Selective Mutism

Selective mutism is defined as a failure or inability to speak in specific social situations, despite speaking in other situations. Children with selective mutism can speak in some social situations, such as at home or when they’re alone with their parents, but they cannot speak in other situations, such as when they’re at school/daycare or in environments that may make them uncomfortable . It is important to note that selective mutism is often a symptom of an underlying anxiety disorder. Other symptoms that can present themselves along with selective mutism include excessive or crippling shyness, dependency on parents, oppositional behavior, and being withdrawn. Children with selective mutism are not doing it on purpose; Many of them report that they want to speak and participate in social situations, but are afraid to for some reason.

Many times, children with selective mutism are not identified until preschool, or for some not until they start elementary school. Parents will often notice that their child is “shy” or “quiet” in social situations, but the extent of their “shyness” is not realized until they begin school and don’t talk there. If an SLP or teacher suspects selective mutism, they should make a referral to a child psychologist. The psychologist, SLP, teacher, parents, and others who may be involved can then work together to develop a treatment plan for the child. It is important to remember that anxiety is typically the underlying cause of the mutism and the child’s treatment needs to focus on reducing the general anxiety, as well as the mutism. Often, the child’s anxiety in the classroom can be reduced by making sure the child understands activities, having a consistent schedule, and having changes (to the schedule, new activities, etc) explained ahead of time. 

When working with children who have selective mutism, it is important to recognize and validate any attempt at communication. This includes nonverbal attempts such as eye contact, nodding yes and no, thumbs up/down, pointing, etc. Many times, the child will begin to attempt to communicate first in a quiet, secluded setting that feels safe to them, which is often in individual therapy sessions. They may begin with the above-mentioned nonverbal communication and then progress to mouthing words, whispering words, writing or drawing pictures. Once the child is comfortable with a communication behavior in a therapy session, teachers can begin attempting to elicit that same behavior in other settings around the school. Oftentimes, there is slow progress with the mutism, but there are improvements in the other symptoms of anxiety. The duration of mutism is extremely variable. It may take some time before the child is comfortable speaking in various social situations. It’s important to be patient and encouraging. 

Summary

Children with selective mutism are unable to speak in specific social situations, but can speak in other situations that are viewed as comfortable or safe for them. Many times, a child with mutism is not identified until they begin school and won’t speak there. The mutism is usually a symptom of an anxiety disorder and therefore, a referral to a child psychologist is necessary and appropriate. Treatment should focus on the mutism, as well as a reduction of the child’s general anxiety. Remember, the child wants to speak and participate in social situations, but they find themselves unable to do so. Be positive and encouraging at any attempts at communication- both verbal and nonverbal- and have patience!

If you feel that your child may be exhibiting some behaviors of selective mutism, please contact our office. We would love to work with you!

-Madison Collins, M.A., CF-SLP

References:

Shum, R. L. (2002, September 1). Selective Mustim: An Integrated Approach. Retrieved from https://doi.org/10.1044/leader.FTR1.07172002.4