Selective Mutism

Selective mutism, also known as psychogenic mutism, causes people who are otherwise able to speak normally to stop speaking in some situations, particularly social and stressful situations. The causes of this condition are unknown, and although it can affect anyone, it is most common in young children, affecting somewhere between .03% and 1% of children.

What Is Selective Mutism?

Mutism can be caused by a number of conditions, including deafness, speech delays, and developmental disabilities. But selective mutism occurs when someone—usually a child—who is capable of speaking stops doing so. Most adults have witnessed intermittent examples of selective mutism when a young child who is capable of talking does not respond to an unfamiliar adult. Typically, though, selective mutism is far more all-encompassing and interferes with daily functioning. Some children with selective mutism do not speak at all in social situations, at school, or during times of immense stress.

Because there is a strong correlation between selective mutism and shyness, parents whose children are selectively mute occasionally interpret the child’s behavior as rudeness and believe that he or she is simply refusing to speak. In fact, the child is truly unable to speak in isolated circumstances. Most children with selective mutism also experience some sort of phobia, such as social anxiety.

Symptoms of Selective Mutism

While children and adults with selective mutism may be able to speak at home or in other familiar settings, they may be shy in social situations and exhibit fear and anxiety around people they do not know. For selective mutism to be diagnosed, the behavior must continue for one month, and it must not be due to cultural issues. For example, selective mutism is not indicated when a child is learning a new language and is reluctant to speak it at school. Those with selective mutism may also have a characteristically blank expression, exhibit stiff or awkward body language, and seem unable to smile.

What Causes Selective Mutism?

Selective mutism has no known causes, although those who experience it often have a family history of anxiety and extreme shyness, social phobias, and/or an inhibited temperament, which is thought to be explained by decreased levels of excitability in the amygdala. The condition almost always accompanies some degree of shyness, stress, or inhibition.

How Is Selective Mutism Treated?

Selective mutism can interfere with a child’s ability to succeed in school and social situations and often worsens if not treated. Treatment for selective mutism primarily centers on reducing anxiety for the person experiencing it. Because the condition is triggered by social pressure and inhibition, attempting to force someone with selective mutism to speak can actually exacerbate the condition.

The key to treating selective mutism lies in behavioral changes. Parents of children with selective mutism can help their kids make lifestyle changes by gradually introducing them to new people, choosing small schools, helping them work on social skills, and praising the child’s efforts rather than trying to convince them to speak or simply brushing off their condition. Anti-anxiety medications may be helpful to some people with the condition, especially for those in whom the condition is severe.

When selective mutism accompanies another condition, such as generalized anxiety or a social phobia, treatment begins by focusing on the underlying concern.

Selective Mutism in Popular Culture

In popular culture, traumatic mutism is often confused with selective mutism, as the two conditions may appear to be similar. Traumatic mutism, which can occur as a result of a traumatic event, is more commonly portrayed in books and movies, such as Maya Angelou’s memoir I Know Why the Caged Bird Sings and Laurie Halse Anderson’s young adult novel Speak. The protagonists in both of these books become mute after experiencing rape.

The portrayal of selective mutism in popular culture is limited. The sitcom The Big Bang Theory portrays an adult, Rajesh Koothrapali, who experiences selective mutism with anxiety. Silent Bob, a character who appears in many Kevin Smith films, also seems to experience selective mutism. “She’s Given Up Talking,” a song by Paul McCartney, which depicts a young girl who speaks at home but not at school, is a clear representation of childhood selective mutism.

References:

1. Berger, F. (2014, February 24). Selective Mutism. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/001546.htm.
2. Harwood, R., Miller, S. A., & Vasta, R. (2008). Child Psychology: Development in a Changing Society. Hoboken, NJ: John Wiley & Sons.
3. Selective Mutism. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, Virginia: American Psychiatric Association.
4. Shipon-Blum, E. (n.d.). What Is Selective Mutism. Retrieved from http://www.selectivemutismcenter.org/aboutus/whatisselectivemutism.

Last Updated: 08-21-2015