Selective mutism

Selective mutism is a complex childhood anxiety disorder characterized by a child's inability to speak and communicate effectively in select social settings, such as school. These children are able to speak and communicate in settings where they are comfortable, secure, and relaxed.

Etiology

Selective mutism is believed to be a psychosocial disorder that results from anxiety, specifically social anxiety, that causes the child to be unable to speak in certain situations. It is not a form of stubbornness or defiance. It is also not a result of trauma or a developmental disorder.

Symptoms

Children with selective mutism often exhibit the following symptoms:

• Consistent failure to speak in specific social situations where there is an expectation for speaking (e.g., at school)
• The disturbance interferes with educational or occupational achievement or with social communication
• The duration of the disturbance is at least 1 month (not limited to the first month of school)
• Failure to speak is not due to a lack of knowledge of, or comfort with, the spoken language required in the social situation
• The disturbance is not better accounted for by a communication disorder (e.g., stuttering) and does not occur exclusively during a Pervasive Developmental Disorder, Schizophrenia, or other psychotic disorder.

Diagnosis

Selective mutism is diagnosed based on specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). A comprehensive evaluation should be conducted by a mental health professional who is knowledgeable about this disorder.

Treatment

Treatment for selective mutism involves a multidisciplinary approach that includes the child, family, school professionals, and mental health professionals. Treatment options include behavioral therapy, cognitive behavioral therapy, play therapy, and family therapy. Medication may also be used in conjunction with therapy.

See also

• Anxiety disorder
• Social anxiety
• Childhood psychiatric disorders

References

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