Selective Mutism

What is it?

Selective Mutism is one of the various types of specific phobias, within the spectrum of anxiety disorders that children and adolescence can develop in regard to speaking out in particular social situations. The characteristics of Selective Mutism are very closely aligned with the symptoms of social phobia, as children appear to hold an intense fear of certain social interactions and communications for fear of being judged negatively or embarrassed. Selective Mutism may be more easily identified as an extreme case of childhood shyness or timidness, and while it may seem harmless in the short term, if it is not treated early, the disorder can inhibit the development of essential communication skills in their future years in adolescence, and in their adult life – only creating a much larger problem to untangle down the track.

What are the signs and symptoms?

The symptoms of Selective Mutism vary across individual children, but the most common characteristics are identified in their behavioural symptoms, such as:

  • Extremely shy behaviour and an inability to communicate properly around others apart from limited few (eg: family or other people the child feels comfortable around)
  • Fear of and inability to speak in particular social settings such as: school, day care, birthday parties, play dates, or extended family gatherings or celebrations
  • Social withdrawal
  • Lack of eye contact & poor body language when communicating with others
  • Clingy behaviour to parents including tantrums when having to separate from them or when confronted with their feared social situations (usually occurring at home)
  • School refusal
  • Blushing, looking down, freezing, or exhibiting other symptoms of extreme distress when confronted with speaking in social situations

How do we treat Selective Mutism?

Treatment for Selective Mutism involves Cognitive Behavioural Therapy (CBT), where the child and their parents are guided with the help and support from an experienced psychologist in the field. The first step of CBT involves identifying the child’s negative thoughts and beliefs causing their Mutism behaviours. Following this, the child is re-educated on alternate ways of thinking to replace their old negative thoughts with new, more realistic ones.

A big part of CBT involves GRADUAL exposure therapy – meaning that the child’s fears are tested in real life, in order to prove to them that their engrained, negative thoughts are incorrect and do not result in the outcomes that have become engrained in their belief system over time.

Importantly, parents are not the only ones who need to be involved in the child’s therapy – it is essential that school teachers are kept in the loop and made aware of the situation so that they can facilitate and support the child’s treatment plan. It is also critical for teachers not to punish the child for their Mutism behaviour as this can only exasperate the problem. Teachers should instead try to encourage communication opportunities in the classroom, by prompting more conversational and open-ended questions with the child, aiming to prevent short one worded answers.

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