Selective Mutism: Helping Kids Find Their Voices

Parents and professionals alike often wonder: What is selective mutism?

Selective mutism is an anxiety disorder that renders children who are often fabulous little chatter boxes at home, speechless in situations such as school, at church or temple, at the playground and when ordering ice cream. It is considered an anxiety disorder and not a refusal to speak, which is often a myth that some people have about selective mutism. A child who has selective mutism is not refusing to speak but really can’t speak in these various situations.

Parents may start to notice symptoms when their children are three or four, as they start to go on play dates or go to the park and notice that their child may be inhibited or too shy. We also know that when children enter school, this is when we hear complaints from teachers that a child is really unable to talk in their setting — even ask for help, ask to use the bathroom, and other things like that.

People often wonder how common is selective mutism. Our best estimates are that one in 140 children ages 3 to 8, have selective mutism. When you compare this with 1 in 20 children who have ADHD, it may seem that selective mutism is extremely rare. And while it certainly is less frequent, it is extremely debilitating as a child has to go to school every day and interact with friends. And when they’re unable to speak, they not only are missing opportunities to connect with others, but they’re unable to meet very important milestones and ask for help when necessary.

The good news is there are excellent evidence-based treatments available for children with selective mutism. This involves a robust behavioral intervention program that helps children learn skills to face people, places, and situations where they were previously nonverbal. The goals include increasing verbalizations in helping kids flex brave muscles so they can talk in a variety of settings.

Good treatment should involve parents and should teach them the same skills so that they can best support their children when they’re not in session. This involves helping parents develop skills to help children brave talk in situations like school, at the ice cream store or the library.

At the Child Mind Institute, we have a very robust selective mutism service, which offers comprehensive diagnostic evaluation and allows us to have an opportunity to observe your child. We offer individual treatment and also many treatment options for families who live out of town, whether it’s in California or in England. We also offer Brave Buddies program, which is an intensive classroom style program that is offered several times a year. Visit us on the web at childmind.org for more information.