Is Your Child Just Shy — Or Is It Selective Mutism?
If your child is bubbly at home and silent in public, she may have selective mutism. Early diagnosis is critical to improve symptoms and treat social anxiety.
Has a teacher reported that your child does not speak readily at school? Does your talkative, bubbly child suddenly clam up with you walk into a larger family gathering or into her dance class?
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If your child is a completely different person at home than she is in other social settings, she may have selective mutism. Selective mutism is often misunderstood and can be misdiagnosed, but early detection and treatment is crucial to better outcomes down the road.
Selective mutism was always believed to be rare, however more children may meet the criteria of a diagnosis than previously thought.
Child psychologist Kristen Eastman, PsyD, says that in the past, children who were thought to be “just shy” or “defiant” for not talking may actually meet the criteria for selective mutism. Many seemed to think that a child would “grow out of” the behavior, which is not always the case.
What may appear as “just shyness” actually has its roots in anxiety, specifically an underlying fear of the expectation to talk, she says.
“Shy kids may not volunteer to read aloud to the class, but when they need to do things, they can,” Dr. Eastman says. “The main difference is that shy children function, whereas children with selective mutism cannot.”
A child with selective mutism may not communicate in select social settings (often school), but he or she can comfortably talk in at least one other place (typically home).
Both girls and boys can be affected, though the condition tends to impact girls more than boys. The average age of onset is under age 5, but it is often more evident when a child enters a structured social setting (such as preschool or daycare).
Children with selective mutism are overcome with anxiety at the prospect of giving a book report, saying hello to a classmate or talking with their coach at soccer practice. So they’re rendered frozen and unable to initiate and/or respond. Because of this, their experience at school and in other social settings may be hindered, teachers may be unable to assess them and they may struggle socially.
Selective mutism can look different depending on the child:
It’s important to understand that there’s much variability in how it appears — from day to day, from person to person and from setting to setting. These are all examples of selective mutism.
Watch for these signs of selective mutism:
It’s important for parents to trust their instincts. If you feel like your child is acting very differently in select social settings outside of your home, and/or with select people, it is important to talk to your doctor.
“The earlier you can make a diagnosis and start intervening, the better the prognosis long-term,” Dr. Eastman says.
Dr. Eastman says that when she works with children with selective mutism, her goal is “to help the child to start associating social settings with less anxiety and increased comfort as soon as possible.”
She suggests the following initial strategies:
Don’t avoid placing demands on the child or avoid social situations because of your child’s selective mutism. It is important to realize that a child with selective mutism won’t improve while sitting at home with her immediate family, as she is already comfortable and talking here.
Though dealing with the problem may seem stressful at first, your child’s anxiety will reduce with time and you will see progress, Dr. Eastman says.
Talk with your physician who can help you create a plan of action. Selective mutism typically does not go away on its own, and in fact can lead to worsened anxiety and social difficulty if not addressed. Treatment requires a cohesive plan between home and school to produce lasting change.