There are multiple reasons why a child may be quieter than his (or her) peers. Due to natural variations in personality, some kids need a bit of extra time to warm up to new people and situations – a trait known as shyness. For others, social settings are a source of chronic and severe anxiety, to the point where the child has difficulty attending school or forming friendships. Much more rarely, interacting with others is so overwhelming and distressing for a child that it interferes with the ability to speak. Kids in this category suffer from a rare, complex, and poorly-understood condition called “Selective Mutism,” which affects just under 1% of the population. Unlike shyness, which kids can overcome with parental support and the use of confidence-boosting techniques, Selective Mutism requires treatment from a mental health professional.
What is Selective Mutism?
Selective Mutism is a type of anxiety disorder that affects a child’s ability to speak in some situations but not others. Kids with this disorder often express themselves well at home while being unable to converse in unfamiliar situations or in settings they perceive to be stressful, such as at school. Because kids with Selective Mutism can speak fluently when they’re at ease, they’re often incorrectly labelled as shy or defiant. In reality, however, these kids have no control over when they can and cannot speak.
Selective Mutism usually develops early in life (before age 5), though it sometimes only becomes evident after a child starts attending school. Some signs that a child has Selective Mutism include:
- Appearing frozen or unresponsive when asked to engage in conversation.
- Displaying unusually rigid posture, or appearing tense or poorly coordinated.
- Fidgeting, avoiding eye contact, or looking startled when asked questions.
- Having delayed or insufficient responses in social situations.
- Strongly preferring to use gestures, such as nodding or pointing, to communicate. (More rarely, kids with Selective Mutism mumble or make sounds, like “Hm” or “Uh-huh,” rather than forming complete words.)
- Displaying “clinginess” with parents in unfamiliar situations (especially after age three).
For a diagnosis of Selective Mutism to be made, the child must display these symptoms for longer than one month. Likewise, the child’s symptoms must not be better explained by another condition (e.g., Autism Spectrum Disorder), a physical inability to speak, or a stressful life event.
Are Selective Mutism and Social Anxiety the Same Thing?
Current research suggests that Social Anxiety and Selective Mutism are two distinct but interrelated conditions that often occur together. Close to 40% of kids with Selective Mutism also have Social Anxiety Disorder, and 33% of kids with Social Anxiety Disorder also display mild speech problems (usually in the form of stuttering). There are, however, several notable differences between Social Anxiety and Selective Mutism:
- Kids with Social Anxiety are more likely to experience somatic symptoms, such as frequent stomachaches and headaches.
- Kids with Selective Mutism have a higher rate of speech abnormalities (e.g., language delays, speaking too quietly or not enough, problems processing speech).
- Selective Mutism typically has an earlier age of onset than Social Anxiety.
- The anxiety experienced by children with Selective Mutism is more situation-specific than the anxiety experienced by children with Social Anxiety alone.
- Kids with Selective Mutism usually score higher on levels of behavioural inhibition (the tendency to react to unfamiliar situations with distress and withdrawal) than kids with Social Anxiety.
Because there is such a high rate of overlap between Selective Mutism and Social Anxiety, it’s important to ensure your child is screened for both conditions if he (or she) is extremely hesitant to engage socially.
What Causes Selective Mutism?
Selective Mutism appears to have a strong genetic component. Many children with this condition have a family history of anxiety disorders, and they often begin displaying multiple signs of anxiety (such as separation anxiety, mood swings, rigid behaviours, sleep problems, and social withdrawal) at a very early age. Researchers believe that kids with Selective Mutism may have increased sensitivity in the amygdala, the part of the brain that regulates the fear response, which causes their brains to misinterpret social situations as a type of threatening stimuli. Unlike Traumatic Mutism, Selective Mutism isn’t linked to early childhood trauma or neglect.
The hypothesis that Selective Mutism arises from differences in the brain (rather than environmental factors) is supported by the fact that 20-30% of children with this condition also have sensory or language processing disorders. Kids with Selective Mutism have much higher rates of Sensory Processing Disorder, Auditory Processing Disorder, and language delays than the general population, for example. These disorders may contribute to the child’s anxiety about speaking and social situations, making them more susceptible to developing Selective Mutism.
How is Selective Mutism Different from Being Shy?
