Do you care for a child who has suddenly, or for most of their young life, refused to talk in certain settings? Maybe they will say a few words or even whole sentences around people they’re comfortable with, and then when they’re at kindy, school, or out in public they freeze up and refuse to say a word. If you’ve had this experience, it’s possible that the child in your care is experiencing Selective Mutism.
You might’ve heard of it before, maybe in movies or popular culture, but still have a lot of questions swirling around in your head. When will it go away? Can it go away on its own? Keep on reading to find the answers you’ve been searching for.
What is Selective Mutism?
Selective Mutism is a childhood disorder characterised by a persistent failure to speak in certain situations. It’s called a childhood disorder as it usually starts in childhood and is identified between the ages of 3-6 years old. The latest research indicates that it is more common in girls. If left untreated, Selective Mutism can persist into adulthood and can impact a child’s involvement in education and social activities.
What Are the Symptoms?
The symptoms that are associated with Selective Mutism are:
- Failure to speak for at least 1 month (not limited to the first month of school)
- Consistent failure to speak in specific social situations despite speaking in other situations
- “Shutting down” at school that impacts educational or occupational achievement
- A failure to speak that is not related to a lack of knowledge or comfort with the spoken language required in the social situation
- Inability to speak even to familiar adults (such as parents) in the presence of others
Selective Mutism has been associated with excessive shyness, fear of social embarrassment, social isolation and withdrawal, clinging, temper tantrums or controlling behaviour particularly at home.
Who Can Diagnose This Condition?
Psychologists and Psychiatrists are the best professionals to speak with when seeking a diagnosis of Selective Mutism. They are able to rule out other psychological and cognitive causes of a persistent failure to speak in certain situations.
Once a diagnosis has been made, Psychologists will often work alongside Speech Pathologists to provide therapy to help the child address their anxiety around communication. Speech Pathologists can also help to differentiate this condition from an Expressive Language Disorder through the use of different types of assessment and analysis including analysing video recordings from home-based interactions, artefact analysis of kindy or schoolwork, and gathering information on the child’s developmental history.
What Causes This?
While there is no single definitive cause of Selective Mutism across all cases, there have been some possible causes listed in research, including:
- Environmental influences
- Genetic influences / family history
- Overactive autonomic nervous system
- Trauma including abuse or death of a parent
How is Selective Mutism Treated?
Early intervention is strongly recommended for children as left untreated the condition is not known to resolve on its own. Treatment for Selective Mutism generally involves psychological and behavioural therapy led by a Psychologist or Psychiatrist alongside speech therapy with a Speech Pathologist. In some cases, children are recommended Alternative and Augmentative Communication (AAC) devices to support their communication, particularly when school aged, however speech therapy is unlikely to be successful on its own if psychological support is not provided.
In some cases, children with Selective Mutism may be home schooled for a period of time if their lack of communication impacts their ability to attend to school tasks.
The Good News About Selective Mutism
Reading this article may have made you feel a bit worried about the child in your care who is refusing to talk. We understand that this can be a concerning time for parents and families, and we want to assure you that Selective Mutism is very treatable with the right care. Make an appointment with your GP or Paediatrician to refer to psychology or psychiatry to explore your child’s mutism in more depth.
As Speech Pathologists supporting children with Selective Mutism, we know how important it is to go slow and help them by slowly stepping up therapy as to not overwhelm them. As the condition is often associated with heightened anxiety, our team are mindful of this and do everything they can to create a welcoming and relaxing therapy environment for your child.
If you suspect that a child in your care has Selective Mutism, we would highly recommend making an appointment with your paediatrician who can then recommend a psychologist or psychiatrist for further assessment.