Selective Mutism

A challenging yet treatable silence.

Imagine the anxiety that arises when having to give an oral presentation to an audience of 500 people. Now, can you imagine being a child living with that feeling six hours a day while at school? I can. That’s because I had selective mutism as a child. As an adult, I treat children and teens whose lives have been taken hostage by this complicated anxiety disorder. Selective mutism robs youngsters of their ability to speak in situations where speaking is expected.

Selective mutism confuses parents, doctors and school personnel alike. Certain children who are animated in the home cannot make eye contact nor say a word when approached by an adult in the classroom. Just as I knew, these children know at an early age that if they make eye contact, a question will follow.

Some selectively mute children can respond to a teacher with a one-word whispered answer if the teacher leans in closely to the child. Yet this same child would never approach another child to ask to join a group game on the playground. Instead, the child with selective mutism paces back and forth or walks the perimeter of the fence during recess. Often, these little ones sit silently at snack time or in the sweltering sun at camp unable to ask for a drink of water when parched with thirst. They are invisible because they are silent. They have learned to dodge questions from others. I know because I’ve been in their shoes.

Selectively mute children may writhe and contort themselves with discomfort as they avoid the bathroom in school. After all, they can’t ask to go to the bathroom. Even if they are given the opportunity to use a nonverbal means to request to go to the bathroom, many selectively mute children do not initiate communicative interactions without therapeutic assistance. And as requesting to use the bathroom with a nonverbal communication device may draw unwanted attention to selectively mute children it causes anxiety to flare among this population. Some of these children also fear that they won’t be able ask for help if they get locked in the bathroom. As such, these bright yet silent children learn as young as 3 years old to restrict their intake of fluids while outside the home in order to abstain from requesting to use public restrooms.

Are parents aware of the issue? Not likely. Selectively mute children often tell their parents that they love school, birthday parties and gatherings with peers, although these kids may not participate at all or sit rigidly for hours without smiling or laughing while away from home.

In making school site visits, I’ve noticed that classmates tend not to speak to a selectively mute child. If I urge a peer to ask a selectively mute child if she has seen a show the group has been talking about, I always get the same response, “Oh, she doesn’t talk.” The classmates continue to act on this belief and don’t talk to the selectively mute child. This denies the selectively mute child the necessary conversational practice in one’s most anxious environment— school.

A 2002 study in the Journal of the American Academy of Child and Adolescent Psychiatry put the incidence of selective mutism close to seven in 1,000, making the disorder almost twice as common as autism. Still, it can be overlooked because people generally think of a selectively mute child as totally mute. However, there is a spectrum. Some of these kids answer questions through their parents or friends. When taken from this comfortable dyad, however, these selectively mute children are unable to speak to anyone else.

Likewise, some selectively mute children can only answer a teacher’s questions in a structured setting. They cannot interact conversationally with peers, nor negotiate conflict appropriately. Meanwhile, some selectively mute children can only speak with their immediate and extended family members. While they play, laugh and converse freely with cousins and siblings, selectively mute children are at a loss with the outside world. In relation, they are unable to compete with their peers when it comes to spelling bees, oral reports, foreign language exams and sports. Selectively mute children also refrain from developing friendships and asking for playdates.

In later life, the ability to use verbal language persuasively is necessary for dating, college interviews and thriving in the professional world. Fortunately, we are living in a time when there is help and hope for selective mutism. Again, I know.

Do You Suspect Your Child Is Selectively Mute?

  • Have your child evaluated by a mental health professional experienced in anxiety disorders.
  • Educate yourself about selective mutism.
  • Talk to your child’s teacher to determine how your youngster functions in school versus at home.
  • Organize playdates among your child and another child.
  • Give your child verbal choices when asking questions in the community, such as at stores, restaurants and the movies.
  • Don’t pressure your child to speak.
  • Provide natural opportunities for speaking.