Selective Mutism

Selective Mutism (SM) is an anxiety disorder when a person does not speak in specific situations or to specific people. As an anxiety disorder, the prevailing symptom is that speaking in certain settings evokes a sense of intense fear and terror.
The age of onset is usually in preschool years and without intervention, can persist for years. Parents are often unaware of the problem until the child starts school as many of these children speak openly at home and are only mute in school or other social settings.
It is important to note that there are many reasons a child may not speak in the school setting. These include: hearing difficulties, learning disabilities, poor language comprehension (as with children from multilingual families) or even autism spectrum disorder. These challenges ARE NOT considered classic SM. Before treating any such condition, it is important to receive a proper diagnosis.
Below are some basic facts about SM:
  • Girls are three times more likely to have SM than boys
  • Children with SM often have excellent comprehension of the material being taught in school
  • They might use non-verbal communication such as hand and head motions
  • There can be a family history of anxiety
  • SM is usually related to an anxious or shy temperament
  • The child is not necessarily stubborn or defiant
  • Some children may appear happy, but in reality are experiencing pain or anxiety
  • The child’s behavior could become more entrenched as time goes on, so early intervention is prudent. If left untreated, there is a risk of developing social anxiety into adulthood.
The child’s behavior could become more entrenched as time goes on, so early intervention is prudent. If left untreated, there is a risk of developing social anxiety into adulthood.
For treatment to be successful, there should be collaboration between the therapist, school, and the parents. Although SM falls under the general category of anxiety disorders, the intervention needs to be custom-tailored to SM, so a clinician with training and experience in this diagnosis is vital.