Selective Mutism

DEFINATION: Selective Mutism (previously called Elective Mutism) occurs when a child persistently fails to speak in certain social situations where speaking is expected

EXPLANATION:  A child who speaks at home when with family members but will not speak at all to teachers or peers at school may have Selective Mutism. According to DSM criteria, symptoms  must last at least one month, and it must be clear that affected children’s refusal to speak is not the direct consequence of some other disorder before the diagnosis of Selective Mutism can be made.

The course of Selective Mutism is variable. Some children will remain selectively mute over years, while others will start talking after a few months.

PREVALANCE: Research suggests that that Selective Mutism is a rare condition. According to the DSM, the less than 1% of children treated by mental health professionals are diagnosed with this disorder. Between 0.03% and 0.02% of the general population of children seem to have Selective Mutism.  These prevalence data may not be entirely accurate because the general public is unfamiliar with the problem. As a result, some children with Selective Mutism may go undiagnosed and untreated.

SEX BIAS: Both boys and girls are develop the condition, but slightly more females are diagnosed than males.

AGE OF ONSET:

ETIOLOGY:

CLASSIFICATION:

SIGNS AND SYMPTOMS: The diagnostic assessment for children suspected of having Selective Mutism is likely to include behavioral observations to document that the child is capable of fluent speech, as well as a hearing evaluation.

  • Selective Mutism appears to be a form of anxiety disorder.
  • Child may refuse to speak in selective social situations,
  • Child often demonstrates shyness, anxiety, and fear of embarrassment and expects negative evaluation.
  • Child may isolate himself socially, withdraw from peer interactions, or cling to parents and other “safe” figures.
  • Frequent temper tantrums and other negative or compulsive and controlling behaviours are shown.
  • Some children engage in oppositional behaviours, especially within the home.
  • Children with selective mutism may substitute gestures and other non-verbal forms of communication for spoken language.

ASSOCIATED PROBLEMS: Children whose mutism remains persistent may eventually be diagnosed with one or more adult anxiety disorders.