Selective mutism (SM)
Selective Mutism (SM) is a serve anxiety disorder which prevents those affected from speaking in certain situations, such as at school or in public.
A child with selective mutism does not refuse or choose not to speak at certain times, they’re literally unable to speak.
The expectation to talk to certain people triggers a freeze response with feelings of panic, like a bad case of stage fright, and talking is impossible.
However, children with selective mutism are able to communicate clearly and effectively in settings where they feel comfortable, secure, and calm. These children will speak at home in the presence of immediate family members or with close friends.
The main characteristic of this is the marked contrast in the child’s ability to engage with different people, characterised by a sudden stillness and frozen facial expression when they’re expected to talk to someone who’s outside their comfort zone. Children experiencing Selective Mutism may not be able to give you eye contact and may seem:
- Uneasy and socially awkward
- Excessively shy and withdrawn, dreading that they will be expected to speak
- Stubborn or aggressive, having temper tantrums when they get home from school
- Frozen and expressionless during periods they cannot talk
Children with Selective Mutism may communicate using gestures – for example, nodding or shaking their head to get their message across. They may manage to respond with a word or two, or speak in an altered voice, such as a whisper.
If you believe that your child may be struggling with selective mutism, look for the following symptoms:
- Expression of a desire to speak that is held back by anxiousness, fear, or embarrassment
- Fidgeting, eye contact avoidance, lack of movement or lack of expression when in feared situations
- Inability to speak in school and other specific social situations
- Use of nonverbal communication to express needs (e.g., nodding head, pointing)
- Speaking easily in certain situations (e.g., at home or with familiar people), but not others (e.g., at school or with unfamiliar people)
Selective mutism usually occurs in early childhood and is first noticed when the child begins to interact outside the family circle – for example, when they start nursery or school. It can last a few months but, if left untreated, can continue into adulthood, although this is rare.
© University of East Anglia