As children get older and become more social, we witness their personalities start to shine. Some children (just like adults) are more outgoing and extroverted, while others tend to be shy and reserved.
But what if your child appears too shy to speak in certain situations?
Children with selective mutism may feel comfortable speaking with certain people and in certain places, but not others. For example, they may talk regularly at home or with friends, but once they get to school they seemingly lose the ability to speak. This happens time and time again in these situations.
If this sounds familiar, it may not be caused by shyness at all - it could be that your child has selective mutism. This article is going to cover what you need to know about selective mutism, including symptoms, treatment, and how it impacts children's' day-to-day life and overall well-being.
Symptoms of Selective Mutism
Selective mutism is diagnostically an anxiety disorder, not a communication disorder. Many children who have selective mutism are genetically predisposed to selective mutism, as well as other anxiety disorders.
Symptoms of selective mutism often present themselves during early childhood, between ages 3-6 years old. Some common symptoms of selective mutism include:
- Lack of eye contact
- Freezing/appearing paralyzed
- Hiding /running away
- May speak with some people but not others
- May speak in some situations but not others
- Difficulty speaking with people they are usually comfortable with when in the presence of others (i.e., not talking to their parents when their teacher is nearby)
- Using gestures instead of verbal communication
- Some less affected children may whisper or gesture to communicate
- This behavior lasts for more than one month, and doesn't include a period of time when it may be expected that your child wouldn't talk right away, such as the beginning of a school year
- Your child doesn't have a speech or language disorder that may be affecting their ability to speak or understand others
Differences Between Selective Mutism and a Language or Social Language Delay
It's not uncommon for selective mutism to be confused with other types of language or social disorders, which may look similar to an untrained eye. As much as parents, caregivers, and teachers should be aware of what selective mutism is, it's equally as important to know what selective mutism is not.
Let’s discuss some differences between selective mutism and an expressive language or social language delay.
- Selective Mutism: A child with selective mutism wants to talk, but freezes when placed in difficult communication settings. They are doing their very best but cannot force the words to come out.
- Language Delay: An expressive language delay is a child’s inability to use words and sentences at an age-appropriate level to express their wants and needs. It's a developmental delay of their language abilities.
- Social Language Delay: A social language delay happens when a child has difficulty understanding how to interact in social situations, read non-verbal cues, and engage in conversation with ease. It's a developmental delay in understanding various social skills.
It's important to note that receptive and expressive language delays, as well as social language delays, can co-exist with selective mutism. However, they are separate disorders and not the cause of selective mutism.
Selective Mutism is Not Disobedience
As a caregiver to a child with selective mutism, it can be upsetting to watch them struggle to speak in certain situations. You may even become frustrated at times.
However, it's important to remember that children with selective mutism are not intentionally choosing to not speak. This is a disorder, not disobedience. They are not being defiant or stubborn, but rather they're simply unable to communicate in the presence of certain people or situations. The majority of children who suffer from selective mutism also have an accompanying disorder of social phobia or social anxiety.
Therefore, it's not appropriate to reprimand children with selective mutism. Speaking negatively to them about their inability to talk, or assuming that they're purposefully choosing not to speak, can be very hurtful. In fact, it can even make it more challenging for them to communicate.
How Does Selective Mutism Affect Children
Imagine wanting to be able to communicate with those around you, but being completely stuck. You'd likely feel extremely discouraged and probably embarrassed. Children with selective mutism experience these feelings daily.
While every child with selective mutism is different, many find it difficult to speak in a school setting. When children cannot properly communicate with teachers or school administrators, it can lead to poor academic performance. For example, they may not raise their hand in class, ask for help, or request assistance for basic needs such as using the restroom.
These socially anxious feeling don't just extend to their interactions with adults - some children with selective mutism have trouble speaking to peers their own age. During early childhood and school-age, children play and socialize together in the classroom, on the playground, and during extracurricular activities. There is so much social learning that goes on during these times. For children who cannot verbalize and engage in these scenarios, it can negatively impact their social development as well as their mental health and well-being.
The Importance of Identifying Selective Mutism Early
The earlier a child is diagnosed with selective mutism, the better. Children often respond positively to early intervention, and the longer a child goes without a diagnosis means the later treatment starts.
Children should also begin treatment as early as possible to help prevent selective mutism from persisting into adulthood, and to avoid the worsening of symptoms. The SMart Center lists the following impacts that delayed intervention can have on children, and why early treatment is so beneficial.
- Worsening anxiety
- Depression and manifestations of other anxiety disorders
- Social isolation and withdrawal
- Poor self-esteem and self-confidence
- School refusal, poor academic performance, and the possibility of quitting school
- Underachievement academically and in the work place
What To Do If Your Suspect Your Child Has Selective Mutism
Sometimes children with selective mutism can simply be labeled as “shy.” However, dismissing selective mutism as shyness can have serious implications for your child down the line.
If you believe your child has selective mutism, or if you notice the specific symptoms described in this article, be sure to speak with your child’s pediatrician. You may also need to seek the advice of a psychiatrist/psychologist if they do not have experience screening for this disorder. Either way, it's imperative that you seek out a professional’s opinion in order to have a formal evaluation completed.
Treatment may consist of behavioral therapy or family therapy. In some cases, a psychiatrist may decide that medication is necessary, as well.
Apart from seeking professional help, there are simple communication techniques you and your child can use around people they have trouble communication with. Let’s review some tips below:
- Do not draw attention to your child's lack of speech. Also, try to avoid putting pressure on them - this only makes it more challenging to express themselves. Removing pressure may help your child relax and feel more comfortable, setting up a supportive environment in which they may be more prone to talk.
- When speaking with your child, do not provide eye contact. Eye contact can be very overwhelming for children with selective mutism. They also may prefer that you sit next to them, instead of face-to-face.
- Remember to continue the conversation even if your child does not respond. Provide plenty of time, and take intentional pauses, to allow your child the opportunity to answer. If they don’t answer, continue talking and providing more opportunities for conversation.
- Select a task that your child really enjoys. Perhaps even one that you frequently participate in it together. Talk about the activity and provide several opportunities for your child to comment.
- Always remember to offer encouragement and support for your child and their efforts to communicate. They are doing the very best they can, and they will greatly benefit from knowing you are their biggest advocate, cheering them on along the way!