Do you know a child who does not speak, speaks to a select few or barely whispers? This child may suffer from an anxiety disorder called; Selective Mutism
By Dr. Elisa Shipon-Blum, CEO and Executive
Medical Director, Selective Mutism Group Childhood Anxiety Network, SMG~CAN Selective Mutism is a childhood anxiety disorder characterized by a child's
inability to speak in select social settings, such as school, but is able to
talk normally in settings where he/she is comfortable, secure and relaxed. Selective Mutism is more common than autism and affects 3.5/500 children,
yet so few have heard of Selective Mutism that many treating professionals
are unaware how to evaluate and assess the disorder. Many children are misdiagnosed
as being autistic. Teachers are also not sure how to help the child in the
classroom setting. As a result, children are often misdiagnosed with other
disorders such as; autism, learning disabled, oppositional or 'just shy'. Over 90% of children with Selective Mutism also have social phobia or social
anxiety. This disorder is quite debilitating and painful to the child. Children
and adolescents with Selective Mutism have an actual FEAR of speaking and social
interactions where there is an expectation to talk. Not all children manifest their anxiety of speaking the same way. Some may
be completely mute and unable to speak to anyone in a social setting, while
others may be able to speak to a select few or perhaps whisper to others. Some
children may stand motionless with fear, as they are confronted with specific
social settings. They may freeze, be expressionless, unemotional and may be
socially isolated, while other, less severely affected children, may 'look' relaxed,
carefree and socialize with one or few children but are unable to speak. Why does a child develop Selective Mutism?
The majority of children with Selective Mutism have a genetic predisposition
to anxiety, specifically, social anxiety. Often, these children show signs
of severe anxiety, such as separation anxiety, frequent tantrums and crying,
moodiness, inflexibility, sleep problems, parental separation issues, and
extreme shyness from infancy on. Approximately 20-30% children with SM
have subtle speech and language abnormalities and/or from bilingual
families. In addition, a large proportion of children have sensory integration
disorder (DSI) that causes them to shut down only exacerbating anxiety.
There is NO evidence that the cause of Selective Mutism is related to abuse,
neglect or trauma. When are most children diagnosed as having Selective Mutism?
The average age of diagnosis is between 3 -8 years old. Thought to be 'just
shy' it is not until children enter school, and there is an expectation
to perform, interact and speak, that Selective Mutism becomes more obvious.
* If mutism persists for more than a month, a parent should mention this to
their physician. Why is it so important for a child with SM to be diagnosed when he/she is
very young?
Because Selective Mutism is an anxiety disorder (#1 mental illness among children)
if left untreated, it can cripple a child for life and, unfortunately,
curb
the way for an array of academic, social and emotional repercussions. How is Selective Mutism Treated?
The main goal with treatment is to lower anxiety, increase
self-esteem and increase social confidence and communication
in social settings.
Emphasis should
never be on 'getting a child to talk.' ALL expectations for verbalization
should be removed. Present treatment consists of behavioral therapy to progress
communicatively and 'unlearn' mute behavior with or without the
use of medication. It is important to realize that with proper diagnosis and treatment, the
prognosis for overcoming Selective Mutism is excellent, however if left untreated
it
often leads to years of suffering and social withdrawal.
There will be a Selective Mutism Conference in Parsippany, New
Jersey at the Sheraton Parsippany on Oct 2-3, 2004. For more information, visit the SMG~CAN website at: www.selectivemutism.org or contact us: sminfo@selectivemutism.org or 215-887-5748 *SMG~CAN is a division of the 501(c)3 nonprofit organization, the Childhood
Anxiety Network, Inc. (CAN)
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