Certain kids might talk freely at home, but they can get quiet at school. This condition is called Selective Mutism. If you are a parent or an educator who wishes to learn more about SM in general and how to help children who are fearful of talking, then this guide can help you.
The application of Applied Behavior Analysis (ABA) therapy is one of the most powerful techniques to aid children with SM. ABA is a scientific approach that involves behavior analysis, Positive Reinforcements, and self-goals to develop new skills and behaviors.
What is Selective Mutism?
Selective mutism is an anxiety disorder where speaking is impeded in particular environments like school, work, or amongst strangers. People who deal with stressful situations and who become very socially anxious can talk normally with their family or friends in familiar situations positively, but when these people are expected to talk to someone who is out of their comfort zone, they become absolutely speechless. It is not that people are shy and rude but they are so frightened about talking. Early childhood Selective Mutism most times affects these age brackets 2-4 and it brings negative effects to academics, social skills, and personal growth. Selective mutism often occurs together with social anxiety disorder, and the therapy options include cognitive-behavioral therapy, medications, or together.
Selective Mutism in Children
Selective mutism of children is the condition when a child does not want to speak in certain social situations like at school, work, or with strangers or other unfamiliar people although they can communicate normally in other situations for example, at home with familiar people. It is not a liking or a shy kind gesture but an anxiety disorder that hampers the child from talking. Selective mutism is one of the most vital nonverbal communication disorders and most of the time starts in early childhood when children are between ages 2 and 4. This disorder negatively affects their education, social skills as well as their self-esteem.
Some of the Symptoms of Selective Mutism in Children are:
- An ongoing pattern of not talking in certain social circumstances and where people expect to talk or to be spoken to.
- The instinct to say something that remains unrealized because of a fear, indecisiveness, or modesty.
- By using nonverbal communication for the purpose of needs expression (e.g., nodding head and pointing).
- Lack of communication, loneliness, and non-participation in conversation among a lot of children in the age bracket of 2-4.
- Spontaneous speaking in some particular circumstances (eg, at home or with loved ones)or not in other (eg, at school or among unfamiliar people)
- The physical indicators of anxiety, for instance, fidgeting, avoiding eye contact, moving or showing up less, abdominal pains, headaches, nausea, and diarrhea.
The Causes of Selective Mutism in Children are not Fully Understood, but Some Possible Factors are:
- A family history of anxiety disorders.
- A unique peculiarity of reticence and scared in unknown environments.
- The neurological reaction to safety alarms originating from the outside environment.
- A common disability like autism spectrum disorder, or obsessive-compulsive disorder, or developmental delays, or sensory processing problem can also happen.
What Is the Difference Between Selective Mutism and Autism?
Selective mutism and autism are separate conditions that may impede communication abilities of a child, but they are distinct. Here are some of the main differences between them:
👨⚕️ Selective Mutism
👉Selective mutism refers to the anxiety disorder that arises among kids when they are unable to communicate in certain situations, like at school, work, or with strangers even though they can speak with the familiar people with whom they are comfortable at home.
👉Selective mutism generally develops in early childhood and takes hold between the ages of 2 and 4. It is usually found in children who suffer from social fear.
👉Selective mutism is diagnosed according to the criterion of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which states that the disability to speak is not related to a lack of language fluency, a communication disorder, or autism.
👉In the case of selective mutism, medication, cognitive-behavioral therapy or a combination of both methods are used during the treatment, which aims to reduce anxiety levels and enhance verbal communication skills in various settings.
👨⚕️ Autism
👉Autism is a Developmental Disorder that makes a person different in the way they perceive and relate with the world; and can cause such challenges as social communication, behavioral, and sensory regulation.
👉Autism is a birth defect, or it becomes noticeable at an early stage of life, and it should not be confused with anxiety because some people with autism might also have anxiety disorders.
👉Autism is diagnostically characterized by the observation of a repetitive set of symptoms found in the DSM-5. Accordingly, the patient demonstrates persistent deficits in social communication and interaction, and restrictive, repetitive patterns of behavior, interests, or activities.
👉Autism is treated with a number of interventions that may possibly comprise behavioral therapy, Speech Therapy, Occupational Therapy, social skills training, medication, or alternative treatments, that may ultimately aim to improve the person’s functioning and quality of life.
Selective mutism and autism, which are conditions complicated and diverse in nature, may cause problems in communication in some different ways to the person. In fact, what triggers the disorders, their symptoms, and also what will act as a remedy for each also varies. If you suspect that you or someone you know has selective mutism or autism, it is recommended that you watch over them close by so as to mention it to a qualified health professional for diagnosis and treatment. In order to cater for the affected individuals and families, AutismCOE requires to provide the necessary support and resources to help them in seeking the appropriate diagnosis and customized treatment plans that will enable them do well.
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How is Selective Mutism Diagnosed?
To assess and diagnose selective mutism, a mental health provider for example a psychiatrist or a psychologist will probably evaluate the behaviors and manifestations of the children in various settings besides anxiety levels. The diagnosis is based on the following criteria:
- The children usually fail to speak in situations such as a school where it is expected to speak, but on the other hand, they are able to speak at home.
- When the Childrens do not express him or herself, it affects their school performance or social emotions and brings on stress.
- The overall period of the condition is not less than one month but can well be the first month of school.
