DISORDERS

Selective Mutism

Click here to listen to Dr. Bari Goldman Cohen discuss treatment for selective mutism.

Selective mutism occurs in young children and may last into adulthood. It is thought to be an early pediatric expression of severe social anxiety disorder. It occurs when a child is unable to use functional speech despite being able to do so in “safe” environments such as the home or when talking just to parents or siblings. Children with selective mutism may whisper to parents when outside the home and not be able to speak audibly with peers, teachers or other adults. They may be unable to respond to friendly grandparents or aunts and uncles who greet them. Instead, they hide their face, ignore the other person or hide behind a parent. Parents of children with selective mutism know that their child is very talkative at home and are puzzled by their child’s behavior outside the home. Children with selective mutism may tantrum or complain of illness when adults force them to try to speak. These tantrums are caused by anxiety, as opposed to a desire to be defiant. Children with selective mutism puzzle their parents and teachers because they greatly enjoy preschool or school and recount all the exciting events of the day with enthusiasm, yet appear to be quiet and withdrawn while at school.

Children with selective mutism cannot be “forced” to speak. This only worsens their anxiety. Some data suggest that a selectively mute child’s vocal cords may be paralyzed with fear during episodes of speechlessness. These children are also at higher risk for having mild speech and language delays or other developmental concerns such as sensory integration disorder. These subtle neurodevelopmental delays may be interacting with social anxiety to make functional speech at in public settings difficult.

Treatment of selective mutism consists of behavioral therapy that promotes the reduction of social anxiety and gradual increase of non-verbal then verbal social skills. Parents and school staff are taught how to gradually encourage full social participation in the child and to skillfully manage tantrums or avoidance behaviors.

Staff at AATC are experienced in providing the specialized help that young children with selective mutism need. We will work with you and the staff of your child’s school to develop a comprehensive program that encourages your child to overcome their social anxiety and to develop their own voice that can be heard by all. Staff will observe your child in their preschool or school setting and help you and your child’s teachers develop an individualized program that best suits your child.

LEARN MORE

For more detailed information about selective mutism and the science behind the treatment that AATC provides, visit:
Selectivemutism.org