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Selective Mutism

What is selective mutism?

Selective mutism is the situation where the child or young person can talk and communicate comfortably in environments where they feel comfortable and safe, but not in certain social environments such as school, playgroup or places where they have not been before. The child speaks and communicates with family members and relatives he/she sees frequently, but cannot speak when there is a stranger in the environment. Selective mutism falls under anxiety disorders and its main source is anxiety. Some studies suggest that selective mutism is the more severe form of social anxiety. The child with selective mutism may think that if he speaks, something will happen to him, that he will be disgraced or that he will say the wrong thing and be criticized. These children do not feel safe in unfamiliar environments and become withdrawn. Selective mutism is a rare problem.

Although there is no specific reason for selective mutism, factors such as unsafe home environment, anxious structure, emotional problems, low self-confidence, speech and vocalization disorders are among the factors that trigger selective mutism.

Selective Mutism

What is the age range for diagnosis?

Children with selective mutism or selective mutism are not often found in environments other than their family and close acquaintances in the preschool period. The silence of the child, who speaks and communicates with his/her close environment without any problems, can be interpreted as shyness and the possibility of selective mutism is not considered. The diagnosis of selective mutism is usually noticed when the child starts school and begins to communicate with people other than family members and to be in new environments. The age range for diagnosis is therefore 2.5 – 4 years. It is noticed that the child who is separated from his family or in social environments such as a nursery, playgroup or school with one of his parents does not speak at all, even in some cases, does not communicate by standing still, and in some cases he communicates only with signs and facial expressions.

In order for a child to be diagnosed with selective mutism, it must be known that he does not speak only in certain environments, but that he speaks to his family and relatives in environments where he feels safe. In certain environments, the state of not speaking must continue for at least 1 month. However, for a child who has just started school, waiting only 1 month is not enough to make the diagnosis. Considering the period of adaptation of the child to the new environment and order, it should be taken as the basis for the 1 month after the first month of school.

The reason why the child does not speak should not be that he does not know enough the language spoken at school or in the environment he is in. In addition, selective mutism should be differentiated from communication disorders, psychotic disorders and pervasive developmental disorders. A child with any of these diagnoses is not diagnosed with selective mutism.

What are the general characteristics of children diagnosed with selective mutism?

Children diagnosed with selective mutism usually

constantly lured to its parents,
unable to speak in social situations,
hardly speaks little or not at all to their parents and acquaintances when a stranger is present,
If self-confidence is relatively high, they use gestures and facial expressions instead of words to communicate in social environments,
they are usually closed to communication and dull children.
Some children with selective mutism may also have speech problems, behavior and anger problems.

Selective mutism negatively affects the child’s development, performance in social environments, academic performance, and function in daily life. The child who does not speak at school cannot show his full potential in the lessons, and has problems in friendship relations because he has difficulty in communicating with his peers.

What is the difference between selective mutism and traumatic mutism?

Selective mutism is the situation in which the child does not speak because he does not feel safe and comfortable in social situations. The child with selective mutism does not need to have experienced a traumatic event prior to this situation. However, traumatic mutism is when the child stops speaking due to a traumatic event.

While the child with traumatic mutism does not speak in any environment, the child in selective mutism talks to certain people in at least one environment. Traumatic mutism is accompanied by symptoms of post-traumatic stress disorder. These symptoms are; being upside down in situations that remind of the traumatic event, repetitive thoughts about the event, recreating the event in their games, high fear, difficulty separating from the parent, sleep problems, nightmares and recurring nightmares about the traumatic event.

Selective Mutism

Why is early diagnosis important?

Selective speech negatively affects the child’s life in many areas. They experience performance problems at school, cannot communicate with their peers, avoid certain environments and socialize, and have low self-confidence. All these problems can be minimized or even eliminated with early detection. With the right specialist support, the child develops his/her skills in academic and social areas and gains the skills that his/her peers gain, and the difficulties he encounters in his daily life disappea

What should families do when they suspect their children have selective mutism?

In cases where parents suspect that their children have selective mutism, they should consult a specialist as soon as possible for correct diagnosis and guidance.

The main source of selective mutism is anxiety, so the main goal of experts, teachers and parents should be to manage and reduce anxiety, not to start the conversation immediately. In the process of intervention in this situation, the family, the specialist and the school should cooperate.

Your family,

not forcing the child to speak,
helping them feel safe in unfamiliar environments,
reassuring the child that he can speak when he is ready,
not reflecting their own concerns to the child,
rewarding the child for what he does to communicate,
It should help the child develop social skills.

Families should not forget that this is due to an anxiety problem and that the child does not choose not to speak, on the contrary, they cannot speak in certain environments. Thinking that the child deliberately and willingly refuses to speak can cause the family to become angry and depressed, causing more pressure on the child, thus reinforcing the situation of not speaking.

Selective mutism can be treated with a carefully planned therapy process in which family, specialist and school cooperate.

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