Selective Mutism

Selective mutism is a complex childhood anxiety disorder characterized by the child's inability to speak and communicate effectively in selected social situations, such as school.

These children have the ability to talk and communicate in environments that inspire them with security, relaxation and comfort.

More than 90% of children with selective mutism also have social phobia or social anxiety. The disorder is particularly painful for the child.

Children and adolescents with selective mutism show a real phobia for speaking, for social interaction and in general for situations where from this communicative participation.

Many children with selective mutism have significant difficulty initiating or responding to communication even in a non-verbal manner. Therefore their social involvement can be limited for many children when they are approached by others in a context that is too warm or where they feel that there are communicative demands on them.

Not all children express their anxiety in the same way. Some children may be completely mute or unable to speak and communicate with anyone in a social setting, while others may speak or whisper to a select few. Some children may stand still and fearful as they face various social challenges. They may become frozen, inexpressive, apathetic and socially withdrawn. Children with less severe pathology may give an impression of ``relaxation'', carelessness, and may have the ability to communicate with one or a few children but be unable to speak and communicate with their teachers or with most of their interlocutors.

When compared to the typically shy and modest child, children with selective mutism are at the extremes of shyness and modesty.

Why does a child develop Selective mutism?

The majority of children who present the disorder have a genetic predisposition to the appearance of anxiety. So simply, these children have inherited the tendency to stress excessively from one or more members of their family. Very often, these children show signs of severe anxiety, such as separation anxiety, frequent bouts of anger and crying, moodiness, sleep problems, lack of flexibility and intense shyness from infancy onwards.

Some children with selective mutism may show obvious abnormalities in speech and language development, such as language disorders in the reception and production of speech or language delays. Some children may have complex learning difficulties such as auditory processing disorder. A shy personality is observed in the majority of these cases. The added pressure of a language disorder, learning disability or stimulus processing disorder may lead to the child feeling even more anxious, insecure or uncomfortable in some situations where they are required to speak.

Preliminary research from studies at the Center for Research and Treatment of Anxious Selective Aphasia (Smart Center) indicates that there is a percentage of children with selective aphasia who come from bilingual/multilingual families, families who have lived a significant amount of time in a foreign country or have been extensively exposed to another language during the developmental period of formation of language structures (2-4 years). These children usually have an inherently shy personality but the added stress of having to speak a language other than their mother tongue as well as insecurity about their ability to use the other language is enough to cause increased levels of anxiety and perhaps muteness.

A small percentage of children with selective mutism do not appear to be shy in the least. Many of these kids go out of their way to attract the attention of others and could be classified as 'professional mimes'. The causes of the muteness of such children have not been clarified,but research from the Center for Research and Treatment of Selective Autism (Smart Center), indicates that these children may have other than the typical causes that are thought to contribute to the onset of the disorder. For example when someone has been mute for years and has therefore assimilated mute behavior despite the lack of symptoms of social anxiety or other developmental or language problems. These children are really "stuck" developmentally at a non-verbal stage of communication.

Selective mutism as inferred from what has been said above in this article is essentially a symptom. Rarely will a child be only mute. Particular emphasis must be placed on the causes of dumbness and the contributing factors in the occurrence of dumbness.

It should be noted that there is no research evidence to support the hypothesis that the cause of selective mutism is related to abuse, neglect or injury.

What are the most common characteristics of children with selective mutism?

Most, if not all, of the characteristics of children with selective mutism can be attributed to stress.

• Persistent difficulty or inability to speak and respond in specific environments and usually most seen in the school environment.

• Little or no eye contact and general interaction with another person.

• Some children may use non-verbal communication to respond or direct speech by pointing or nodding their head.

• Other children may speak little or whisper to people they trust or other children their age.

• In activities, he may either participate non-verbally, or isolate himself and remain expressionless, apathetic, or stand frozen aloof with shyness and fear.

• Children's phobia increases in educational environments (school) where their participation is required and their performance is judged.

• He may present a completely different image at home (being active, talkative, funny, etc.) than he presents in the school context. The onset of symptoms may coincide with the start of school.

• Due to the inability to manage situations that cause anxiety and phobia in children, they can be led to unintended behaviors (being timid, stubborn, rude and manipulative).

• Symptoms may also coexist (such as nocturnal or non-enuresis, tics, onychophagia, finger sucking, tremors, nausea, abdominal pain, etc.).

• Some children can talk normally on the phone due to the absence of face-to-face eye contact.