Selective Mutism

Selective Mutism

Selective Mutism formerly called elective mutism, but was changed in recognition of the fact that a child does not choose, or elect, to be selectively mute. SM is still called Elective mutism in other areas of the world. This psychiatric disorder most commonly found in children, characterized by a persistent failure to speak, so as to be heard in select settings which continues for a reasonable period of time, usually a month or two. These children understand language use and have the ability to speak. In typical cases, they speak to their parents and a few select others. Most do not speak in school or in other social situations. Generally, most function normally in other ways, although some may have additional disabilities. Most learn age appropriate skills and academics.

General Discussion

Selective mutism is a rare psychiatric condition primarily occurring during childhood. It is characterized by the failure to speak in social situations. Ability to understand spoken language and to speak is usually not impaired. Symptoms include excessive shyness, and social anxiety.

Child Selective mutism

Selective Mutism is a childhood anxiety disorder.   It is much more than just shyness, and it is not a child willfully refusing to speak.

Selective mutism is characterized by a consistent failure to speak in specific social situations in which there is an expectation for speaking. Children with selective mutism have the ability to both speak and understand language, but fail to use this ability as a result of what we would consider to be social anxiety in adults. Most children with selective mutism function normally in other areas of their lives. Selective mutism is not a communications disorder and is not part of a developmental disorder. By definition, selective mutism does not include children with conduct disorders, oppositional/defiant behavior, and/or attention-deficit hyperactivity disorder.

Causes of Selective Mutism

Some of the research on what causes Selective Mutism describes biological difficulties as a cause of this disorder. Biological deficiencies combined with psychological and social problems have been indicated in some groups of selectively mute individuals. The social consequences of any disability whether it is speech, language, or intellectual may deter the child from speaking in select social situations (Nolan, 1970). It is essential to indicate whether the absence of speech is related to any biological difficulty that child may be experiencing. Therefore tests related to speech, language, and intellectual development need to be administered prior to giving the diagnosis of Selective Mutism.

Selective Mutism Treatment effectiveness and the future

Although rare, selective mutism deserves careful attention because of its persistence and debilitating impact on young children. Behavioral therapy approaches, the use of medication, and their combination are receiving more attention in the treatment of selective mutism. With the publication of careful case studies and controlled studies that incorporate good scientific designs, mental health professionals now have the resources to formulate sound plans for the treatment of selective mutism. Although much scientific evaluation needs to be completed before it can be said that we have a definitive cure, the picture is much brighter than it was even 5 years ago.

Helping a selectively mute child to speak:

There are various ideas about how to help a selectively mute child to speak again. Most research indicated that a combination of behavior modification combined with some models of family therapy (structural and intergenerational models) is most effective in helping a selectively mute child to speak. One could seek counseling services for evaluation prior to diagnosing. Further, if no biological difficulties are indicated as the cause of the child being selectively mute, it would be advisable to have a more extensive evaluation done where social, family, and work/school conditions are examined.

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Is there any methods out there that address the stress management techniques for kids with selective mutism? - Tracy

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