Because shyness and Selective Mutism both arise from having an inhibited temperament, they can sometimes appear similar. However, kids with Selective Mutism experience a much greater level of disruption to their daily activities. Unlike shy kids, who warm up to new people (and situations) over time, kids with Selective Mutism remain “stuck” in a partially nonverbal state that limits their ability to make friends, excel at school, and achieve their goals. Selective Mutism can even put kids in danger by reducing their ability to ask for help if they’re lost, ill, or hurt.
To determine whether a child is just shy or selectively mute, pay attention to the following patterns:
1. How the child responds to questions.
Shy children are typically capable of answering questions, even though they may speak more softly than other children or use fewer words. Kids with Selective Mutism, on the other hand, cannot respond at all in certain situations (such as when they’re at school or surrounded by unfamiliar people).
Similarly, shy kids usually don’t struggle to answer basic questions; they can provide their age, name, birth date, etc., with little hesitation. For kids with Selective Mutism, even these simple inquiries can be overwhelming and cause the child to “shut down.”
2. The type of situations that trigger silence.
Shy kids tend to “clam up” when they’re around unfamiliar adults, during group activities, and after they have had a stressful day. At the same time, however, they’re capable of warming up to other kids their own age relatively quickly, especially when they’re allowed to interact one-on-one or in small groups. This typically isn’t true for kids with Selective Mutism, who may struggle to speak to other children and fail to become comfortable with unfamiliar adults, even after months of positive contact.
3. The degree of difficulty speaking.
Shy kids can speak up when they need to (such as when they require help), but often prefer to use text, email, and other means of nonverbal communication. For kids with Selective Mutism, silence isn’t a choice; many kids with this condition desperately want to make friends or express their needs but find themselves unable to do so.
How Can You Help a Child Struggling With Selective Mutism?
The first and most important step to helping a child with Selective Mutism is to seek therapy from a child psychologist with experience treating this condition. Kids don’t “outgrow” Selective Mutism, and unlike shyness, it can lead to long-term emotional, psychological, and social difficulties. In addition to the high rates of overlap with other anxiety disorders, kids with Selective Mutism face a significant risk of developing depression, low self-esteem, and other problems related to social isolation. The earlier your child receives treatment, the better the chances are of them making a complete recovery from Selective Mutism.
Some other tips for supporting a child with Selective Mutism include:
1. Never try to make your child speak.
Feeling pressured to speak will only increase your child’s anxiety about talking. Help your child feel safe and relaxed in social situations by empathizing with their feelings of fear and working together to find coping strategies. Use positive parenting techniques to reinforce your child’s successes.
2. Find ways to help your child socialize comfortably.
Many kids with Selective Mutism have a much easier time communicating in environments where they feel safe, such as the home. With your child’s permission, try inviting other children over for playdates, so your child can interact with his (or her) peers outside of school.
Another way to help your child feel less anxious about socializing is to choose activities that don’t involve a lot of speaking. For instance, you might suggest that your child watch a movie with a friend or play a video game together. For younger kids, try setting up nonverbal games like charades or treasure hunts.
3. Give your child extra time to prepare for social situations.
Try rehearsing social situations at home to allow your child to practice formulating responses while he (or she) is relaxed. Arrive early to social events so your child can ease into the situation, and have a system in place for coping with stressful moments, such as taking a brief “time out” or using deep breathing techniques.
4. Discuss your child’s condition with their relatives and educators.
Letting other people know that your child has Selective Mutism can prevent them from mislabeling your child’s behaviour as defiant, obstinate, or shy. You can also collaborate with educators to develop a system where your child can use gestures to communicate if needed. (For example, using a thumbs up or thumbs down to answer questions, or having a special hand signal your child can use to ask for help.) However, try to avoid speaking for your child (or allowing others to speak from them); this can remove your child’s sense of agency and reduce the likelihood that they’ll become a more confident communicator.
5. Work closely with your child’s therapist to set and achieve goals.
Though it’s crucial to avoid pressuring selectively mute kids to speak, it’s equally important that you don’t inadvertently reinforce muteness over time. Form a structured treatment plan with your child’s therapist that involves gradually stepping your child out of their comfort zone through techniques like exposure therapy, “fading,” and behaviour shaping. These types of therapy are proven to help kids with Selective Mutism make steady, consistent, and lasting progress against their disorder.
By providing your child with the treatment, tools, and support they need to overcome Selective Mutism, you’ll give them the gift of self-expression. Throughout the treatment process, your child will also learn valuable coping tools that reduce anxiety in many other areas of life. Together, these developments will ensure your child grows into a confident, happy young adult.
