Selective Mutism is an anxiety disorder which usually presents in early childhood (typically between 2-5 years of age). It’s often first noticed when the child starts to interact with people outside their family, such as when they begin nursery or school. This disorder is thought to affect 1 in every 150 children; however with childhood anxiety on the rise I have seen an increase in the number of children presenting with Selective Mutism on my caseload.
Children and Young People with Selective Mutism have a phobia that consistently prevents them from speaking in certain social situations, for periods of over one month (two if they have started in a new setting). These children’s difficulties can not be better explained by other Speech, Language and Communication difficulties (e.g. Developmental Language Disorder, Hearing Impairment, Autism); however it is very common that children with SM will often have a co-occurring diagnoses.
Children/ Young people with SM will speak happily and fluently in some settings; however they will remain consistently silent in others.
These children will experience significant anxiety which will leave them unable to speak in places where there are expectations on them to speak (e.g. school, family gatherings) or in public places where they risk being heard by others (e.g. the shops, the park).
Is he/ she not refusing to talk? Are they not just shy?
As Selective Mutism is a relatively unknown disorder, parents and school staff can initially struggle to understand that it is fear that is causing the child/ young person not to speak in certain social situations. I have heard people initially use terms such as “defiant”, “attention seeking”, “refusal” and “just shy” to describe these children.
This confusion often comes from not understanding Selective Mutism and how it can present differently in every child/ young person.
Signs of Selective Mutism
The child or young person:
- May avoid eye contact
- May present with tense body language
- May appear withdrawn
- May look subdued, have a blank expression or have a fixed smile on their face
- May ‘freeze’ when someone asks them a question
- May manage to respond with a word or two, or they may speak in an altered voice, such as a whisper.
- May not initiate interactions with others to have their needs met
- They may use gestures to respond to questions (e.g. nod/shake head)
- They may speak to children in school, but not adults (or visa versa)
What causes Selective Mutism?
No single cause has been identified; however emotional, psychological and social factors may influence its development (e.g. personality traits, response to life events).
How might Selective Mutism impact my child if untreated?
- Mental health difficulties e.g. social anxiety disorder, depression
- Difficulty forming friendships and relationships, which may lead to isolation
- Unhealthy dependency on others e.g. family members
- Affect school performance
How can I help my child?
If you suspect that your child or a child in your care has Selective Mutism, you should seek professional help and support immediately (e.g. Speech and Language Therapist, Clinical Psychologist). Early diagnosis and treatment of Selective Mutism is linked with better outcomes.
When seeking support for your child be sure to check if the professional you have chosen has specialist knowledge/experience in this area.
I have included advice leaflets from the Selective Mutism Resource Manual (2nd Edition) by Maggie Johnson (Leaflets provided courtesy of SMIRA). These leaflets contain the top tips you can use to support your child or the child you are working with, both while they await specialist input and alongside a specialist programme:
References:
- The Selective Mutism Resource Manual: 2nd Edition by Maggie Johnson & Alison Wintgens
- http://www.selectivemutism.org.uk
- https://www.rcslt.org/speech-and-language-therapy/clinical-information/selective-mutism
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