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The Informed Parent

Selective Mutism

by Peter W. Welty, M.D., F.A.A.P.
Published on Apr. 13, 2009
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A six-year-old child was presented to me as having adjustment problems in kindergarten. It seems that she refuses to speak. No coaxing, cajoling, threatening, or ignoring seems to work.

By contrast, once home, the child is a “motor mouth”. When mom confronts her to inquire why she refuses to speak in school, she shrugs her shoulders and says “I don’t know”.

Selective mutism occurs when a child fails to talk in specific situations while speaking in others. Some percentages report that up to two percent of second graders have selective mutism. Many children with selective mutism do not speak to teachers or classmates, but they converse normally at home or with parents or siblings. Some children are noted to be stubborn or oppositional. But research shows that there is a high prevalence of anxiety disorders in children with selective mutism. Some people think it is a type of social anxiety.

There does not seem to be a correlation between selective mutism with the type of parenting. Children from all sorts of families and from different backgrounds display selective mutism. About one third of children with selective mutism do poorly at school, generally because teachers underestimate their verbal and reading abilities. Only about eleven percent of children with selective mutism have learning disorder.

Regarding their social functioning with peers and in the community, children with selective mutism are generally not bullied more than one would expect. They tend to be anxious but not depressed or submissive, which is a factor that tends to predict a child being bullied.

Speak with your doctor if you note that your child is displaying selective mutism. Treatment frequently focuses on addressing your child’s symptoms of anxiety and learning appropriate intervention strategies.

PART 2

This subject was touched upon in the April 13, 2009 article. To review:
What is selective mutism and how does it affect children? Selective mutism is a disorder whereupon children fail to talk in specific situations while speaking in others. While many with selective mutism do not speak to teachers or classmates, they often converse normally at home with parents and siblings. Prevalence seems to range between 0.038 percent and 0.069 percent.

There is a high prevalence of anxiety-related ailments among children with this disorder. Some people think it should be reclassified as a social phobia. There are more complaints of somatic symptoms like headaches and stomachaches in children with selective mutism. Teachers report that they display less oppositional or attention deficit hyperactive disorder. However, it is noted that children with selective mutism tend to engage in impulsive and oppositional behavior at home, but they are inhibited at school. There does not appear to be inconsistency in parenting or in discipline issues noted in these children.

It also appears that children with selective mutism do not differ in their academic achievement as compared to children without this disorder. Only 11 percent of children with selective mutism are noted to have speech, language or learning disabilities. Contrary to popular belief, research shows that these children are not bullied or victimized more than their peers.

Further research into parenting issues, family functioning, academic performance and social behaviors will be important to understand more about selective mutism. See your child’s doctor if you have any specific questions or concerns.




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