Selective Mutism
Selective mutism is a kind of anxiety disorder in which an individual cannot communicate verbally in some social situations; for example, with relatives and classmates, they don’t see much. It typically starts in childhood, and if it gets untreated, the diagnosis leads into adulthood. An individual with the condition will not choose to stay silent in events; rather, they cannot speak.
The expectation of communicating with some people may trigger a freeze response through stage fright or panic, in which talking becomes impossible.
With time, the individual may learn to anticipate the condition which may provoke such distressing reactions, and they may try to do things to avoid such conditions. However, individuals with selective mutism can speak with no hesitation to people like friends or family when there is no big trigger.
Selective mutism may impact around 1 in 140 pediatric patients. It is a condition more common in children trying to learn a second language and girls.
Table of Contents
What Are the Signs of Selective Mutism?
Selective mutism typically initiates in early childhood in ages 2 to 4. It is typically observed when the child interacts with people other than family, such as in school. One warning indication is the child’s inability to engage with people with frozen facial expressions and sudden stillness when the children are expected to communicate with other people outside of their comfort zone.
They might try avoiding eye contact and may appear to be:
- Uneasy and socially awkward
- Sulky or rude
- Clingy
- Withdrawn and shy
- Tense or poor coordination
- Aggressive and stubborn with temper tantrums as they arrive from school
- Easy communication with other children having selective mutism
- However, children who are more severely affected may try avoiding other communication forms like written texts as well
- Some children might appear to respond using some words or speak in a whispering voice.
What Are the Causes of Selective Mutism?
Selective mutism comes as a phobia related to talking to other individuals. The right cause is not clear as always; however, it is linked with anxiety. Children may tend to anxiety and may have difficulty participating in everyday events.
Many children may get distressed to speak up as they separate from their home and then project this anxiety to other adults who try settling them. Given a speech disorder, speaking maybe even more stressful.
Some children might see a challenge processing information like jostling and loud noises, called sensory integration dysfunction. It may make them shut and become unable to communicate as they get overwhelmed in a rush surrounding them. What’s more, the anxiety may get transferred to other individuals in the environment. There is found to be no evidence suggesting children having this condition have a higher chance of having experienced neglect, trauma, and abuse.
When selective mutism occurs because of post-traumatic stress disorder, it comes with a unique pattern in which the child stops communicating verbally in the environment in which they didn’t communicate in those environments in which they did not have any difficulty. However, this speech withdrawal might lead to this condition if the triggers are not addressed, and then the child gets some communication anxiety.
There is another misunderstanding that a child with such a condition is manipulative or autistic. However, it is found there is no relationship between autism and mutism.
How to Diagnose Selective Mutism?
If left untreated, it is a condition that may lead to problems such as low self-respect, isolation, and even social anxiety disorder. It may progress to adulthood if the condition is not managed. A child may overcome the condition if it gets diagnosed earlier and is managed appropriately.
The condition needs to get diagnosed so that the family and the schools may work together to reduce the anxiety of the child. School staff and families may get training for the child to get the appropriate expertise for tackling the condition of the child.
If the child is suspected of getting selective mutism and there is no help around, or there are some other problems like your child cannot comprehend routines or instructions, then get an appointment with a language and speech therapist.
How is Selective Mutism Diagnosed in Adults?
The adults can overcome the condition of selective mutism. However, they might continue experiencing the practical and psychological effects of spending years with no social interaction or not being capable of getting the most out of their occupational or academic potential. A mental health therapist may see adults with the accessibility of support from a professional such as a language and speech therapist.
How is Selective Mutism Treated?
With the right treatment and care, most children can overcome selective mutism. However, when they age and are diagnosed later in life, their healing time will also get affected. The overall effectiveness of the option of treatment depends on the following things:
- How long the individual has had selective mutism
- Whether or not the individual has some additional learning or communication difficulties
- The overall cooperation of people involved with their family life and education
- Treatment doesn’t focus on speaking but alleviating the anxiety linked with speaking
It starts by, first of all, removing all the pressure on the individual to speak. They then need to gradually progress through different relaxing techniques and then move to say single sentences and words before communicating with multiple people in all kinds of settings.
The overall requirement for treatment may be avoided if the staff and the family in the early years work in combination to alleviate the child’s anxiety by creating a positive environment for the people. It eventually means:
- Not enabling the child to acknowledge the anxiety
- Reassuring the children, they will be able to communicate freely when they get ready
- Focus on having fun
- Praising all kinds of struggles the child makes to interact with other individuals, like taking and passing toys, pointing and nodding
- Not showing any kind of surprise when the children may speak, however, responding warmly as you would respond to any normal child.
Older children might require some individual support as well to battle their anxiety. Some of the most effective treatment types include behavioral therapy and cognitive behavioral therapy.
How Does CBT Help in Selective Mutism?
Cognitive Behavioral Therapy or CBT aids a person in focusing on how they think regarding themselves, the area around them and all other people, and how their overall perspective of such things influence their overall feelings and thoughts. CBT, in addition, also challenges the preconceptions and the fears with the graded exposure technique. Mental health professionals are trained to give CBT to patients, especially older children and adults with mutism and anxiety disorder.
Some young children might also get an advantage from CBT approaches to support their overall wellness. For instance, it might involve getting to know about anxiety and acknowledging how it impacts their behavior and body, and learning various coping schematics and anxiety management techniques.
How Is Behavioral Therapy Helpful for Mutism?
Behavioral therapy is created to reinforce helpful behaviors by replacing bad habits with good habits. Instead of examining the thoughts and past of the person, the therapy helps combat the present difficulties and challenges with a slow step-wise approach to overcome fears.
What Are the Techniques for Selective Mutism?
There are different behavioral therapy and CBT techniques, which may be useful to treat selective mutism. These techniques might be used simultaneously by people, staff, or family members under the guidance of a professional such as a language and speech therapist.
What is Graded Exposure for Selective Mutism?
Graded exposure is a technique in which the triggering factors for anxiety are addressed. The anxiety linked with such factors is decreased with repeated exposure and setting realistic targets. Adults and older children are appreciated to work on the different causes and situations triggering anxiety.
What Is Stimulus Fading for Selective Mutism?
Stimulus fading is a condition in which an individual with selective mutism can communicate with a person, such as a parent, when nobody is around. Then, there is an entry of a third person in that meeting – as they are talking, the parent goes away.
What is Shaping for Selective Mutism?
Shaping is a technique in which the individual can produce a response for showing positive behavior. For instance, reading aloud with interactive reading sessions and games helps in healthy two-way communication.
Final Word
These are some important points and details about selective mutism. With timely management and care, a patient with selective mutism can get positive results.
Originally posted 2022-02-15 21:24:23.
Megan Santiago
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