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Selective Mutism

Children with selective mutism can become fearful of vocalising in other ways too, such as coughing or laughing.

Selective mutism is a severe anxiety disorder where a person is unable to speak in certain social situations, such as with classmates at school or to relatives they do not see very often.  It usually starts during childhood and, if left untreated, can persist into adulthood.

Selective mutism is best thought of as a ‘speech phobia’. Children with selective mutism can become fearful of vocalising in other ways too, such as coughing or laughing. Over time, children with selective mutism may withdraw more generally and then fear other means of communication, such as writing or pointing. They may become ‘frozen’ and then find it difficult to point to indicate or use gesture. Eye to eye gaze and facial expression may also diminish.

Signs and Symptoms:

  • The main warning sign is the marked contrast in the child’s ability to engage with different people, characterised by a sudden stillness and frozen facial expression when they are expected to talk to someone who’s outside their comfort zone.
  • They may avoid eye contact and appear:
    • nervous, uneasy, or socially awkward
    • rude, disinterested or sulky
    • clingy, shy, and withdrawn
    • stiff, tense or poorly co-ordinated
    • stubborn or aggressive
    • having temper tantrums when they get home from school or getting angry when questioned by parents.

For the diagnosis to be made, the condition must be sufficiently strong to:

  • Interfere with the child’s education and social and cognitive development.
  • The duration is at least one month beyond the first month as school.
  • The failure to speak must not be due to a lack of knowledge of the language.
  • The disorder is not due to another communication or language learning difficulty.

ISLTS Ltd therapists are trained in the assessment, identification, and management of selective mutism, working in collaboration with school/college staff and other professionals, depending on the unique needs of the child or young person.

Further information on this condition can be found at http://www.selectivemutism.org.uk/

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