Selective Mutism and its myths

Selective mutism (SM) is an anxiety disorder where children are chatty at home but they are unable to speak in public setting including schools or any other outside settings.

Many people misinterpret this behaviour and they feel with these children are refusing to talk, however it is an inability to speak at all in specific social situations.

In this article I would like to clarify some myths about SM,  clarifying aspects on this not well known anxiety disorder.

When I say that I work with children with SM one of the first thing that people say is:

“That’s a shame that child has been abused”

This is a very unfortunate and there is no evidence that SM is linked to trauma. Experts believe that the condition has a strong genetic link and children who suffer from SM, although able to speaker home, struggle to overcome their anxiety in social situation.

As a speech therapist working with this client group, people think that kids with SM have a speech problem but in this article I explaining what is the role of the speech and language therapist.  SM can coexist with speech delay or dld or phonological delays however these children don’t have any specific speech or language problem that stop them from speaking. Their fear is linked with social situations, also as teachers or other school members don’t hear them speaking, this leads them to believe that they have reduced verbal skills

Children with SM also have autism: SM coexists with other conditions and it is true that a child can have both SM and autism, however this is not always the case and these pathologies can stand on their own.

These pathologies have a lot in common such as:

  • lack of eye contact
  • controlling behaviours
  • rituals
  • reduced social engagements
  • solitary play

However this is because of the reaction of the anxiety as children with SM do not lack social and communication skills but they are only inhabited in speaking in certain situations.

Children with SM are defiant and manipulative: Many people believe that children with SM choose not to speak and initially this condition was cold “elective mutism” indicating the conscious decision of NOT speaking (this would be defiant). They are totally frozen when they are faced with a question …. think of yourself in your in front of your worst fear.

SM is only a form of shyness it doesn’t require any treatments and children will grow out of it: People feel that they will get better with time. There is certainly a clear difference between shyness and anxiety of speaking as these children feel totally frozen and unable to speak in certain social situation and this has a huge impact in their life and development. While some children do eventually overcome SM without any treatment this is a long pathway for them as they miss out on appropriate activities which then has an effect on the development of their social skills.

There is not enough research at present although therapists working with this client group report that  one of the most important aspect of therapy is to create a team, support families and schools in order to create the right environment.

Anna Biavati-Smith

specialist speech and language therapist

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