Children who are talkative at home but are not able to speak in certain settings or around unfamiliar people could have selective mutism (SM). There are children who are naturally shy but are still able to communicate verbally with others. SM, however, is included in a wide range of anxiety disorders and is often seen in children. While there are children who are not able to speak and communicate, children with SM are able to speak when the setting is secure and comfortable for them.
Some would attribute the condition to speech issues linked with autism, but this is not the case. While it is possible that it is a comorbid condition, it is not a tell-tale sign of autism. While signs of SM could be apparent when the child is around three or four years old, a diagnosis can be given when they are school-age.
Children with SM are polite in the classroom. This leads teachers to think that they might just be shy, and is rarely seen as a barrier to their learning. Because the condition is rare, even teachers and doctors are not able to recognize it at first glance.
Other people even see SM as oppositional defiance, because their refusal to talk could come off as rudeness or opposition. However, a child with SM does not refuse to speak
They are unable to speak.
These kids are more than shy; they feel extreme anxiety. If left untreated, this disorder can impair a child’s learning experience. It can affect their performance in school. It is also a barrier to forming social relationships with peers and adults.
SM can prevent children from asking for help from teachers and caretakers. It can also prevent them from being able to enjoy play dates and other activities that require verbal communication skills. Yet, the disorder is not a sentence for a lifetime. Children can cope, especially with the right support.
Connections with bilingualism
Selective mutism can be common among children in bilingual households. Having two or more languages does not cause SM. However, kids could feel anxiety when they are expected to speak in a language that they are not comfortable with.
Some kids in bilingual households can display silence or SM when they are forced to speak in their second language. For others, their fear of speaking can take over their bodies. Hence, they will refuse to speak in either language.
There is a different way to diagnose children with SM when they are raised in bilingual households. They are not diagnosed with SM if their failure to communicate is due to difficulty in understanding the second language. It could be that the child is merely acquiring and mastering the target language.
Treating children with selective mutism
Selective mutism in children can be treated. With early intervention, SM can be addressed while the child is young. Children with SM are able to respond to behavioral therapy. These sessions are tailored to help them speak in new settings with new people.
For the treatment to be more effective, it is encouraged that parents establish a diagnosis for the child’s case. This diagnosis or evaluation should tap on specific circumstances when the child is able to speak and when they are unable to do so. It is possible that the child experiences occurring conditions that are based on patterns. This evaluation can also help rule out other possible diagnoses like language disorders.
In therapy, children with SM are not forced to speak. The treatment is done gradually, and they are not asked to speak when it is difficult for them. With specialized behavior therapy techniques, speech is first prompted then reinforced with praise and incentives. This helps children gain more confidence while preparing them for more challenging tasks.
Effective treatment programs help children speak in everyday circumstances. Therapists model their treatment in real-life situations where speech is necessary to operate. Some do simulated classroom activities and field trips. With these techniques, children are able to apply what they have learned in therapy in real-life settings where they are previously silent.
While behavioral therapy sessions are able to address SM, medication can help children who are not able to cope with therapy alone. The child should be making progress in the first two months of behavioral therapy. If this is not the case, they should be taken to a child psychiatrist who can prescribe the right medication.
Most psychiatrists would prescribe an antidepressant that is a common medication for anxiety disorders. However, these medications can take weeks to work and are not instant pills that help them speak after the first dose. These medications can help children loosen up while in therapy, so they can perform speaking tasks better. Therapy and possible medication for SM usually takes nine to 12 months to complete.
Children can overcome selective mutism. It can be intimidating at first, but it is treatable. With the right support and tools, children can feel less anxious in different social settings.