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What is selective mutism?
Selective mutism was first described in the 1870s, at which time it was called “aphasia voluntaria”. This name shows that the absence of speech was considered to be under the control of the child’s will. In 1934 the disorder began to be called selective mutism, a name that still implied purposefulness on the part of the silent child. In the 1994 edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-IV ) the disorder was renamed selective mutism. This name is considered preferable because it suggests that the child is mute only in certain situations, without the implication that the child remains silent on purpose.
Selective mutism is characterized by a child’s inability to speak in one or more types of social situation, although the child is developmentally advanced to the point that speech is possible. The child speaks proficiently in at least one setting, most often at home with one or both parents, and sometimes with siblings or extended family members. Some children also speak to certain friends or to adults that are not related to them, but this variant of selective mutism is somewhat less common.
The most common place for children to exhibit mute behavior is in the classroom, so that the disorder is often first noticed by teachers. Because of this characteristic, selective mutism is most frequently diagnosed in children of preschool age through second grade. As the expectation of speech becomes more evident, selective mutism can have more pronounced negative effects on academic performance. Children who do not talk in classroom settings or other social situations because the language of instruction is not their first tongue are not considered to have the disorder of selective mutism.
What are the symptoms?
The symptoms of selective mutism are fairly obvious. The child does not talk in one or more social situations in which speech is commonly expected and would facilitate understanding. Some children with selective mutism do not communicate in any way in certain settings, and act generally shy and withdrawn. The disorder is also often associated with crying, clinging to the parent, and other signs of social anxiety. Other children with the disorder, however, may smile, gesture, nod, and even giggle, although they do not talk.
Consensus regarding the most common causes of selective mutism has changed significantly over time. When the disorder was first studied, and for many years thereafter, it was thought to be caused by severe trauma in early childhood. Some of these causative traumas were thought to include rape, molestation, incest, severe physical or emotional abuse , and similar experiences. In addition, many researchers attributed selective mutism to family dynamics that included an overprotective mother and an abnormally strict or very distant father. As of 2002, these factors have not been completely eliminated as causes of selective mutism in most cases, but it is generally agreed that they are not the most common causes.
Instead, selective mutism is frequently attributed at present to high levels of social anxiety in children and not to traumatic events in their early years. Children with selective mutism have been found to be more timid and shy than most children in social situations, and to exhibit signs of depression, OCD , and anxiety disorders. Some children have been reported to dislike speaking because they are uncomfortable with the sound of their own voice or because they think their voice sounds abnormal.
Many links have also been found between selective mutism and speech development problems. Language reception problems have also been documented in selectively mute children. Although there is no evidence indicating that selective mutism is the direct result of any of these difficulties in language development, possible connections are being explored.
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