Is your child mute in some places? It's called Selective Mutism - let's talk about it!

Your little one is very talkative at home, reading non-stop, and talking loudly even when playing. But when they go to school, to relatives' houses, or to parties, does their mouth seem to be completely silent? Does they just nod their head and not speak when someone asks them something? You might think this is shyness, or stubbornness, or just a little bit of a babbling babbling. But it could be something deeper, a mental health condition caused by fear and anxiety . Today, we'll talk about this condition called 'Selective Mutism.'

What is Selective Mutism?

Simply put, Selective Mutism is the inability to speak in certain social situations, in places where you feel uncomfortable or afraid. This is not intentional . In places where you feel familiar and safe, like at home, you can speak without any problems. But in places like school or in places where there are strangers, your voice seems to be stuck.

This is different from someone who is simply shy. Selective mutism is an anxiety disorder. It often begins in childhood, around the age of 5. It is often recognized by preschoolers and first graders. However, it can also affect younger people and adults.

This condition is said to be slightly more common in girls than boys. But that may be due to societal perceptions. However, it is a very rare condition. It affects less than one in 100 people.

What are the symptoms of someone with selective mutism?

The word "selective" in the name suggests that this is something that happens only in selected situations . That is, you can speak without any problems in situations where you feel comfortable. However, in situations where you feel uncomfortable or afraid, it becomes very difficult, if not impossible, to speak.

These symptoms can vary from person to person. Some people are completely speechless, while others speak in a limited, limited way.

A state of being unable to speak or close to it

This involves avoiding talking as much as possible, or stopping it altogether. It could look like this:

• You feel like you can't talk. This happens because your mind is hardened due to excessive fear and anxiety. Even though it may seem like you don't want to talk, this is not something you do intentionally, it just happens.
• His body is tense and he looks like he's been stoned. Like a deer caught in a light and scared.
• There is a blank expression on the face .
• Avoids eye contact.
• Avoids or does not participate in social interactions . Imagine, when the teacher asks something in class, this child looks at the floor while the other children answer.
• They don't ask for things they want. For example, they may go to the toilet at school without asking the teacher, and may even ask for something in their clothes.There are also times when you have to urinate .
• Behaves in a deliberately disruptive manner to avoid talking (e.g., struggling, crying).

Nonverbal communication

• Instead of words , they use sounds that everyone understands, like "Uu huun" (yes) and "Ah ah" (no).
• To avoid talking , they write things down and do things like show you something in a book .
• Uses gestures and facial expressions instead of words (e.g., nodding, pointing).

Speaking little or limitedly

• It's time to respond.
• They answer in one or two words or use very short sentences.
• They mumble, stutter, or speak very slowly and in a whisper.
• Speaks with a changed voice (e.g., like a robot, or by changing the pitch of their normal voice).

Why does this selective mutism occur?

Experts still don't fully understand the exact cause of this, but they think several factors may play a role.

Other mental health conditions

Selective mutism is strongly associated with other mental health conditions. These are not the only causes, but people with these conditions are more likely to develop selective mutism.

• Social Anxiety Disorder: This is very common among people with selective mutism. Experts say that between 75% and 100% of people have both.
• Phobias: Excessive fear of various things.
• Other anxiety disorders.
• Autism Spectrum Disorder.
• Separation Anxiety: Excessive fear of being separated from parents.
• Post-Traumatic Stress Disorder (PTSD): Psychological distress that occurs after a traumatic event.

Family history or genetic influences

Anxiety disorders can run in families. A person with selective mutism is more likely to have a close relative (parent, sibling, child) with the condition or another anxiety disorder.

Other speech disorders

Some children may develop selective mutism due to anxiety about how they speak or difficulty understanding what others say (e.g., auditory processing disorders , learning delays).

It can also be caused by speech difficulties, such as fluency disorders . Some children may develop selective mutism because they dislike their own voice or are afraid of how they sound when they speak.

Social factors

Some social factors can also cause children to develop selective mutism.

• Being bullied by others.
• Severe traumatic events or abuse.
• Family issues (e.g., emotional, verbal, or physical abuse at home).
• Moving to a country or region where a different major language is spoken.

What are the possible complications of selective mutism?

This situation can have adverse effects on your life in various ways.

• Social awkwardness, loneliness, or isolation.
• Development of other anxiety-related conditions or symptoms.
• Impact on educational activities or job performance .

How do you diagnose this?

Selective mutism is often diagnosed by a mental health professional, such as a psychiatrist or psychologist. Speech-Language Pathologists or Speech Therapists can also help rule out other conditions and make a diagnosis.

A doctor diagnoses this condition by looking at symptoms and behavior patterns. They will ask you (or your child) questions about these experiences and other factors that may be contributing to this.

Typically, your doctor will use questionnaires and checklists to determine if you have the condition. According to the American Psychiatric Association's DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, fifth edition text revision™) , to be diagnosed with selective mutism, you must meet these five criteria:

1. Constantly not speaking in social situations where you are expected to speak, but there is no problem speaking at other times.

