Selective Mutism for Kids – Causes & Treatment

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Selective Mutism for Kids

Has a teacher told you that your child doesn’t speak willingly at school? Does your talkative child suddenly refuse to go with you to a large family gathering or to her dance class?

If your kids behave differently at home than they are in school, they may have selective mutism.

What is selective mutism?

Selective mutism is an anxiety disorder characterized by a child’s inability to speak and communicate readily in social situations with other children. Kids with selective mutism hesitate to initiate a speech or respond when spoken to others in social settings.

Kids with selective mutism may not communicate in select social settings, but they can comfortably talk in another place. It usually begins before a child is five years old. People often misunderstand a child with selective mutism, which’s why it can be misdiagnosed, but early detection and treatment are essential to better outcomes down the road.

Symptoms of Selective mutism

If you have a firm belief that your child is struggling with selective mutism, look for the following symptoms.

  • Slow to respond in a social situation
  • Always expressionless, flat face
  • Social isolation
  • Temper tantrums
  • A high level of shyness
  • Refusal to speak to specific situations
  • Difficulty maintaining eye contact
  • Use of non-verbal communication to express needs.

While most children say these behaviors are self-protective, other kids may often perceive them as defiant.

Causes of selective mutism

Due to the rareness of selective mutism, risk factors are not fully understood. Before, it was believed that selective mutism resulted from trauma, childhood abuse, or upheaval.

Today, research proven that the disorder is related to social and generalized anxiety disorder. But there are some other triggers as well that can be linked to the disorder, including:

  • Children diagnosed with selective mutism tend to be very shy.
  • They may have an anxiety disorder.
  • Overly controlling behaviour on the part of parents can also be a risk.
  • Children fear embarrassing themselves in front of others.
  • Genetic predisposition

Sometimes selective mutism co-occurs with other disorders such as:

How is selective mutism diagnosed?

Diagnosing selective mutism typically involves a comprehensive assessment that may include the following steps:

  1. Medical History: Your child’s healthcare provider will gather information about your child’s medical history and ask about their speech and language development.
  2. Academic Reports and Teacher Input: Bringing academic reports and teacher comments to the appointment can be helpful for understanding your child’s behavior in school.
  3. Observation: The healthcare provider may want to observe your child’s behavior both at home and at school. You might also be asked to record videos of your child in these settings.
  4. Medical Examination: A physical examination of your child, including an examination of their ears, lips, tongue, and jaws, will be conducted. A neurological examination and hearing test may also be included to rule out other medical conditions.
  5. Multidisciplinary Assessment: Other healthcare professionals, such as a speech-language pathologist (SLP) and a psychologist or psychiatrist, may be involved in the assessment. The SLP can assess your child’s language skills, while a psychologist can help identify any underlying emotional issues contributing to the condition.

Consequences of selective mutism

Understand that selective mutism can negatively impact children in many ways. Children with this disorder struggle to participate in classroom discussions and co-curricular activities, engage in reciprocal social interactions with other anxiety disorders, and fail to express their needs outside of the home.

Selective mutism can result in the following consequences:

  • Academic problems – if children with selective mutism fail to speak up about their lack of understanding in the classroom, they can fall behind academically.
  • Social isolation – as we mentioned before, children with selective mutism struggle to engage themselves in social interactions, making it difficult for them to make and maintain friends.
  • Other than that, it may also lead to low self-esteem and social anxiety if it goes untreated.

Who is at risk for selective mutism?

Selective mutism is most commonly observed in children, typically starting in early childhood. It’s important to note that any child can potentially develop selective mutism, but there are certain factors that may increase the risk:

  1. Shyness or Social Anxiety: Children who are naturally more reserved, shy, or have social anxiety may be at a higher risk.
  2. Family History: If there is a family history of anxiety disorders or selective mutism, a child may be more predisposed.
  3. Traumatic Events: Children who have experienced traumatic events, such as abuse or a significant life change, may be more prone to developing selective mutism.
  4. Environmental Factors: A highly stressful or overly-demanding environment can contribute to the development of selective mutism.
  5. Developmental Disorders: Children with other developmental or anxiety-related disorders (such as autism spectrum disorder or social anxiety disorder) may be more likely to develop selective mutism.
  6. Bilingualism: Children who are exposed to more than one language may be at a slightly higher risk, although this is not a direct cause.

