Selective Mutism: The Silent Child

What does Selective Mutism Look Like?

A teacher notices that a child in the classroom never speaks. They may occasionally whisper to a classmate they know well. The child is unresponsive when spoken to, sits in a rigid body position, and may appear expressionless with that deer-in-the-headlights look.The child may cling to parents when entering the school, and may be hesitant or slow to communicate with peers.

This is typical of a child with Selective mutism. It’s more than just shyness. A shy child may be reticent, but can participate when encouraged. It is unlike a child with inattentive Attention Deficit Disorder (ADD), who may have similar symptoms but can engage in activities and respond when someone talks to them. The child with Selective mutism is often found to have anxiety, their body rigid with stress, and they physiologically cannot speak (Learn about other speech disorders here).

How do Children with Selective Mutism Behave?

Selective mutism can co-exist with shyness and social anxiety disorder, but symptoms typically occur only in certain situations, such as school or other social occasions. Children avoid speaking because they worry about attention or embarrassment. Initiating a conversation can be extremely difficult. Some may stand frozen when approached for social interaction. Some children may eventually become socially isolated.

In the past, people have mistaken symptoms of Selective mutism for simple shyness or defiance. It’s not a learning disability, although it may co-exist with one. Selective mutism is also not a speech or language disorder, or mental illness. It tends to run in families who have members with anxiety disorders, shyness, or even Selective mutism itself. Children may experience separation anxiety, moodiness, sleep problems and have the characteristic of being extremely shy from as young as infancy.

Selective Mutism is Situation-Dependent

Despite difficulties communicating in certain environments, these children are fully capable of effectively communicating at home. Perhaps feeling more relaxed and safe at home; they can be lively and talkative. Some children will communicate well with extended family members or close friends of the family. A parent’s first indication that their child has Selective mutism is usually a result of concerned educator.

Selective mutism typically develops before age five and usually gets diagnosed when the child enters school. Sadly, it may continue through adolescence and into adulthood, if it’s not treated. It can be an emotionally painful disorder.

An adult woman who was diagnosed with selective mutism described the experience: "Looking back, I can clearly see the symptoms. As a child, I hid behind my parents' legs when someone tried to have a conversation with me. In some settings, I could only whisper to someone I felt comfortable with.... At school, children bullied me for being chubby, and I couldn't stand up to them. I couldn't even ask my friends to help, and my silence perhaps implied consent [to my mistreatment]...I developed PTSD."

Problems in school may arise. A child may not be able to ask to go to the bathroom all day. They may not respond despite knowing an answer. Asking for help from others may be impossible.

Selective mutism can also present a problem when a child is put in a testing situation, leading to a misdiagnosis of a deficit in the child’s cognitive function.

Children who do not speak in preschool may also be silent during extracurricular activities such as camp, scouts, or sports. It may have negative academic or social effects on them as they age, and it gets worse if it’s not treated. It can also progress very quickly. Some children cannot participate in activities they enjoy if there are other people present.

Solutions for the Child with Selective Mutism

Such children have a genetic predisposition to Selective mutism. At least one parent is likely to have an anxiety disorder. However, play therapy and behavioral therapy can be useful, as the addition of medications.

The parent and teacher of a child with selective mutism should work together to assist the child. Parents should never insist that a child must speak in social situations. Allow the child time to adjust to the environment, begin to relax, and feel more confident. If possible, rehearse with the child what may encountered at an event and practice managing possible scenarios. Preparing for an event may be very helpful.

The use of a device such as Forbrain bone conduction headphones may help a child habituate to their own voice while practicing verbal activities at home or in a therapy office. In a controlled environment, Forbrain may help the child gain confidence in their own verbalizations; a quality that are often lacking in children with selective mutism. Professionals around the world have reported successful treatment with Forbrain to improve awareness and confidence in speaking situations (Read a review from a non-verbal user here). 

Professionals trained to assess and treat children with selective mutism include psychologists, speech-language pathologists, occupational therapists, and other specialists including those that do sensory integration therapy.

Children with selective mutism do not have to suffer in silence. With the support of professionals and family members, these children can grow into confident, effective communicators with much to contribute to the conversation. For more information and how to get help, visit the Selective Mutism Association.