Selective mutism
Selective mutism (SM) is a phobia of speaking, which is triggered by certain situations.
When the phobia isn’t being triggered, affected children or adults can speak freely. When they are unable to speak, they experience their throats feeling ‘frozen’ or ‘blocked’. Pressure to speak, even when well-meant, makes the situation worse.
Those with SM dread being expected to speak. It can have far- reaching effects into their life, and into family life. The pattern of SM will be different for each person.
SM is different to traumatic mutism, which can occur following a trauma, and typically results in no speech in any setting. Traumatic mutism is treated by mental health professionals.
The old name, elective mutism, wrongly gave the impression that speakers were choosing not to speak. There is no choice being made – ‘selective’ means ‘specific’ – unable to speak in specific situations. SM needs treatment or will persist; it doesn’t ‘go away’ following childhood.
SM can affect more than speaking – some people are too frozen to use gesture or write or use symbols when their fear is triggered.
It is estimated that about 1 in 140 young children are affected by SM.
There are online resources to explain SM such as Selective Mutism Information & Research Association (SMIRA).
Important facts
SM can be diagnosed where there is a consistent failure to speak in specific social situations in which there is an expectation of speaking (e.g. school), despite speaking in other situations. In addition:
- the lack of speech is interfering with the child’s education, social and cognitive development
- the symptoms of SM have lasted at least one month beyond the first month at school
- the child can understand spoken language and is able to speak freely in some situations
- the failure to speak cannot be better explained by a communication disorder or any other abnormality.
Children typically have no idea why they freeze in these situations, and we shouldn’t ask them why it happens. They need re-assurance that there is lots of fun they can have without speaking.
Help for SM
Speech and language therapists provide advice for children and young people, families, schools and colleges. Sometimes a specific programme will need to be put in place.
Treatment and advice will depend on the child’s age and where the difficulty with speaking occurs.
The first stage is to make sure everyone in the child’s environment understands about what SM is, and understands how to remove all pressure to speak.