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Selective mutism is when a child can’t speak in certain settings, but can speak fine in others. For example, a child may not be able to speak at school, but can speak with no problem at home. It is called selective mutism because the child is only mute in select situations. It’s a rare childhood condition. It can cause problems with school and social situations.
A child with selective mutism may find certain social situations very stressful. This may cause anxiety so severe that the child feels unable to speak. Selective mutism is not caused by a child’s willful refusal to speak.
In some cases, a child may have other speech problems as well. But in many cases, a child may not have any trouble at all when he or she feels comfortable.
Selective mutism often begins in very young children, around ages 2 to 4. But it may not be recognized until a child starts school.
There is no single known cause of selective mutism. Researchers are still learning about factors that can lead to selective mutism, such as:
Selective mutism can also run in families.
The main sign of selective mutism is a month or more of failure to speak only in certain social situations. The problem is not due to another communication disorder, such as autism. And it is not due to not knowing the spoken language.
Some children with selective mutism may show additional signs, such as:
Your child’s healthcare provider will ask you about your child’s medical history and signs and symptoms. You’ll be asked about your child’s speech and language development. It may help to bring your child’s academic reports and teacher comments to the appointment. Your child’s healthcare provider might want to observe your child at home and at school. You may be asked to record videos of your child at home or school.
Your child will be given a medical exam. This will include an exam of your child’s ears, lips, tongue, and jaws. Your child may also have a neurological exam. He or she may also need a hearing test. The healthcare provider will look to rule out other medical conditions, such as schizophrenia.
Other healthcare providers may help assess your child. These may include a speech-language pathologist (SLP), and a psychologist or psychiatrist. An SLP can assess your child’s ability to understand and use language. A psychologist can help find emotional issues that may cause the condition.
Treatment varies based on the needs of your child, and may include:
With treatment, a child is likely to stop having selective mutism. With no treatment, the speaking problems are more likely to continue.
It’s important to remain patient with your child. Remember, your child is not choosing to not speak. Your child is too anxious to be able to speak.
For the best outcome, stay closely involved with your child’s therapy. You may be able to find ways to structure situations outside the home that can increase your child’s communication. Work closely with your child’s teachers.
For more resources, contact The Selective Mutism Group at www.selectivemutism.org. It is a nonprofit group that gives support to families dealing with selective mutism.
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