Selective mutism is a disorder attributed to anxiety.
It is characterized by the inability to speak or communicate effectively in social settings while retaining the ability to speak and communicate in familiar, comfortable, and relaxed settings.
Selective Mutism in Children
A parent dropped their talkative 5-year-old child off at school for several weeks before a shocking call came from the teacher, “Sam will not talk in school. He is withdrawn and will not participate with others in activities. He appears to not be paying attention.”
Why would Sam talk at home but not in school? His behavior at home seemed normal. After seeking professional help, Sam was diagnosed with selective mutism. The culprit was the intense anxiety that Sam felt in the school setting. This caused him to ‘shut down’ as he experienced overwhelm. He literally could do nothing but stand motionless in fear.
It had nothing to do with unwillingness or stubbornness. Sam’s high-level anxiety in the school setting subsequently caused him to struggle with staying on task and following directions.
Studies indicate that less than 1% of children have selective mutism. This could explain why few teachers, therapists, and physicians recognize the disorder.
Most children develop selective mutism between the ages of 2 and 4. If they are diagnosed, it typically happens once the child enters school, which creates a gap between onset, identification, and treatment.
Because very few people understand this disorder, misinterpretation of a child’s behavior is common. A teacher may tell a parent that their child is stubborn, shy, or controlling when the child is displaying common characteristics of selective mutism, such as temperamental inhibition, social anxiety, and communication difficulties.
Some professionals falsely view selective mutism as a form of autism or a learning disability. Children with learning disabilities or autism may demonstrate symptoms of the disorder, but selective mutism is not commensurate to an autism or learning disability diagnosis.
Selective Mutism in Adults
It is not unusual for an adult to step onto a podium in front of an audience to only discover that their voice will not work. What causes this? Extreme anxiety.
This adult may have no other anxiety issues, with no problems socializing and communicating in other settings, but when they stepped up to the microphone their reaction closely resembled selective mutism. The likeness is that they could not speak, they felt intense panic, and they may have stood frozen in one position—unable to move or speak until they used their internal mechanisms to lower their anxiety level. These mechanisms are lacking in adults and children with untreated selective mutism.
Selective mutism is not a disorder that is specific to children. It usually starts in childhood and can persist into adulthood. Adults diagnosed with selective mutism experience anxiety and the inability to speak…the ‘shut down effect’ that occurs in certain pressing social situations, which results in intense emotional and physical difficulties.
Selective Mutism In Relation to Autism
In her article, Selective Mutism: Being Quiet Doesn’t Mean I Have Nothing to Say, posted on the TheArtofAutsim.com, writer, and artist Kimberly Gerry-Tucker reaches out to succinctly teach the world from her diagnosis and her experiences with selective mutism as an adult on the autism spectrum.
“Like many people who have been diagnosed autistic (in my case Aspergers), I have an overlapping condition: Selective Mutism. Over-excitability in the amygdala region of the brain is said to cause the physical inability to speak. Anxiety often becomes the uninvited guest or party crasher in the room.
There is an exaggerated fight or flight response that takes place beyond my control. My body shuts down signals to make facial expressions and to speak aloud. I often imagine words in fancy fonts swirling out of my mouth only to fall on the floor unheard. So many misconceptions about selective mutism exist. Well, here are a few facts:
- Selective Mutism (SM) is NOT shyness.
- It is not ‘caused’ by a baseball, a rock, or any other trauma hitting the head.
- It can be lifelong.
- SM is not stubbornness.
- It is not manipulative behavior.
- Just because a person with SM is silent, doesn’t mean they have nothing to say.
- Anxiety plays a big part in what feels like a freezing of the vocal cords.
- There is often a hereditary component.
- ISpeak, an organization that gives a voice for people with selective mutism, says this:
They genuinely cannot speak because attempting speech rouses too much anxiety. Almost all children and adults with Selective Mutism would love to be able to speak in every situation but they cannot. They are not ‘making their difficulties up’, ‘being difficult’, ‘rude’, ‘antisocial’, or anything else.”
The earlier a child is treated for selective mutism, the more positive the results. Early treatment helps to tamper down repercussions such as worsened anxiety, depression, social isolation, and poor self-esteem.
We understand and find it important to distinguish between co-occurring conditions (such as selective mutism) and autism itself. At RDI®, we help you get beyond the myths and figure out which ones need to be addressed.
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