Selective mutism is an anxiety disorder characterized by a child's inability to speak in some situations despite speaking freely in other situations. Most often, although not always, children speak comfortably to immediate family members in the home but are not able to speak to teachers, peers, and other adults outside of the home. This inability to speak is due to anxiety; the child is otherwise very capable of communicating using the language spoken in the social situation. This inability to initiate conversations or respond to other's questions occurs often enough that it negatively impacts the child's relationships and daily activities, including friendships and school success (e.g., participating in classroom activities, reading aloud, being evaluated at school).
What Selective Mutism is "NOT"
1. "Just shyness" - Selective mutism is an anxiety disorder that negatively impacts the child's daily functioning.
2. Autism Spectrum Disorder - Which involves other symptoms that extend beyond communication concerns.
3. Trauma - Children with selective mutism are no more likely to have experienced a traumatic event than children who do not have selective mutism.
4. A speech and language disorder - Although communication disorders can also be present.
5. Intellectual disability - A diagnosis of selective mutism is only considered if the child is capable of speaking in some situations (such as at home!).
If your child is struggling with issues similar to the ones above, a qualified mental health professional will be able to assist you in clarifying the concerns, and developing a tailored treatment plan that will lead to the best possible outcome for your family.
When Do I Seek Help?
Families often become very used to having a child/sibling who does not talk in certain situations and have found ways to support the child in 'non-talking' situations (e.g., providing explanations to others -"she is just shy," answering questions for their child). However, when not-talking leads to missed opportunities to interact and play with peers and the child is not able to fully participate in school and extracurricular activities (beyond the first month of school), it may be time to seek help. More information about selective mutism and treatment options can be found at selectivemutism.org.
Won't My Child Just "Grow Out Of It"?
Maybe. But maybe not. In the meantime, children with selective mutism often miss out on social interactions and play with other children, which are important for their development and well-being. Although many children with selective mutism will play and communicate with their friends and teachers non-verbally (e.g., pointing, showing) these children are not reaching important developmental milestones in their communication skills and academics. Moreover, children with selective mutism often do not communicate their personal needs to others (e.g., when they need to use the washroom, when they are hurt). The risk of waiting for children to "grow out of it" can be significant. The good news is there is treatment available that has been shown to be effective for managing selective mutism!
What Can I Expect From Treatment?
It is important to ask your therapist for treatment that is evidence-based (i.e., supported by research). Evidence-based treatment for selective mutism includes Behavioural and Cognitive-Behavioural Therapy (CBT), which is also the first line of treatment for other types of anxiety. Treatment will involve practicing "brave talking" in new situations, during new activities, and to new people. Children and their parents are very involved in planning next steps in treatment, which will allow your child to always know what to expect. In other words, there will be no surprises or expectations to talk before s/he is ready! It is important for parents to be involved in treatment to learn more about selective mutism and to learn tips and tricks for supporting their child outside of the therapy office, where we most want talking to occur! Timing of treatment will need to be considered, as daily brave talking tasks are critical to gain momentum in treatment and to build on successes. Given the daily practice plan, small rewards will be important - brave talking is HARD WORK! While it can be hard work, treatment will also be FUN and involve lots of games and activities that support brave talking.