Myths About Selective Mutism

Selective mutism (SM) is a relatively rare anxiety disorder in which children who are talkative at home are unable to speak in more public settings,  including school. Their behavior is often misinterpreted as an inability to speak at all, or as a willful refusal to speak. Here are some of the most common myths about SM.

This is an unfortunate myth because it may prevent parents from seeking help for a child for fear of being suspected of abuse. There is no evidence linking selective mutism to trauma; children who are selectively mute are comfortable speaking at home but overcome by anxiety in social situations. Experts believe the condition is familial and possibly genetic.

SM is a type of social anxiety that is much more extreme than ordinary shyness; it’s a paralyzing inability to speak which interferes with a child’s life and development. While some children do eventually overcome SM without treatment, they may endure years of suffering and miss out on age-appropriate activities and development.

While some children with SM do have a speech delay, the two conditions are unrelated and many selectively mute children have no speech or language learning problems. When children cannot speak to unfamiliar adults, their verbal skills may be underestimated.

The idea that children “choose” selective mutism was such a popular idea that for a while SM was known as “elective mutism,” and it was attributed to poor parenting. The truth is that SM stems from social anxiety and inhibition, not anger or a desire to control; the children experience it as an inability to speak.

Pressure to speak is precisely what children with SM find most paralyzing. What they need are interventions to reduce anxiety and encourage efforts to speak with positive reinforcement. Being careful to give a child 5 seconds extra time to respond to a question can also increase the chance that she will find her voice.

Children with SM, when they are feeling anxious, often react with lack of eye contact, a blank expression, and other behaviors that may look like an autism spectrum disorder. However, SM is fundamentally different from autism; while children with autism lack social and communication skills, children with SM are severely inhibited in speaking in certain situations.