2. Not speaking affects social, educational, or work life .

3. The inability to speak lasts for more than a month.

4. Not speaking is not because you cannot speak or understand the main language used by others.

5. The difficulty speaking cannot be caused by another speech disorder, such as stuttering . Also, it cannot be solely related to autism spectrum disorder , schizophrenia spectrum disorders, or other psychotic conditions.

Is there a treatment? Can it be completely cured?

With treatment, the severity of symptoms and the frequency of their occurrence can be reduced. If recognized and treated early, some people may even experience complete resolution of symptoms.

The most common treatments are:

Mental health therapy

Mental health therapy (especially Cognitive Behavioral Therapy or CBT)) is usually the first treatment used. It is also the one that produces the most results. Behavioral therapy helps you understand and cope with the anxiety and other distressing emotions that cause selective mutism. It also helps you control the disruptive behaviors that can accompany the condition.

When treating children with this therapy, it is important to involve their caregivers (parents, guardians). Their support is very important for the success of the therapy.

Speech Therapy

Speech therapy involves working with a speech therapist. This can be especially helpful when selective mutism is present along with a speech disorder.

Medications

If mental health therapy or talk therapy alone does not work, medication may also be used as part of the treatment.

The most common medications for selective mutism are SSRIs (Selective Serotonin Reuptake Inhibitors) . Although these are primarily used to treat depression, they can also help with anxiety disorders like selective mutism. Other medications may also help. Your doctor (or your child's doctor) can tell you more about these and help you choose the right one for you.

It's best to ask your doctor about the side effects of medications.

What happens if I or my child has selective mutism?

If a child has this condition, it can affect their schoolwork, the way they interact with friends, and their ability to make friends. Sometimes, children may be tempted to remain silent, even in very important situations.

If you have selective mutism as an adult, it can continue to have negative effects. It can make it difficult to make friends and build relationships (social, professional, romantic). It can also affect your studies and work.

For many people, symptoms seem to go away as they get older. However, sometimes symptoms persist and can mimic other anxiety disorders (especially social anxiety).

If it is recognized and treated early, the results are very good. If it is recognized and treated at an early age, most people can either get rid of this condition or cope with it and live with it. Then it will not have a major impact on their lives.

However, if it is left unrecognized and untreated, the outcomes are not so good. This is not a dangerous condition, but the adverse effects can be significant.

Can selective mutism be prevented?

Unfortunately, selective mutism cannot be prevented. Experts don't fully understand what causes it, so there's no way to reduce the risk of it occurring.

How can I help my child if he has selective mutism?

You may feel frustrated when your child doesn't talk in certain situations, and when you say, "Talk, talk," but he doesn't talk. This frustration can be even greater when your child struggles to avoid talking, such as by crying.

But, the most important thing to remember is that selective mutism is a mental health condition. It's not something your child can control. But, you can control your child's condition and how you respond to their symptoms.

Here are some important things you can keep in mind:

• Make your child feel comfortable and safe. Don't push or rush them into places where they might feel scared or anxious. It's also not a good idea to talk about this problem in front of them, as it can make them feel embarrassed and even more afraid.
• Reduce fear and anxiety, and then move on. Start by encouraging your child to express themselves in ways that they feel comfortable with. First, gradually introduce them to social interactions, and then help them talk.
• Be patient and give your child time to talk. If you speak for them, they may feel like they are making a mistake. This will make it harder for them to overcome their fear and anxiety about speaking. Help them understand that it is good to think before they answer, and to take their time.
• Praise his efforts. If your child speaks up, praise him for it. Give him a reward (with words) for what he did. Make him feel good about speaking up.
• Don't try to encourage them by punishing them. Children who are afraid of being punished if they don't talk may find it harder to talk because they will be more afraid.

What kinds of things "trigger" selective mutism?

Selective mutism "triggers" are situations or reasons why a person with this condition is more likely to not speak. Some common examples are:

• It feels like other people are so close, it feels like they're entering their personal boundaries .
• Others talking loudly and behaving rudely.
• Strangers, new people.
• The physical characteristics of others, for example , people who are very tall and have a large appearance.
• The gestures or behaviors of others, e.g., people who appear anxious, unfriendly, or make bad gestures .
• Places with more people and more noise.
• Places associated with sad, unpleasant memories.
• Places I've never been before.
• Completely new, or situations where the child has had a previous unsuccessful experience.

These are just a few of the most common triggers. Some people may have different, more specific triggers than these. Triggers can also change over time.

Is selective mutism a type of autism?

No, Selective Mutism and Autism Spectrum Disorder are two separate conditions. However, people with autism are more likely to have selective mutism.

Finally, things to remember (Take-Home Message)

Selective mutism is a condition in which a child is unable to speak due to fear or anxiety. It often starts as early as school age, but it can also affect young people and adults. It is important to understand that children with this condition are not being stubborn or unresponsive. It is also not something they can control on their own.

If you think your child may have selective mutism, talk to their pediatrician or another healthcare professional. There are treatments available, and the sooner treatment is started, the better the outcome. With your encouragement and support, your child can learn to speak up for themselves without losing their voice to fear or anxiety.

` Selective mutism, not speaking, children's mental health, anxiety, social phobia, speech disorders, children's behavior