- Speechlessness is not because one does not possessed some language’s proficiency, or any type of condition like autism.
The mental health professional may also use some tests and tools to help with the diagnosis, such as:
- Specialists, teachers, as well as parents, can perform the observations of the person within the environment and also their behaviors.
- On the other hand, they will conduct examinations of speech development and cognitive tests to exclude all the problems that could affect the development.
- Language assessments including hearing or verbal assessments for blocked development or impairment of language.
- Questionnaires or interviews before treating the person and considering the anxiety and coping skills.
Selective mutism often gets misdiagnosed as shyness or rudeness, which brings out the lack of the person suffering from it to talk to others. It is vital to consult a professional in case you especially suspect yourself or somebody you are aware of to have selective mutism because Early Intervention can enhance the outcome and comfort of life.
How is Selective Mutism Treated?
Some possible ways to help a child with selective mutism are:
- In a slow, gradual manner the new person comes into the child’s life, in a relatively stress-free setting where the child can reflect on themselves without feeling pressured to verify him or her.
- Supporting kid’s effort by any rudimentary means, like gestures, whispering, or mouth word as a sign of communication.
- Playing a video of the child speaking well at home to them when they become nervous at school to uplift their self-confidence.
- Speech therapy will be provided if a child has any speech issues that may lead to poor communication so that the problem is resolved.
- Family and behavioral therapy are needed to address these emotional problems. Some medications can help also reduce anxiety.
- Involving the child’s teachers and helping them make the communication at school less frightening. Likewise, a teacher may have the child speak in small groups first before the whole class.
These are some of the methods that are often used to treat selective mutism but the treatment may differ depending on the child’s needs and preferences. With the right treatment, the child will get rid of the selective mutism and the quality of life will be further improved. With that in mind, the aim of the treatment is to help the problem with speaking improve and not get worse.
What are Some Other Treatments for Selective Mutism?
Some other treatments for selective mutism are:
Parent-Child Interaction Therapy (PCIT) is an approach that puts emphasis on the parents as the kids’ first teachers in assisting them to speak more clearly, and confidently, as well as communicating comfortably.
Operant Conditioning aims at employing the positive effects of rewards and the negative consequences of sanctions to shape the kid’s behavior and encourage him or her to speak in various circumstances.
Through the practice of Mindfulness, children are taught to observe their feelings and sensations, but not evaluate or react to them. Sometimes it is all they need to handle their emotions when they are overwhelmed.
Relaxation Practices including deep breathing, meditation, or progressive muscle relaxation techniques may help a child ease their mind and their body which makes the physical symptoms of anxiety less.
These are the other kinds treatments for selective mutism that also benefit some childs. Nevertheless, the best option would depend on the child’s needs that would be determined in conjunction with the child’s preferences. It is essential to confer with a mental health expert, who should have the distinction and the experience in treating selective mutism, for diagnosis and treatment.
Frequently Asked Questions & Answer
Q1. How Can ABA Therapy Help Children with SM Prepare for School?
ABA therapy might be useful for those who struggle with SM to help them learn how to talk in different settings like school and may entail teaching the areas of focus such as social skills, communication skills, and self-regulation skills. ABA therapy not only helps children to deal with social anxiety, shyness, or rejection, but it is also beneficial in overcoming challenging situations.
Q2. What are Some Examples of Social Skills That ABA Therapy Can Teach Children with SM?
The concept of social skills can be summarized as a capacity to communicate with others in a friendly manner, taking others into account. The group of skills associated with a social interaction include building friendships, sharing, giving turns, working together, and keeping social rules. ABA therapy can teach a person the skill of starting conversations and how to proceed further or pull out from a group activity, as well as how to respond to feedback from others. ABA therapy is also designed to focus on the development of children’s abilities to reflect and appreciate others’ positions.
Q3. How Do You Treat Selective Mutism in Children?
For mutism, the therapy known as behavioral therapy and cognitive behavioral therapy have the strongest scientific backing. Treatment for childhood anxiety integrates the utilized behavioral therapy techniques that include stimulus fading, sequential approximations / shaping, contingency management, and progressive exposure.
Q4. How Long is Treatment for Selective Mutism?
In light of observation, we can inform you that a comprehensive treatment program does it within 12 to 24 months for successful resolution of selective mutism. But on the other hand, there will be many factors which will affect the rate of progress.
Conclusion
Selective mutism is the name for a disorder that many children experience worldwide, which can take its toll and ultimately limit their academic, social and Emotional Growth. Nevertheless, an early diagnosis and provision of appropriate treatment are the crucial steps that can help kids with selective mutism get over their shyness and learn how to interact with the world freely. If you are looking for a professional and compassionate service that can help your child suffering from selective mutism, you may want to consider AutismCOE. AutismCOE is an organization that provides a variety of services for children with Autism Spectrum Disorder and other developmental disorders, including selective mutism.
Please Note: The content of this blog is for informational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Consult a qualified healthcare professional for personalized guidance tailored to your specific situation.
Bhavika Bhasin (Author)
Bhavika Bhasin is the Research and Marketing officer at AutismCOE. She works with children and adults with ASD. Her clinical research includes evaluating various available autism screening and diagnosis methods and their efficacy. She is currently developing a novel screening exam that is indicated to be more accurate than the existing available exams. She is also writes articles papers for various publications.
