Selective Mutism

Some children are uncomfortable speaking in unfamiliar situations or with people they don’t know. They usually start talking when they feel more comfortable. Children with selective mutism have repeated difficulty speaking, or seem afraid to communicate, at certain times or in certain places. Selective mutism might continue into the teenage years and adulthood. Help is available.

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About Selective Mutism

A child with selective mutism will talk at some times and in some places but not in others. This might start when a child goes to school but may start at a younger age. Selective mutism may also continue into adulthood.

Signs of Selective Mutism

If your child has selective mutism, you may notice the following things:

  • They will not speak in certain places or situations, such as in class or in front of certain people. This will happen every time they are in that situation. Your child will talk at other times and in other places.
  • Not speaking gets in the way of school, work, friendships, or relationships.
  • This difficulty talking lasts for at least 1 month. This time period does not include the first month of school because children may be shy and may not talk right away.
  • Your child can understand and speak the language used in this specific situation but is still not talking. Sometimes children don’t speak when people are using a language they are less familiar with but do speak when people are using a language they know. This is not selective mutism.
  • Your child’s mutism cannot be explained by conditions such as autism, stuttering, or mental health disorders.

Causes of Selective Mutism

There is no single cause for selective mutism. Many factors play a part in selective mutism, such as

  • having an anxiety disorder or a family history of social anxiety or selective mutism,
  • being very shy or afraid to embarrass themselves in public, or
  • wanting to be alone and not talk to friends or other people.

Testing for Selective Mutism

Talk to your doctor if you have concerns about selective mutism. The doctor may refer your child to a psychologist or psychiatrist to see if they have anxiety. A speech-language pathologist, or SLP, can test your child’s speech and language.

Speech and language testing may include the following:

  • Having your child’s hearing screened
  • Seeing how well your child’s lips, jaw, and tongue move
  • Seeing how well your child understands what others say to them
  • Talking with you about when and where your child speaks or doesn’t speak
  • Listening to how well your child says words, answers questions, and talks about their ideas
  • Seeing how well your child communicates ideas and needs without speaking, such as their use of gestures, writing, or facial expressions

Some children will not talk to the SLP. If that happens, the SLP may ask for video or audio recordings of your child talking or may ask to watch you and your child interact.

Treatment for Selective Mutism

Each person with selective mutism works on different skills. Your doctor may suggest medication. SLPs will work to get your child more comfortable talking in different situations.

To help your child become more comfortable with talking, the SLP may use the following techniques:

  • Stimulus fading. The SLP slowly introduces your child to situations that they are less comfortable speaking in. Your child may be with someone they talk to easily at first. Then, a new person may slowly join in. This will help your child get comfortable with new situations.
  • Shaping. The SLP will praise or give rewards to your child for trying to communicate. Your child may first only point or use other gestures. Then, they may say the word silently or in a whisper before they say the word out loud. The goal is for your child to speak in many situations.
  • Self-modeling technique. The SLP may ask you to take videos or audio recordings of your child talking in a comfortable situation. These clips can then be played in places or situations where your child is usually uncomfortable speaking. The SLP may also edit to show your child speaking in challenging situations or environments. This may help your child feel more comfortable speaking after “seeing” themselves successfully talk in that new situation.

The SLP may also work with different people in the places where your child has trouble speaking. These people may include your child’s teachers, counselors, coaches, or family members. The goal is for your child to be comfortable talking in many situations. The SLP will also work with your child if they have trouble saying sounds or words, if they have problems explaining their ideas, or if they don’t like the sound of their own voice.

To find a speech-language pathologist near you, visit ProFind.

Other Resources

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