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Selective mutism is a complex childhood social anxiety disorder characterized as a child who constantly fails to speak in specific social situations when there is an expectation for speaking (e.g. at school) despite speaking in other situations. The duration must occur for at least 1 month (which does not include the first month of school) and it often interferes with their educational and/or social communication. It is important to know that selective mutism is not due to a lack of knowledge of the spoken language nor is it the result of a communication disorder or a psychotic disorder.

Selective Mutism (SM) is a rare disorder that affects between .03% and 1% of the population depending on setting (clinic vs school vs general public) – That’s about 7 per 1,000 kids in the U.S. It also affects more females than males with a ratio of 2:1. Although selective mutism can manifest in adolescents and adults, it is most typically seen in younger children typically before the age of five. While the cause of SM has not yet been identified there have been many factors that coexist and play a role. For example, research has found a strong link connecting social phobia and SM.

So what can we do to help those with selective mutism? Something that many of us don’t think about but minimizing eye contact can be very helpful. For some individual’s, especially those with social phobia or high anxiety, eye contact can be very unsettling and cause higher anxiety. Another method is to create activities that require joint attention (shared attention/focus of two individuals on an object), providing behavioral descriptions rather than direct questions, and continue to converse with them despite no response. By doing just these few techniques it alleviates some of the pressure many of those with selective mutism feel. Other methods are family therapy and psychodynamic therapy, use of an audio or video recorder where the individual can speak and answer questions in a comfortable environment but then have it played back repeatedly at a later date, and lastly, have them talk with someone in a comfortable environment who is familiar and then slowly bring in outside environmental factors (new people or new settings).

Source: American Psychiatric Association, 2013; Cunningham, McHolm, Boyle, & Patel, 2004; Remschmidt, Poller, Herpertz-Dahlmann, Hennighausen, & Gutenbrunner, 2001; Steinhausen, H. C., Wachter, M., Laimböck, K., & Metzke, C. W. , 2006, American Speech-Language-Hearing Association, 2019, Camposano, L. (2011). Silent Suffering: Children with Selective Mutism. The Professional Counselor, 1(1), 46-56. doi:10.15241/lc.1.1.46