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Selective mutism

“Selective mutism is a rare childhood anxiety disorder in which a child experiences a trigger response and is unable to speak in certain situations or to certain people” (Psychology today, 2023). It may appear to be quite timid, yet shyness is not what it appears to be. And contrary to what some would assume, it’s not a purposeful lack of words.

People with selective mutism, however, are able to converse freely with specific persons, such as close family members and friends, when there are no other people around to trigger the freeze reaction. About 1 in 140 young children have selective mutism. It’s more common among girls and young people who have recently relocated from their home country.

Symptoms

Rather than a complete loss of speech, selective mutism refers to the incapacity to speak in specific social circumstances. Children abruptly stop moving and have a frozen expression when they have to talk to someone who is not in their comfort zone. The most obvious indicator that anything is wrong is this. This disorder’s typical signs and symptoms include:

• Feeling uneasiness, anxiousness, and discomfort in strange places.
• Moving slowly, not making eye contact, fidgeting, and struggling to articulate oneself in specific circumstances or in strange environments.
• Using nonverbal cues like pointing, head nodding, etc. to communicate demands.
• Having unpleasant side effects while at school or job might subsequently have an impact on how well they do there.
• When a child is between the ages of two and four, they may experience fear of conversing with strangers, albeit this symptom may not continue for very long.
• When a person is at home, they may be difficult or hostile, or they may become irrational when their parents challenge them.

Causes

Because the disorder tends to be somewhat uncommon, its risk factors are not well understood. Historically, childhood trauma, abuse, or instability have been linked to selective mutism. Experts are still unsure of the specific cause of selective mutism. An academic review from 2010 lists a few of the following main hypotheses:

Behavioral theory

It is a taught, subconsciously used preventive approach for anxiety management since this disorder appears to be closely tied to anxiety problem. Your freeze response keeps you from communicating when you are in unfamiliar or uncomfortable social situations.

Social anxiety theory

Selective mutism, according to some psychologists, is a severe form of social anxiety because people with social anxiety disorder typically avoid speaking in front of others or engaging with strangers. Additionally, it’s crucial to remember that social anxiety often first appears in early to mid-adolescence, whereas selective mutism typically appears in infancy. Last but not least, selective mutism typically goes away with maturity, although social anxiety does not.

Developmental psychopathology theory

This more modern theory asserts that once children start school, classmates who have early speech or language difficulties may harass or taunt them. In circumstances when they don’t feel safe, people could choose not to speak because they might feel ashamed.

Post-traumatic stress theory

Abuse and other traumatic experiences might also contribute to selective mutism, according to another theory. When you experience a trigger that causes you to recall your trauma, you could accidentally dissociate — that is, temporarily become emotionally detached — for a short while. This might make speaking seem impossible.

Treatment

Despite the chance that selective mutism will improve on its own, medical professionals nevertheless suggest being treated after the illness has been recognized. Treatment options for selective mutism range widely. According to Schiff, these are the most common treatments:

Therapy

• Speech-language therapy — Children who are selectively mute typically have issues with their speech or language. SLPs can assess a child’s communication skills with a range of people and in a number of settings to rule out any potential speech and language problems. The SLP might then instruct them using a variety of exercises to gradually increase their speaking confidence. They might focus on dealing with the child if they see that they have a tendency to be quiet.
• Cognitive behavioral therapy (CBT) — Concentrates on recognizing and changing thinking patterns about oneself, other people, and the outside world in order to lessen anxiety.
• Behavioral therapy — You will gradually build confidence speaking in strange contexts by employing this method to expose you to increasingly challenging situations over time. For instance, your child who is mute just when he wants to talk to you could do so before a third, unrelated party enters the conversation. Once your child is at peace speaking in front of the two of you, you leave the conversation. a six-month school-based CBT program for kids ages three to nine. Five years later, 17% of patients reported improved symptoms, and 70% were no longer diagnosed with selective mutism.
• Family therapy — When family relationships seem to be a contributing element in selective mutism, it may be advantageous for parents and siblings to participate in treatment. The underlying causes of selective mutism can be identified, and a family therapist can advise on how to assist the child overcome it.

Medication

Additionally, taking medicine may be required, particularly in cases with severe or ongoing illnesses or when other therapies have failed to improve the situation. Before considering whether to use medication, a parent should talk to a doctor who has experience prescribing anxiety drugs for children. Antidepressants may be used in addition to a treatment program to lessen anxiety, particularly if earlier attempts to entice the individual to participate in treatment have failed.

Summary

According to what can be inferred from the entire text, anxiety disorders like selective mutism make people unable to speak in specific situations, typically in front of strangers. It can, however, also persist well into adulthood or come back after you start getting better. Young kids are frequently affected.

In addition, the future of selective mutism seems promising. Except in cases when there is another problem that adds to the condition, most children with special needs function well in other areas and do not need to be placed in special education classrooms. This demonstrates the potential impact therapy may have on a youngster who is selectively mute. It’s important to keep in mind that selective mutism can be fully cured with the appropriate care provided by a medical practitioner or psychiatrist. The youngster can successfully overcome the anxiety problem with the correct assistance from family and friends.

References:

Strong, R. (2022). Signs of Selective Mutism and How to Get Support. [online] Healthline. Available at: https://www.healthline.com/health/anxiety/selective-mutism-symptoms#takeaway [Accessed: 30 Jul. 2023].

Psychology today (2023). Selective Mutism. [online] Psychology Today. Available at: https://www.psychologytoday.com/us/conditions/selective-mutism [Accessed: 30 Jul. 2023].

Cuncic, A. (2022). Understanding Symptoms, Diagnosis and Treatment of Selective Mutism. [online] Verywell Mind. Available at: https://www.verywellmind.com/what-is-selective-mutism-3024702 [Accessed: 30 Jul. 2023].

NHS (2021). Selective mutism. [online] nhs.uk. Available at: https://www.nhs.uk/mental-health/conditions/selective-mutism/ [Accessed: 30 Jul. 2023].