October is Selective Mutism Awareness Month! And while the selective mutism (SM) community is growing, there are still many misconceptions out in the world about SM and related behaviors. These myths not only impact family decisions to pursue treatment, but also school decisions to inform families of students’ non-speaking behaviors. So to help raise awareness about selective mutism, I am taking a page from The Discovery Channel’s MythBusters and shedding some light on the most frequently held, yet inaccurate beliefs about SM.
Myth: Selective mutism is oppositionality
Clinicians often hear kiddos with SM described as “stubborn” or “refusing to speak” as others may perceive the child’s non-speaking behaviors as willfulness or noncompliance.
Fact: Selective mutism is an anxiety disorder
- Diagnostically speaking, selective mutism is characterized by a child or adolescent’s consistent failure to speak in specific social situations (e.g., at school, in their community, with unfamiliar adults) despite speaking in other situations (e.g., at home, with parents).
- It’s not that individuals with SM are refusing to speak, but rather that they are unable to speak in certain situations because of their impairing and overwhelming anxiety. While it is not uncommon for a child with SM to also demonstrate disruptive behavior, this typically represents anxious avoidance (e.g., throwing toys when prompted to speak).
Myth: Children who don’t speak in school are just being shy and will outgrow it
When families share concerns about their child’s failure to speak in certain situations with others, they are commonly told not to worry as their child is just shy and will grow out of it.
Fact: Children with selective mutism do not outgrow it
When untreated, challenges associated with selective mutism can snowball into severe impairments in multiple areas…
- Specifically, every day in which a child continues with impairing SM symptoms, their habit of speech avoidance strengthens and their belief that they are capable of speaking decreases. Similarly, the longer children avoid speaking, the more that others around them (peers, teachers, etc.) perceive them to be the child who doesn’t speak, thereby stunting social relationships with peers and potential mentors.
- Academically, SM impacts children’s ability to participate in general education settings in a typical manner. As such, educators are frequently unable to accurately gauge the child’s status and progress, putting students at risk of having to repeat the academic year.
- All of this can be incredibly demoralizing, putting youth at risk for self-esteem issues. Without the proper treatment and supports in place, children with selective mutism are at considerable risk for subsequently developing added mental health challenges, such as social anxiety, generalized anxiety, or even depression.
Fact: Selective mutism can be reversed with the appropriate interventions!
- Our practice has been able to return most of our school age patients to functioning within normal limits using evidence based approaches.
Fact: Children with selective mutism are not necessarily shy
- There is a large subset of children with SM who are socially anxious introverts with more reserved personalities. These children are anxious in all social situations, even when talking is not expected. As such, they not only avoid speaking, they also tend to avoid engaging in eye contact with others and participating in play activities (like Simon Says or running around on playground). However, this is not the rule with all kiddos with selective mutism.
- Many children with SM are actually social butterflies with rich social lives! Such children will typically play nonverbally with familiar others and enjoy birthday parties and playdates, actively participating on the playground or other nonverbal activities.
Myth: Selective mutism is a result of trauma
Occasionally parents wonder if their child with SM has been exposed to a traumatic stressor and whether their avoidance of speaking was caused by trauma.
Fact: It is highly unlikely that selective mutism is caused by trauma
- Children who have been exposed to trauma typically present with reexperiencing symptoms, and may persistently avoid places or activities that remind them of the stressor, and/or experience shifts in their thoughts or mood that may result in their withdrawing from others.
- Being selectively mute, however, is not a defining feature or symptom seen in children exposed to a traumatic stressor. SM instead is typically a result of genetic predispositions to anxiety and negative reinforcement in the child’s environment whereby others accommodate to their avoidance of speaking.
Myth: Children with selective mutism are on the autism spectrum
Since children on the autism spectrum experience challenges with social communication and social interaction, sometimes schools mistake SM for autism.
Fact: Selective mutism does not indicate autism
- Children on the autism spectrum experience the above mentioned challenges across all settings and situations. Whereas, children with SM live in a divided world in which they have rigid rules of
- who they speak to and who they don’t
- where they speak and where they don’t
- and when they speak and when they don’t
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