SELECTIVE MUTISM
Selective mutism is a severe anxiety disorder where a child or adult is unable to speak in certain social situations. It is not a choice, it is a neural response. Those suffering with the condition are literally unable to talk, rather than refusing to do so, often at great personal cost. As one young adult put it:
“It’s like that scene from Scrooge where he looks through the window and he can see people having fun being together. I’ll always be stuck outside looking in.”
“It isn’t me. I know who I am and I’m not shy or quiet, maybe that makes it harder. When I’m with my parents I can be myself but around everyone else it’s like it [selective mutism] takes over. I can get the words in my head but something won’t let me say them and the harder I try the more of a failure I feel like when I can’t.”
It is estimated that one in 140 young children have selective mutism (SM) in the UK. It is more common in girls and in children of ethnic minority populations. Studies have shown that over 90% of children with SM have Social Anxiety Disorder, also known as Social Phobia. This results in a partial or complete withdrawal from social contact which can lead to extreme loneliness and isolation.
The longer it goes on, the harder it becomes for the child to overcome as they feel trapped in the identity of someone who does not speak. Young adults who suffer from this condition describe feeling as if they are imprisoned in their own bodies, unable to communicate. If left untreated, it can continue into adulthood and lead to other anxiety disorders and depression, impairing life in and outside school and work, to the extent that people can become virtually housebound.
Sometimes, it isn’t just speech that’s affected, it’s any form of communication, even gestures or a handshake. Children and young adults suffering with this condition are hyper-vigilant, anxious about attention, worried about doing something wrong or getting told off. Physical proximity and direct eye contact can also be triggers. Their whole body may stiffen or freeze, their faces blank, as they effectively ‘shut down’.
SM sufferers may also develop other phobias or obsessive traits.
"Having selective mutism can feel like you're living your life in a box. The box is see-through so you can see out and hear people, but you can't leave no matter how hard you try.”
Selective mutism normally develops during early childhood, when children enter new social environments - such as nursery or school - away from their immediate family. There are often specific triggers. They may have experienced traumatic social interaction in the past or they may not know why they cannot speak, or what started it.
There is usually one situation where they feel comfortable talking; this could be with a trusted adult, often a family member, or their peers, and they will talk with that person in ‘safe’ environments like the home.
People unfamiliar with the condition can misinterpret it as children being stubborn or defiant, because they know the children are able to speak in other situations and they see no obvious explanation for why they can’t talk to them. This can be difficult for family members or friends who may feel rejected or hurt. Even though SM sufferers don’t have impaired vocal cords, for them, sometimes, it’s simply impossible to talk.
“When I was at secondary school, because no one expected me to say anything it became kind of impossible to say anything, like, other kids just avoided me. Even the teachers would treat me differently.”
SM sufferers develop their own strategies for communication. e.g. asking a friend to talk on their behalf, or whispering. Some may use devices for written communication at school. Others may be happy to use gestures such as nodding or pointing.
They often have a very specific set of rules about who they will or will not speak to and they stick to these rigorously. These children are extremely sensitive and self conscious, keenly aware of the slightest pressure to speak. They are afraid of being embarrassed, judged or criticized, wary of receiving any scrutiny or attention.
The good news is that selective mutism can be completely cured, but this takes time and patience with family and school members, and trust must be built. Speech therapists usually work with the school to build a small steps plan, with the support of the child’s family or trusted adult. Cognitive behavioural therapy is often used. In cases of trauma induced mutism, children may be referred to a clinical psychologist.
More reading
This website is an extremely comprehensive resource about selective mutism with additional help and resources for parents and children.