directly. In either case, the right selective mutism treatment team can assess, diagnose, and treat your child’s selective mutism. And remember: They can go on to live a happy, successful life.