The selective mutism of children: a communication problem?

It costs us many overcome shyness when they introduce us to someone or when we find ourselves in an environment that makes us uncomfortable or that we are not used to. When it comes to young children, it is not unusual for them to hide behind their parents if they do not know the person they are talking to. But in the case of some children, what we think is pure shyness may turn out to be a psychological disorder known as selective mutism.

What is the selective mutism of children?

Some children are very talkative when they are with their parents and yet they are not able to talk to their grandparents, a cousin or their teachers. Many of these children, when they find themselves in a situation or environment that bothers them, will be unable to speak out loud and will have to whisper in the ears of those they feel most comfortable with. Of course, when nobody else is watching.

Selective mutism is a problem of inhibition of speech that usually begins in the preschool stage. The child selectively inhibits the verbal response with certain people or in certain social situations, despite not presenting any speech impediment. One of the many dangers of this disorder is that mutism can lead them to act without first consulting with an adult. They may, for example, disappear without telling anyone they were leaving.

These are some of the characteristics of selective mutism:

1. An anxiety disorder. The DSM frames selective mutism in anxiety disorders and phobias. Although the causes are unknown, it is believed that it is due to a mixture of genetic and environmental factors. It can start with extreme shyness and progressively mute, or arise from a stressful situation such as hospitalization, separation from parents, loss of a relative or change of city.

2. A vicious circle. In some children it occurs almost like a vice: when feeling anxiety in front of some new situation the child can be unable to speak and the adult who accompanies him will go to his "rescue" and will answer for him. The child will feel a short-term relief from his anxiety and this behavior will be reinforced. And before your father or mother realizes it, it has become a habit for the child to the point that he will no longer consider talking to be an option.

Elena Villa, a child psychologist, says that selective mutism is not very common (its prevalence is around 1% of the child population) and is more frequent in girls than in boys. However, it is a disorder that worries the experts because 50% of children who suffer from selective mutism also suffer from some other type of anxiety disorder, almost always a social phobia or a separation anxiety disorder.

How to recognize selective mutism in a child

Diagnosis is not always easy since children with selective mutism usually speak normally at home and parents may not realize until months (or even years) have passed since they began.

In addition, it is easy to confuse selective mutism with shyness. The most normal thing is that children with selective mutism do not speak in class, so it is usually the teachers who alert parents when they notice how the child, despite appearing happy, does not talk to his classmates or communicates with gestures .

However, it is normal for the child to talk a lot during the first months of school. less or even nothing at all. In order to differentiate mutism from other problems, the duration of the alteration must last at least one month (not counting the first one of school). There must be a persistent inability to speak in concrete situations, despite the fact that the child speaks normally in others, without it being due to a speech impediment. Another important indication is that their inhibition interferes with their school performance.

The bad behavior of the child can also be an anxiety sign before having to face a situation that is difficult for him; They can do everything possible to avoid a social event that causes them anxiety. In general, children with this disorder have above-average intelligence and are especially sensitive to the feelings of others. If they are very active and talkative when they are comfortable (something not uncommon in these children), it will be easier to identify the situations in which they will suffer from mutism.

Selective infantile mutism or shyness?

It is not uncommon for children to be shy in certain situations, but to what extent is their shyness normal? If your child does not do something that you know he likes systematically when he is with a specific person or in a certain place or is paralyzed completely in certain situations, it is more likely that it is more than just shyness.If, for example, he likes to paint a lot but does not do it at his grandparents 'or friends' house, it is not a normal shyness.

When it comes to differentiating a child with selective muteness from a shy or introverted child, it can be appreciated that the latter, although it may cost him to talk to strangers, as he takes confidence will be able to interact with that stranger, although be of minimal form. However, a child with selective mutism will not speak in certain contexts or to certain people without this being corrected over time.

In addition, a shy child can follow the academic rhythm and does not have to present academic problems, while a child with mutism, in general, will have difficulties in school. Children with this disorder will have trouble talking with their peers, which does not happen in case of mere shyness in which relationships with peers will not be affected.

Reduce anxiety to treat the mutism of children

Although it may seem like a minor disorder, if left untreated, selective mutism can lead to a more serious and more complicated social anxiety disorder. In fact, there are cases in which people in their 40s, who looked like this child disorder, are now completely unable to speak (not even with their relatives). Others develop depression or severe anxiety disorder.

When mutism has been identified, the intervention will focus on reducing anxiety. The child will be taught relaxation techniques to later expose him, gradually, to the feared situations. For the modification of the behavior, it will be possible to use, with control, prizes to motivate the patient to change and minimum punishments (such as loss of points, etc.). To treat the most severe cases in which medication has been needed, selective serotonin reuptake inhibitors such as fluoxetine (better known as Prozac) have been used.

As with any disease, it is important to be very careful with what are known as secondary gains. When our child is sick we increase the signs of affection, attention and, frequently, we relieve him for a time from his obligations. The problem is that the child can stop perceiving the disease as something negative, which means that he does not dedicate all his efforts to improve.

Elena Villa recommends identifying the problem as soon as possible to provide the child with an adequate treatment and to avoid conflicts in the areas most affected by this problem: the family, the social and the academic.

Marga Wesolowski
Advice:Elena Villa, child psychology.

Video: Selective Mutism: What is it? // Mental Health w/Kati Morton

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