Selective Mutism

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What is selective Mutism?

This is a disorder in which children completely avoid speaking in certain situations (e.g. school).

What are the Signs & Symptoms of Selective Mutism?

The problem usually starts between 2 to 3 years of age although help is often sought out around 5 to 6 years of age. According to Dr. Kurtz, “ the lag time is a real problem—the condition is there and continue to get worse.” Help is generally not sought out in time and the child may continue to stop speaking in other situations as time continues to pass. Selective mutism should not be confused for a speech delay or an auditory processing disorder. Children with selective mutism can be right on target with their speech and language skills. Common symptoms include:

  • consistent failure to speak in specific social situations (in which there is an expectation for speaking, such as at school) despite speaking in other situations.
  • lasts at least 1 month (not limited to the first month of school).
  • not due to a communication disorder (e.g., stuttering). It does not occur exclusively during the course of a pervasive developmental disorder (PPD), schizophrenia, or other psychotic disorder. (ASHA.ORG)

What are the Causes of Selective Mutism?

            There is a strong genetic component to selective mutism, with about 75% of children having one parent with an anxiety disorder. The child who feels anxious in a new or unexpected situation may feel as if they are unable to speak. Often, the adult will try to “help” and speak for the child further perpetuating the issue. The child then may make non-speaking a habit.

How is Selective Mutism Diagnosed?

            A child with selective mutism should be diagnosed by a Speech-Language Pathologist (SLP). They will work with a team such as teachers, psychologists, and psychiatrists.

What type of treatment is available for treating Selective Mutism?

            The type of treatment will vary depending on the needs of the person and his/her family. The SLP may create a behavioral program and address speech and language needs accordingly.

A behavioral treatment may include:

  1. Stimulus fading: involve the child in a relaxed situation with someone they talk to freely, and then very gradually introduce a new person into the room.
  2. Shaping: use a structured approach to reinforce all efforts by the child to communicate, (e.g., gestures, mouthing or whispering) until audible speech is achieved.
  3. Self-modeling technique: have child watch videotapes of himself or herself performing the desired behavior (e.g., communicating effectively at home) to facilitate self-confidence and carry over this behavior into the classroom or setting where mutism occurs. (ASHA.org)

A speech/language program may include:

  1. Targeting issues that are making the language behavior worse.
  2. Using role-play: this will help the child gain confidence in different speaking situations.
  3. Help children who do not speak because their voice sounds different or they are uncomfortable with their voice.

 

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