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Understanding Selective Mutism

Selective Mutism is a disorder usually identified in children over the age of five. It is a form of anxiety that inhibits children from speaking in situations where speaking would be expected. These situations may be at school, with friends, with safe adults, etc. The child may be talkative at home or in certain environments, but will not say a word at school or at daycare. Most often a child will appear shy or uncomfortable when expected to speak. They may shut down or withdraw from the environment. They will most likely avoid attention from others and isolate themselves. At school, these children may not want to answer questions, do any public speaking or participate in group activities. Too often this leads to disciplinary issues or further reinforces the child's anxieties when forced to participate. The inability to speak must be limited to certain situations and not as a result of a medical issue that would prevent speech.

Signs of Selective Mutism

Child acts nervous around others

Child is always acting shy

Child does not want to speak to others

Child struggles to speak clearly and correctly in certain situations

Child struggles to communicate needs and wants

Child has been diagnosed with an anxiety disorder in the past

Teacher has talked with you about your child's resistance to class participation


Treatment for Selective Mutism has a great prognosis. Over time, the anxieties lessen, and the child is more willing to engage in verbal expression. Medications can be used to lower levels of anxiety however, various therapies can have a more dramatic impact. Behavior therapy is effective in that it reinforces any positive forms of communication. For example, a child’s teacher “says good morning. He timidly replies, “good morning.” If his teacher reinforces his use of communication positively his anxiety may be reduced and may encourage him to do it again tomorrow morning. Communication therapy helps the child effectively communicate needs and wants to adults and peers. Many children may shut down or use nonverbals to answer questions such as nodding or shaking their head. Having the child use “yes,” “no,” or “I don’t know” is a great place to start opening lines of appropriate communication. Small levels of exposure to the anxiety-producing situations can be helpful but must be taken slowly. For example, while out walking the family dog, a child gets nervous when a neighbor says “hello.” He might try to stay away from this neighbor hoping to avoid interaction. Exposure therapy would place the child in a situation where he would walk past the neighbor’s house regularly until the perceived threat subsides. He may then be able to respond with “hello” when his neighbor greets him again. This will take some time, and should be carefully monitored in order not to create more reasons to be nervous.

With respect to school, it is important to have open lines of communication with your child’s teachers. They need to understand your child’s strengths and weakness while not placing them in situations where they are bound to fail. Group participation, answering questions, and public speaking needs to be on their level with expectations increasing slowly over time.

The difficulty with Selective Mutism is that it can be tricky to diagnose. Make sure to consult with an experienced professional to get the correct diagnosis and treatment.

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