Selective Mutism in Children
Some children have great difficulty speaking when outside of their normal home environment or with people they don’t know well who might come to their home.
This is referred to as selective mutism in children.
Symptoms of selective mutism in children
Other conditions mustn’t be confused with selective mutism. For example, some children seem to be naturally shyer than others when speaking to people they’re not familiar with. Certain children also seem to be naturally less articulate than others of a similar age.
These developmental variations are perfectly normal and are not typically cause for concern.
However, selective mutism in children may be suspected when a child will not speak:
- when outside of their home and parental environment, even though they are otherwise speaking normally;
- to people visiting them or their parents at home;
- and turns away from others trying to speak to them. A variation on this might involve them looking down at the floor when being spoken to.
There are also some physical symptoms to look for:
- physical shaking or flushing when trying to speak;
- the skin becoming sweaty or clammy;
- freezing in place or conversely, becoming very restless and fidgety when asked to speak.
Some of these symptoms though may be due to other things and entirely unrelated to this condition unless they’re seen over an extended period.
Diagnosis
All children may demonstrate the above behaviours at times if they’re stressed, unusually shy or simply in a bad mood. Once again, that typically means nothing.
However, where such behaviour has been ongoing for more than 2-3 months, it would be advisable to seek a professional opinion starting usually with your doctor.
A diagnosis of selective mutism can’t be made by parents or care providers. An assessment by a psychologist or psychiatrist specialising in child development is required.
Selective mutism in children may be a disorder in itself or it might be a symptom of other conditions such as autism spectrum disorder (ASD).
Causes
Selective mutism as a condition is regarded as an anxiety disorder.
As with so many development conditions, the exact causes are unknown. It is known to run in families and therefore the root causes in many cases are likely to be genetic in all or part.
Treatment
After diagnosis, many specialists will recommend a treatment regime typically based on the ‘stepladder’ approach.
That usually involves working with the child in school or pre-school to move them up the ladder, starting perhaps with praising them for responding to the speech of others with a nod, then moving to a single word and then working upwards from there to more complex verbal engagement.
In some instances, sessions at a child development clinic may be recommended and medication may possibly be required to help with stress.
It’s also important that a regime is followed in the home. That usually entails encouraging the child to speak in the presence of visitors by giving them plenty of time, attention and rewards. Praise for progress is essential, as is avoiding criticism or stepping in to speak for them when someone has addressed them.
Outcomes
Sometimes, selective mutism in children may spontaneously resolve itself as a child ages.
More commonly, treatment is required and substantial improvements can be achieved by specialists, schools and parents working together in an agreed programme of activities.
