Selective mutism

"Selective mutism is a rare childhood anxiety disorder in which a child experiences a trigger response and is unable to speak in certain situations or to certain people" (Psychology today, 2023). Even though it can be perceived as being extremely timid, it is not a sort of shyness. It's also not a deliberate omission of speech, unlike what some would think.

However, when no one else is around to cause the freeze reaction, people with selective mutism are able to communicate freely with certain people, such as close relatives and friends. In early children, selective mutism affects roughly 1 in 140. Girls and kids who have just emigrated from their native country are more likely to experience it.

Symptoms

Selective mutism refers to the inability to communicate in some social contexts rather than a complete lack of speech. When a youngster is required to converse with someone who is outside of their comfort zone, they suddenly become motionless and exhibit a frozen look. This is the biggest warning sign of this condition. The common symptoms for this disorder include:

• Experiencing unease, nervousness and uncomfortableness around unfamiliar areas.
• Fidgeting, lack of eye contact, lack of movement and unable to express oneself around certain situations or unfamiliar surroundings.
• Use of non-verbal communication to express needs, such as pointing, nodding head. etc.
• Experiencing unwanted effects when in school or work and may later affect their performance at school or work.
• Fear of talking to people that they are not familiar with, this symptom may not last long, when a kid is about 2 to 4 years of age.
• Stubborn or aggressive when the person is home or throwing tantrums when the kid is questioned by parents.

Causes

The condition's risk factors are not thoroughly recognized because it is usually fairly infrequent. Selective mutism used to be associated with childhood trauma, abuse, or instability. The precise etiology of selective mutism is yet unknown to experts. Several of the key hypotheses are included in a scholarly review from 2010 as follows:

Behavioral theory

As this disorder seems directly related to anxiety disorder, it is a taught, unconsciously used protective technique for anxiety management. When you are in new or unpleasant social circumstances, your freeze reflex prevents you from speaking.

Social anxiety theory

Given that socially anxious persons frequently avoid speaking in public or interacting with strangers, some psychologists think selective mutism is a severe kind of social anxiety. It's also important to keep in mind that selective mutism normally manifests in infancy, whereas social anxiety commonly manifests in the early to mid-teens. The last point is that while social anxiety does not disappear with age, selective mutism frequently does.

Developmental psychopathology theory

This more recent hypothesis contends that youngsters with early speech or language impairments may experience bullying or jeers from their peers once they start school. Because of the potential for shame, individuals could refrain from communicating in situations where they don't feel secure.

Post-traumatic stress theory

A further explanation is that abuse and other painful events may cause selective mutism. You could unintentionally dissociate—that is, become emotionally detached—for a brief period of time when you encounter a trigger that makes you think of your trauma. Speech may feel unattainable as a result.

Treatment

Despite the possibility that selective mutism will get better on its own, doctors nevertheless advise being treated after the condition has been identified. Selective mutism can be treated using a variety of methods. The most typical therapies, according to Schiff, are:

Therapy

• Speech-language therapy - Speech or language disorders are frequently seen in children who are selectively mute. To rule out any potential speech and language impairments, SLPs can examine a child's abilities in a variety of situations and with a variety of individuals. In order to progressively boost their speaking confidence, the SLP might then train them through various activities. When a youngster tends to be silent, they could concentrate on working with that child.
• Cognitive behavioral therapy (CBT) - In order to reduce anxiety, cognitive behavioral therapy (CBT) focuses on identifying and altering thought patterns regarding oneself, other people, and the outside environment.
• Behavioral therapy - By exposing you to progressively difficult scenarios over time using this strategy, you'll gradually gain confidence speaking in unfamiliar settings. For instance, your child who is selectively mute could start a discussion with you before a third, unrelated person jumps in. You step away from the conversation once your youngster feels at ease speaking in front of the two of you. A six-month school-based CBT program with children aged 3 to 9 participants. After five years, 17% of patients reported better symptoms, and 70% no longer satisfied the diagnostic criteria for selective mutism.
• Family therapy - It can be beneficial for parents and siblings to engage in therapy when family dynamics appear to be a factor in selective mutism. Selective mutism may be traced back to its underlying roots, and a family therapist can offer advice on how to help the kid overcome it.

Medication

It may also be necessary to take medication, especially in severe or persistent conditions or when other treatments have failed to make things better. A physician who has expertise writing prescriptions for anxiety medications for kids should be consulted before deciding whether to utilize medication. In order to reduce anxiety, antidepressants may be used in conjunction with a treatment plan, especially if prior attempts to get the person to participate in treatment have been unsuccessful.

Summary

From what can be deduced from the whole article is that anxiety disorders like selective mutism cause people to become unable to speak in particular settings, frequently in front of strangers. However, it can also linger until adulthood or recur after becoming better. It commonly affects young children.

Furthermore, the outlook for selective mutism is generally positive. The majority of kids with special needs perform well in other areas and do not require placement in special education classrooms, unless there is another issue that contributes to the condition. This shows on how much an effect treatment may have on a child with selective mutism. One thing to note is that selective mutism is completely curable with the right treatment given by the health professional or a psychiatrist. Along with the right support from the family members and loved ones is good enough to help the child in overcoming the anxiety disorder.

References:

Strong, R. (2022). Signs of Selective Mutism and How to Get Support. [online] Healthline. Available at: https://www.healthline.com/health/anxiety/selective-mutism-symptoms#takeaway [Accessed: 17 Jul. 2023].

Psychology today (2023). Selective Mutism. [online] Psychology Today. Available at: https://www.psychologytoday.com/us/conditions/selective-mutism [Accessed: 16 Jul. 2023].

Cuncic, A. (2022). Understanding Symptoms, Diagnosis and Treatment of Selective Mutism. [online] Verywell Mind. Available at: https://www.verywellmind.com/what-is-selective-mutism-3024702 [Accessed: 17 Jul. 2023].

NHS (2021). Selective mutism. [online] nhs.uk. Available at: https://www.nhs.uk/mental-health/conditions/selective-mutism/ [Accessed: 17 Jul. 2023].