Silence Isn’t Always Golden
Understanding Selective Mutism
There’s nothing quite like the innocence of a child’s voice, curious and observant as they discover the world around them. There’s also nothing quite like the oppressive silence in the absence of that voice. It’s frustrating and heart-wrenching. It makes you want to pull out your hair from desperation to fix it and bring back that little voice. That’s what it was like in our home with one of our children suffering from selective mutism.
Selective mutism is a complex psychological condition characterized by the consistent inability to speak in certain social situations despite having the ability to communicate in other settings. In my limited experience, it comes down to stress. Whenever my son was in a situation where he was unsure of his role, he would become stressed. This stress, in turn, left him unable to communicate. This condition is often misunderstood and misdiagnosed, but it can have a significant impact on a child’s social, emotional, and academic development.
Selective mutism is distinct from autism, yet there can be an overlap as was the case with my son. Both conditions involve difficulties in social communication, and it’s not uncommon for children with selective mutism to display social anxiety, which is a common trait in autism as well. However, it’s important to note that selective mutism is a specific anxiety disorder, while autism encompasses a broader range of challenges.
This anxiety disorder can look different in different individuals, but there are certain traits that are common across the board. Aside from their inability to speak in certain settings, children with selective mutism might display:
- Social Anxiety: They often experience intense anxiety when faced with speaking in public or unfamiliar situations. For my son, this included being called upon to answer a question he wasn’t confident he knew the answer to. This, for obvious reasons, made traditional schooling difficult as the teacher couldn’t call on him without triggering his selective mutism.
- Freezing Behavior: Children may become physically tense or frozen when confronted with situations that trigger their anxiety. This was the very next thing that happened when my son’s anxiety spiked. It was frightening and at first I was concerned he was having some kind of seizure but the doctor informed us it was not. Seeing this behavior can be very unsettling for the uninitiated.
- Limited Eye Contact: Avoiding eye contact is common among individuals with selective mutism. This is also a fairly common trait among those with autism. As a parent to a young child who didn’t yet realize he had selective mutism, this aspect was infuriating at first. It felt as if I couldn’t get his attention. No matter how many times I asked him to look at me, he wouldn’t. I didn’t understand until later that it was because he couldn’t, not because he wouldn’t.
- Nonverbal Communication: They might resort to nonverbal communication like nodding, pointing, or using gestures to express themselves. This was unfortunately not something that my son ever did. Once he unfroze and self-regulated his fear emotions, he went back to being verbal, but he could not communicate nonverbally with us. It added another layer of difficulty to an already borderline untenable situation.
There are several steps to pursuing a formal diagnosis if you are concerned that your child has a form of selective mutism. The benefit to seeking a professional diagnosis is that it can help your child to receive treatments related to improving communication.
The first step is talking to your child’s pediatrician about getting them a referral to be assessed by a qualified mental health professional, such as a psychologist or psychiatrist, who can then conduct a comprehensive assessment to diagnose selective mutism. They will want information on your observations of the child’s behavior in various settings. They may also want to observe the child as well to see if the mutism response is triggered by certain events.
This evaluation will also assess the level of anxiety the child experiences in specific situations and their overall functioning. Finally, the medical professional will rule out other potential causes of communication difficulties such as speech or language disorders.
Regardless of whether or not you end up seeking a formal diagnosis for your child, there are things you can do to help manage and mitigate the effects of selective mutism. The best advice I can give is not to rush your child. Pressure to speak can exacerbate the situation, making it harder for your child to open up. While patience in these situations can be difficult, it will be worth it in the long run. Other things to consider are:
1. Early Intervention: Identifying and addressing selective mutism as early as possible is crucial. Early intervention can prevent the persistence of the condition and its negative effects on a child’s development.
2. Gradual Exposure: Gradual exposure to anxiety-provoking situations is a cornerstone of treatment. This can be done through strategies like role-playing, social stories, and systematic desensitization to help children build their comfort and confidence in using their voice.
3. Positive Reinforcement: Encouragement and positive reinforcement play a vital role in the treatment process. Praising any attempts at verbal communication, no matter how small, can boost a child’s self-esteem and motivation to overcome their anxiety.
4. Collaborative Approach: Collaboration between parents, educators, therapists, and other professionals is essential. Creating a supportive environment that allows the child to communicate at their own pace can make a significant difference.
The prognosis for selective mutism varies from case to case. With appropriate intervention, many children experience significant improvement and eventually overcome the condition. However, the timeline for improvement can be gradual, spanning months to years. Early intervention and consistent therapeutic efforts increase the likelihood of positive outcomes, but it’s crucial to recognize that each child’s journey is unique, and patience is key.
