In the next thirty days more than a thousand children will be diagnosed with a disorder that no one knew they had before, even though it already existed. The disorder is called selective mutism. It’s an anxiety disorder that first appears in childhood. It’s often not detected until the child starts school and the teacher notices something unusual.
In the first month of school it’s not unusual for young children to be shy and for some not to speak. As children warm up and become comfortable they begin to speak to other children and to the teacher. Children with selective mutism do not warm up, though. They continue to be silent at school. This usually comes as quite a surprise to parents because the children speak normally at home. In fact, parents often describe these children as talkative and even bossy at times.
In certain situations, though, these children become overwhelmed with anxiety and become mute. They go into the fight or flight mode because of the intense anxiety they feel. They often then appear frozen when spoken to, especially when spoken to by an adult.
This disorder is frequently misdiagnosed initially. It can look like the child is on the autism spectrum because of the frozen stance and the lack of speech. It can seem defiant or oppositional. Some may think the child is “just shy” and will outgrow it. Parents will ask, “Why don’t you talk?” and will try to bribe the child to talk. Both of these strategies will only make the problem worse.
The key to helping the selectively mute child is early intervention with a specialist. In addition to taking a thorough history from the parents, I like to get information from the teacher and I like to see a video of the child playing normally at home. This helps me rule out other diagnoses like Autism or Aspergers. Then together the parents, teacher and I work to develop a plan to help the child overcome the anxiety associated with school and other social settings.
For more information and for early intervention visit www.selectivemutism.net, www.selectivemutism.org, or www.selectivemutismcenter.org.
