Counseling - Oregon & Washington

Selective Mutism (SM)

What does it look like?

Selective mutism (SM) is a severe social anxiety disorder or social phobia, in which a person who is generally capable of speech is unable to speak in certain situations, or to specific people. Often the individual speaks freely at home. It is more extreme than shyness, and the problem surfaces in various degrees of severity. The condition is relatively easy to diagnose. It is important to assess for auditory and other processing disorders to make sure the diagnosis is correct. Selective mutism is not a speech disorder and is not related to language difficulty.

Who is affected?

Selective mutism is a childhood disorder that is generally considered a rare disorder. It is found in about 1% of patients in mental health settings, but it occurs in only about 0.01% of the general United States population. Some researchers believe selective mutism occurs more frequently than the data suggest. In other words, there may be many unreported cases of selective mutism that resolve with time and require no intervention.

Where does it come from?

Selective mutism is highly connected with social anxiety and social phobia as the individual gets older. The biggest mistake made regarding selective mutism in children is the belief that “the child will grow out of the problem.”

When does it happen?

Selective mutism may appear at the very beginning of a child’s social experience or may begin in later childhood. The most common age of onset for the disorder is the early elementary school years. Some cases have been recorded in which selective mutism does not begin until high school. Onset in late adolescence is unusual.

The disorder appears to run in families. Children whose parents are were especially timid as children, or suffered from selective mutism themselves, are at greater risk for developing selective mutism.

How do we treat it?

The most effective treatment is child focused Cognitive Behavior Therapy, gradual exposure therapy and parent education.