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If you find yourself unable to speak in certain contexts or with certain people, you may have selective mutism. Help is available.
What is selective mutism?
Selective mutism is an anxiety disorder where people who otherwise have the ability to speak are unable to speak in certain social situations or with certain people. This condition is most common in children. It is important to note that selective mutism is not an overall inability to communicate verbally, but rather an inability to speak in certain contexts or with certain people.
What causes selective mutism?
A combination of several factors can cause selective mutism including genetic, biological and environmental components. Co-morbid conditions include generalized anxiety disorder (GAD), separation anxiety, agoraphobia, panic disorder or specific phobias.
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Selective mutism in children
According to Anxiety Canada, less than 1% of the population experiences selective mutism. It is important to note that selective mutism is not a child simply choosing not to speak. It cannot be controlled at will. The child can sometimes communicate by nodding, using gestures or writing notes. Stressful events such as a move or a change in school can trigger selective mutism. It is more prevalent in multilingual children and children with autism spectrum disorder and cognitive disorders.
Selective mutism and social anxiety
Selective mutism has much in common with social anxiety. What distinguishes them is that social anxiety usually manifests with more physical symptoms. The situations that trigger anxiety also differ between the two conditions, with social anxiety causing fear and worry in more situations and the onset often occurring at a later age.
Autism and selective mutism
There are similarities between selective mutism and autism. However, the main distinguishing factor between the two conditions is that people with selective mutism can communicate verbally in some, but not all situations. If an autistic person has difficulty or does not communicate verbally, this will usually apply to all situations, not just select ones. Additionally, in autism, there may be difficulty understanding social situations, but not in selective mutism.
Is selective mutism a language disorder?
Although selective mutism is often interpreted as difficulties with speech, it is not a language disorder. Selective mutism is an anxiety disorder where individuals can communicate verbally in some contexts but may be unable to speak in others. School staff may need to engage speech therapy and counsellors to support students experiencing selective mutism.
Help with selective mutism
Selective mutism can be treated with therapy. Help is available!
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Symptoms of selective mutism
Selective mutism can develop at an early age and is often noticed in preschool. Some of the symptoms include:
- Silence in specific situations: People with selective mutism are silent or communicate by nodding or using body language in certain social situations or with certain people.
- Early onset: Symptoms usually appear in childhood, for example at school.
- Fear or anger: Children may appear to “freeze”, startle or react with anger when an unknown person speaks to them.
- Speech in familiar or safe environments: At home or with close friends and family, people with selective mutism often do not have difficulty speaking.
Selective mutism treatment
The symptoms can sometimes go away on their own, but may also require additional support. The earlier help is received, the better the outcome. Treatment may include behavioural therapy, relaxation exercises and social skills training. There is little scientific support for drug treatment.
Speech therapy for selective mutism
Speech therapy can be helpful for children with selective mutism. The treatment involves gradually getting the child used to taking up space, talking to others and taking the initiative to speak.
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12 common questions and answers about selective mutism
What is selective mutism?
Selective mutism is an anxiety disorder usually affecting children, where people who otherwise have the ability to speak do not speak in certain social situations or with certain people.
What are the most common symptoms of selective mutism?
The symptoms include fear or anger when spoken to in new or unknown situations, and being able to communicate verbally in some situations but not in others.
How is selective mutism different from social anxiety?
Social anxiety has more physical symptoms, and the situations that trigger anxiety also differ between the two conditions, with social anxiety causing fear and worry in more situations. The onset also often occurs at a later age.
Is selective mutism a language disorder?
Selective mutism can sometimes be interpreted as a difficulty with speech but it is not a language disorder.
How common is selective mutism?
The diagnosis affects under 1% of children in Canada.
What is the difference between autism and selective mutism?
There are similarities between selective mutism and autism, but people with selective mutism can communicate verbally in some, but not all situations. If an autistic person has difficulty or does not communicate verbally, this usually applies to all situations, not just select ones.
How can selective mutism be treated?
Treatment may include cognitive behavioural therapy (CBT), relaxation exercises and social skills training.
What are the long-term effects of untreated anxiety?
Untreated anxiety can lead to depression and other mental health concerns.
Can a speech therapist help with selective mutism?
Speech therapists can help children gradually get used to taking up space, talking to others and taking the initiative to speak.
Can you have other mental health concerns at the same time?
Selective mutism is an anxiety disorder and can co-occur with social anxiety, generalized anxiety disorder (GAD), separation anxiety, agoraphobia, panic disorder or specific phobias.
How much does seeing a therapist at Lavendla cost?
At Lavendla, the therapists and coaches set the price themselves. In general, sessions usually cost around $100-200 CAD.
Where can I go if I need help?
At Lavendla, we have experienced psychologists and therapists who can help. If you are in crisis, please call 911 or go to your local emergency room.
Treating selective mutism step-by-step
Seeking help is a big step towards better health! Here is an overview of the steps usually involved in cognitive behavioural therapy, which has shown to be effective for selective mutism.
Step 1: An initial assessment session
During the first meeting with your psychologist, an assessment is made to review your mental and physical health and how your symptoms manifest themselves.
Step 2: Goal setting
This is where you set concrete short and long-term goals for your therapy. These goals can include which areas of your life are most affected by your wellbeing and how you would like to change them.
Step 4: Treatment with different techniques and tools
This is the start of the actual treatment phase, which involves exercises aimed at giving you tools to overcome and work through your concerns.
Step 5: Monitoring and evaluation
Treatment is monitored regularly to see how well the therapy is working. If necessary, the treatment plan can be adjusted or renewed.
Step 6: Ending and looking ahead
As the therapy comes to an end, it is time to reflect on the progress made. It is also important to monitor the results over time.
A first step in seeking help
If you or someone close to you is experiencing selective mutism, do not hesitate to book a session with one of our licensed psychologists or therapists. We are here, ready to make the difficult easier.
