Selective Mutism (SM) is best understood as a childhood anxiety disorder.  Children with SM speak comfortably and freely in some environments (such as at home with family) but have a persistent inability to speak in one or more social settings (such as at school or unfamiliar places).  In the most severe cases, children appear frozen and unable to respond verbally or nonverbally.  Some appear isolated and unable to socialize with peers.  Other children are able to socialize, but communicate only nonverbally.

 

Often, a child's inability to speak is first noticed when he/she starts preschool.  Parents may have noticed a child's inhibited temperament in social situations, but are unaware that their child does not speak to peers and/or adults until their child’s teacher tells them.  Many children with SM are considered talkative within the comfort of their own home and with their own family.

 

SM is often misunderstood by extended family members, educators and the community at large as shyness or willfulness, a misunderstanding that can add to the anxiety of the child and parent.  However, SM is beyond shyness.  Shyness is a personality trait, with varying degrees among different individuals.  SM is a disorder that requires treatment in order to overcome its symptoms and function at an appropriate level.  The earlier a child with SM is identified and provided proper treatment, the easier it is for a child to overcome its symptoms.  Over time, not being verbal becomes a practiced behavior and a child can get “stuck” in the pattern.

 

SM is not an act of defiance or willfulness, but rather a disorder that requires patience and understanding. It is best addressed through a treatment approach that combines reducing anxiety with the teaching of new skills to bring about a confident voice.