Selective mutism is a severe fear that keeps your child from speaking in public. If your child has this disorder, she fears that if she says anything when other people are around, she will look foolish and be embarrassed. The fear stops your child from doing things like making friends, playing, and doing well in school.
Selective mutism is more than being shy. Shy children usually relax around others after a few minutes. A child with selective mutism is always tense and cannot speak in some settings.
The exact cause of this disorder is not known.
The disorder is more common in girls than boys. It often starts before age 5 but may not be noticed until your child starts school.
Symptoms may include:
These symptoms may confuse you because your child may be very outgoing at home. She may talk easily on the phone to others but not be able to talk to them face to face.
Your child's healthcare provider will ask about your child's symptoms and medical history and examine your child. Your provider will make sure that your child does not have a medical illness or or a speech, hearing or learning problem that could cause the symptoms.
You may want to contact a mental health therapist who specializes in working with children and teens. The therapist will ask questions, watch your child, and may do some tests.
There are several ways to treat selective mutism. The first step is usually to help you and your child learn about the disorder.
Cognitive behavior therapy (CBT) helps your child learn what causes her to feel afraid to talk and how to control the fear of rejection. CBT might also include social skills training, role-playing, and relaxation methods.
Exposure and response prevention therapy (ERPT) helps your child face her fears. ERPT helps your child deal with her fears by exposing her to the things that she is afraid of and helping her practice new ways of responding. Your child learns ways to control her body's response to anxiety, like breathing exercises.
A speech-language therapist can work with your child to help her learn ways to relax and speak more easily.
Sometimes medicine may be used as well as therapy. Your child’s healthcare provider will work with you and your child to find the best medicine and dosage for your child. Your child may need to take more than one type of medicine.
Let your child watch you talking in a relaxed way in a lot of different situations, like with friends, at school events, and while ordering at restaurants. Try to avoid putting pressure on your child to speak in order to get something she wants. Do not say "You can't have it unless you say it first." Praise your child for her efforts and for any improvements, however small.
Help your child to speak where she is comfortable. Usually that means in small groups of people that your child knows. If your child is more comfortable at home, it may be helpful to invite friends over often to give your child more chances to talk with others.