Remember, while these factors may increase the likelihood, they do not guarantee that a child will develop selective mutism. It’s a complex condition, and many children who experience these risk factors do not develop it, while some older children who don’t have any apparent risk factors may.

Treatment of selective mutism

Unlike other disorders, selective mutism is the most receptive to treatment when it is caught early. Treatment of selective mutism involves psychotherapy, medication, or a combination of the two. Psychotherapy is generally the first recommendation.

With selective mutism, some kids have a co-occurring speech and language disorder. That’s why it’s a good idea to perform a speech and language assessment on older kids to rule out communication disorders.


Behaviour management programs are commonly used for the treatment of selective mutism children. These programs include techniques like desensitization and positive reinforcement. Once can apply both methods at home or school under the supervision of a psychologist.


Only in severe and chronic cases or when other methods have not improved, health professionals can suggest medication. The choice of using medicine should be made in consultation with an experienced doctor.

Tips for parents of children with selective mutism

In addition to other treatment options, parents can do some other things to help their child manage their condition.

  • Take away verbal demands in a social situation. Try to lower your verbal demands and expectations. By doing so, your child will gradually learn to associate social situations with positive feelings rather than anxiety. Parents are suggested not to start asking questions from the child as soon as they walk into the birthday party or an event. Additionally, avoid talking about the child’s habit of not talking all the time.  
  • Inform teachers to work with your child. Most often, teachers become frustrated and angry with children who don’t respond. As a parent, it’s your responsibility to inform them about your child’s behaviour. Tell them to encourage your child and offer reward and praise for positive behavior.
  • Avoid punishment. Where praising and rewarding positive behavior is a good thing, punishing silence is not. You need to understand that your child will not overcome the fear of speaking through pressure or punishment.
  • Choose activities according to their skills. Parents are suggested not to engage their children in social situations or activities that demand spoken communication. Instead, involve them in activities that don’t need speech, such as art, reading, or doing puzzles.
  • Focus on non-verbal communication. Instead of asking questions that require a verbal answer, ask your child that allow a nod, such as a thumbs-up or a thumbs-down. Tell their coaches, teachers, and others in their circle to encourage them to ask questions that your kids can respond in the same way.
  • Don’t pressure your child. Family involvement plays a vital role in treatment, but try to avoid forcing your child to speak. By putting pressure, you’re making them more anxious. Show them their due support and acceptance.
  • Work in steps. Put your child in a comfortable situation where they can talk freely and then gradually introduce a new person or add a new demand. Don’t push them to do it all at once.
  • Set realistic goals and work together to achieve them. As long as you initially focus on your child’s comfort, it’s ok to push them so they can progress gently. Setting goals can help in yielding change when accomplished at the appropriate time.

How long does selective mutism last in children?

Selective mutism is an anxiety disorder that typically affects children. The duration of selective mutism can vary widely from one child’s life to another. In some cases, it may resolve relatively quickly, while in others, it can persist for several years.

Early intervention and appropriate therapeutic support, such as cognitive-behavioral therapy, can help many children overcome selective mutism. It’s important for parents and caregivers to seek professional guidance to understand the specific factors contributing to the child’s condition and develop a tailored treatment plan for the best possible outcome.

In Conclusion

Don’t avoid social situations because of your child’s selective mutism. As a parent, you need to realize that a kid with selective mutism will not improve while sitting at home with their family members, as they are already comfortable here.

At the start, you might feel stressed, but with time your child’s anxiety will reduce, and you will see progress. D won’t go away on its own that’s why talk to your doctor, who can help you create a plan of action.

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