Selective Mutism: Causes, Symptoms, and Treatment

Selective mutism is a rare anxiety disorder which is characterized by a child’s extreme discomfort with speaking in certain situations or environments. The condition causes the affected child to feel unable to speak. For some children, the fear of speaking up arises while they are in school. They may feel shy, nervous, or uncomfortable with their peers.

What Can Lead to Selective Mutism?

Because selective mutism is anxiety-related, it is usually caused by a deep-rooted fear in the child. It’s important to remember that although the mute state is referred to as “selective,” children who have the condition are not simply being obstinate. They feel genuinely terrified or extremely discomfited when asked to speak at certain times.

Selective mutism can also be the result of an external event, according to Dr. Martin T. Stein et al. Some life changes the specialists list that can lead to a period of sustained silence and anxiety in a child are: attending a new school, moving, witnessing parents divorce or fight, losing a loved one.

A child who is shy, highly anxious, withdrawn, and fearful of separation is more prone to selective mutism. Children with a family history of anxiety problems are also likely to develop selective mutism.

For some children who refuse to speak at all (rather than in certain contexts), their silence may be the result of a distinct trauma. In this situation, the affected child can feel too afraid or upset to speak. Sometimes the child is silent due to the fear of real or imagined consequences. Poet Maya Angelou has publicly described her experience with selective mutism after being sexually assaulted as a child. She remained silent for years after the disturbing incident.

Conditions that can lead to selective mutism include speech impediments like stuttering and lisping, an unfamiliarity with the language, hearing loss, or a problem with the nervous system. Children who display selective mutism or stop speaking completely must be carefully observed and examined by professional health care workers. Once the absence of a physical ailment is confirmed, the child can be further evaluated for mental health issues.

How is Selective Mutism Treated?

Dr. Stein and his colleagues recommend that children with selective mutism are given treatment by a mental health specialist. Children with the condition can also be treated by a speech-language therapist. The authors of the study advise parents to find a therapist who has “a background in cognitive, behavioral, and play therapy.”