What is selective mutism? Selective mutism is a condition in which a child can but will not speak in one or more specific social situations in which speaking is expected or required. Selective mutism tends to start before the age of 5 but may only be recognized in the first years of school or daycare. Of the 2% of school-aged children who show symptoms of selective mutism, many will outgrow it, while others may develop chronic anxiety disorders. Selective mutism can be diagnosed and treated

What are the signs and symptoms of selective mutism? Of course, the most notable symptom is a child's silence in particular social situations where there is an expectation of speaking (school, church, daycare, etc.). A child with selective mutism may talk and play freely and naturally with their siblings, friends, and relatives - but not speak a word when they walk through the school door. Sometimes a trusted friend will act as "interpreter" for a selectively mute child, translating gestures or voicing mouthed responses.

Whatever their "trigger" situation, a child with selective mutism may also show other symptoms - standing or sitting motionless, lack of expression, withdrawing or turning away from people, and avoiding eye contact. Nervous behaviours - like chewing on or twirling their hair - are also common.

What causes selective mutism? Selective mutism is thought to be related to social phobia, an anxiety disorder in which a person is fearful of social situations. Children who develop selective mutism may be naturally inhibited and shy, and have developed few skills for handling anxiety and stressful situations. Instead, their reserved traits may have been reinforced or nurtured by well-meaning family members who "speak for" the child.

How is selective mutism diagnosed? Seek treatment and information from your child's paediatrician, as well as a speech and language pathologist and a psychologist or psychiatrist. Tests may be needed to rule out speech and language issues, muscle coordination problems, ear infections, or other mental health concerns. Your child's teacher can also provide some background and information about your child's classroom behaviour.

A child is diagnosed with selective mutism if they are able to speak, but persistently fail to speak when in the context of social situations where a child would be expected to speak, for at least one month after the first social situation (as in the beginning of a new school year).

How can selective mutism be treated? Based on diagnosis and testing, your child's mental health care team will coordinate to decide on the best course of treatment. If a speech or language issue is at the heart of your child's selective mutism, like stuttering or anxiety about the sound of his or her own voice, a speech pathologist can provide a treatment program. A psychologist or psychiatrist may be able to help your child address their anxieties through behavioural therapy, medication, or both. And you and your child's teacher can work together to encourage your child's efforts to communicate, rewarding even the smallest of successes.