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Selective Mutism

Selective Mutism

By Sinead Hamill

Selective Mutism is a disorder that usually starts during early childhood.  This debilitating disorder is thought to affect approximately 1% of the population, with girls being more likely to develop it than boys.  Similar to a phobia, selective mutism is a fear or anxiety so profound that it consistently, for periods of over a month, prevents the sufferer from speaking in certain social situations in which they are not entirely comfortable.  Most often these situations include places where there are expectations placed upon the child to speak, such as in school, meeting people outside the immediate family, parties, shopping and so forth. 

Having selective mutism is very upsetting for the child, who is perfectly capable of speaking and for the majority of time would really like to speak, but because they become so anxious in social scenarios, they feel unable to, often comparing the feeling they get to that of a physical blockage.  When the child comes face to face with situations requiring them to talk, they become extremely 

anxious and seek ways to relieve the pressure.  Quite often this relief comes in the form of someone who will answer for them, filling in the awkward silences, temporarily relieving the child from their anxiety and so a cycle of communication avoidance begins.  

Selective Mutism is also extremely upsetting for the child’s parents, knowing the world is not seeing their child as they see them.  It is not unusual for the child to be quite a“chatterbox” at home.   If the disorder is not dealt with at a young age, it may lead to 

devastating consequences for the child growing up, continuing into adulthood.

What are the Causes of Selective Mutism?             

There is no one definite cause of Selective Mutism but often it is associated with one of the following stimulants:

A history of anxiety disorders within the family

A traumatic experience for the child, even if it seems trivial to the adult.

Speech/Language difficulties

Difficulties adjusting to change or the unfamiliar

Extreme shyness

What are possible Effects of Selective Mutism on the Child?

School performance is affected

Ability to form relationships suffers and the child may become isolated

Social anxiety

May develop a dependency on others, such as family members, to communicate for them or relieve them from perceived stressful encounters.


What are some of the Things You Can Do to Help a Child with Selective Mutism?

If you suspect your child or a child in your care of having selective mutism you should seek help and support immediately.   Ask your doctor or staff in your child’s school for options available to you and your child, such as a child psychologist or psychiatrist to first confirm the suspected diagnoses and then proceed to finding a suitable treatment.

Create a stress free environment

Empathise with the child.  Tell them you understand that they are afraid and reassure them that you will be there to help them through it.

Provide the child with communication supports such as a pen and paper and allow other non-verbal communication methods

Never force them to speak

Reward any communication, however small

Communicate, work with and explain the child’s needs to others in his/her life including school staff and even peers who are old enough to understand, so that the child feels supported.

Professional Help

Behavioural Therapy – This is the most common form of therapy for a child with Selective Mutism.  The child is slowly, step by step, exposed to levels of communicating with others.  The level of exposure gradually increases at a rate the child can handle.  This may need to be worked on for many years.

Cognitive Behavioural Therapy – This tends to be used with slightly older children over the age of 7 years.

Medication is occasionally used to relieve the child from the high levels of anxiety they feel.

Speech and Language Therapy – For children who need help developing their speech and language skills.

We are all subject to fears and anxieties, which at times requires help and support from others to get through them.  Selective Mutism is not a child’s way of seeking attention or control of a situation.  The only control they are seeking is control over their anxiety.  It is not them being defiant.  It is a real fear that needs our help and understanding.  So please, if you suspect a child of having Selective Mutism, don’t delay in getting him/her the help they need.  The earlier this disorder is tackled the more chance the child will have of overcoming the disorder.  So be patient, but don’t wait!

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