Selective Mutism

Selective mutism is primarily an anxiety disorder and involves a conscious decision by the child to not speak. It is classified by a persistent failure to speak in very specific situations despite the ability to do so. There is always an underlying psychological reason for the development of the disorder.

Mandy is such an example of this puzzling condition. Six years old, she was a happy, well-adjusted child until her parents started having marital difficulties over a protracted time frame. When the marriage finally dissolved, her mother quickly met another man and he moved into the family home.

Mandy’s two brothers resented the arrival of the stranger but as they were older and both close in age, they withdrew from the situation emotionally and focused their attention on their friends and sports.

Mandy however did not cope with the changeover in father figures. She loved her dad and could not understand why he had been replaced by another man. Initially she expressed her anger and sadness at the situation but when that brought no change, she decided to cease speaking.

As with all cases of selective mutism, the non-speaking was not global but situation-specific – hence the name “selective”. Mandy chose not to speak at home but spoke normally at school and in other social situations. It took a while for her mother to work out that something a little more serious than sulking was happening because initially it seemed that Mandy was just being obstructive, especially when she was displaying no problems at school.

Consequently her mother punished her. Unfortunately this made the situation worse. This of course was not her mother’s fault; it was a normal response to a frustrating situation. And as less than 1% of the population suffers from selective mutism, it is not a condition that immediately springs to mind to a confused and frustrated parent. Once medical help was sought, the situation in that regard was modified.

The condition is more prevalent among girls than boys. The reason is unknown but as it is a more passive reaction to anger and rage it is more likely to be adopted by females than males. The latter are more likely to express their pain in more overt ways.

Although not a lot is known about why one child will exhibit this behavior as a result of trauma, anxiety is known to be one of the root causes. Treatment consists of management in terms of giving praise and positive reinforcement for speaking during the times when mutism is common. It is also important to ignore alternative attempts to communicate, such as pointing, grunts etc, as doing so reinforces the unwanted behavior.

Most children need counseling to assist with the condition. Although the most common age of initial occurrence is between 5 and 8, without appropriate treatment the condition has been known to persist until adolescence and even into earlier adulthood, although the latter is very rare. Most children are able to eliminate the problem by adolescence.


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