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If you have an inability to speak specifically in certain contexts and with certain people, you may have selective mutism, a condition more common in children. Here we explain what selective mutism is and how to get help.
What is selective mutism?
Selective mutism is an anxiety disorder that usually affects children, where people who otherwise have the ability to speak do not speak in certain social situations or with certain people. It is important to note that selective mutism is not an inability to speak, but rather an inability to speak in certain contexts or with certain people. For example, inability to speak or school, but the ability to speak fluidly at home.
What causes the diagnosis?
It is a combination of several factors that cause the condition and it can be linked to genetic, biological and environmental factors. If you suffer from social anxiety, this can be an underlying factor.
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Selective mutism in children
In Ireland, selective mutism affects about 1 in 140 young children and is more common in girls. It is a real problem and cannot be controlled at will. The child can sometimes communicate by nodding, using gestures or writing notes. It can be triggered by stressful events such as a move or a change in preschool and is more common in cases of autism, cognitive difficulties and if a child is multilingual.
As selective mutism is considered an anxiety disorder, there may be co-morbidity with social anxiety, generalised anxiety disorder (GAD), separation anxiety, agoraphobia, panic disorder or specific phobias.
Selective mutism and social anxiety
The diagnosis has much in common with the anxiety disorder social phobia. What distinguishes them is that there are more physical symptoms with social phobia. The diagnosis also means that people are more likely to have language disorders. The situations that trigger anxiety also differ between the syndromes, with social phobia causing anxiety in more situations and the onset often occurring at a later age. But there are similarities between the syndromes.
Autism and selective mutism
There are similarities between selective mutism and autism, but what distinguishes them is that people with autism have difficulties in all social situations, whereas someone who does not speak can function socially in some social situations. In autism, you may have difficulty understanding social situations, but not in selective mutism.
Selective mutism language disorder
Selective mutism can sometimes be interpreted as difficulties with speech, but it is not a language disorder. You can speak in some contexts while remaining silent in others. School staff may need support from BUP or a speech therapist to deal with these children or students.
Help with selective mutism
Anxiety disorder is a common and treatable problem. Seek help today to help reduce your symptoms.
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Symptoms of selective mutism
The diagnosis can develop at an early age and is often noticed in pre-school. You might think that the child is just shy, but if it doesn’t improve after a month, it could be selective mutism. Some of the symptoms are:
- Silence in specific situations: People with the diagnosis are silent or communicate by nodding or using body language in certain social situations or with certain people.
- Often visible in childhood: Symptoms usually appear in childhood, for example at school.
- Related to anxiety: Selective mutism is closely linked to anxiety.
- 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 you may also need more support. The earlier you get help, the better. Treatment may include CBT, relaxation exercises and social skills training. There is little scientific support for drug treatment.
Speech therapy for selective mutism
If you are a parent of a child, you can seek help from a speech therapist. The treatment involves changing the attitude of the environment and thus gradually getting the child used to taking up space, talking to others and taking the initiative to speak.
How therapy can help with anxiety
Talking to a licensed psychologist can give you tools to understand and manage symptoms. This can help you overcome the condition and improve your quality of life.
First steps to change
You can always book a 20- or 45-minute session with our therapists and psychologists. We are here, ready to make the difficult easier.
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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 often develop in childhood and are similar to anxiety disorders. You may talk to people with whom you feel more comfortable but become silent in other contexts.
How is selective mutism different from social phobia?
Social phobia has more physical symptoms, anxiety in more contexts and a later age of onset, while someone who doesn’t speak more often has a language disorder.
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 around 1 in 140 young children in Ireland.
What is the difference between autism and selective mutism?
There are similarities between selective mutism and autism, but what distinguishes them is that autism has difficulties in all social situations, whereas someone who does not speak functions socially in some social contexts.
How can selective mutism be treated?
Treatment may include Cognitive behavioral 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 problems.
Can a speech therapist help with selective mutism?
If you are a parent of a child, you can seek help from a speech therapist. The treatment involves changing the attitude of the environment and gradually getting the child used to taking up space, talking to others and taking the initiative to speak.
Can you have other mental health problems at the same time?
Selective mutism is considered an anxiety disorder and often there can be co-morbidity with social anxiety, generalised anxiety disorder (GAD), separation anxiety, agoraphobia, panic disorder or specific phobias.
How much does a treatment at Lavendla cost?
At Lavendla, the therapists and coaches set the price themselves. On the first occasion you meet, it usually focuses on getting to know each other, defining the challenges that exist and then setting up a plan for how you will work together to achieve the goals.
Where can I go if I need help?
At Lavendla, we have experienced psychologists and therapists working with CBT who can help you feel better.
What does treatment for selective mutism involve?
Seeking help is a big step towards better health, it’s a positive thing to decide to take control of how you feel. Here is an overview of the steps usually involved in CBT treatment.
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 goals for the therapy, both short and long term.
It can define 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 the problem you are suffering from.
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.
If you or someone close to you is seeking professional help, do not hesitate to book a session with one of our licensed psychologists or therapists.
