When my child was diagnosed with Selective Mutism it was discomforting to accept it initially. The first thing that came to my mind was what caused it. It gives some peace of mind and ability to develop the acceptance by understanding the reasons behind it.  I was very curious to understand reasons behind it.

• Genetic

Selective Mutism anxiety may present itself in different forms when the child is young. It could look like

Generally, there is a genetic disorder that contributes to most of the anxiety. Selective Mutism has some genetic predisposition which runs in the family. It is not uncommon for at least one of the parent to have had other types of anxiety such as social phobia, anxiety disorder, obsessive compulsive disorder or Selective Mutism themselves. It is also common for siblings to likely exhibit similar anxieties. 

Additionally, the parents anxiety contribute to the child’s anxiety and makes the child more anxious. The child quickly picks up the anxiety from the parent and it makes it worse for the child. As parent you need to feel comfortable even if the child may not be comfortable in certain situations. It is ok to feel uncomfortable and it teaches the child that its ok as well. 

• Neurological Disorder

It can also be related to neurological disorder. In a normal circumstance when a person experiences danger the brain sends signals to the body, and they experience fear. In this situation a person may choose to fight or flight. In case of a SM child, similar fears are triggered by a social situation where speaking is expected including the school.

• Language disorder or bilingual children

If your family is bilingual then there is a bigger amount of pressure or expectation for the child to be able to speak in both languages. This makes it harder for the child making him more anxious and thus, he may just shut down. They may fear of being incorrect and being judged by others. This heightens their fear and anxiety and they become fearful of speaking.

Since a child with Selective mutism may not get the opportunity to speak as many times as any other children they may face language developmental issues. Children with SM might have inability to express and articulate language properly. They have higher rates of language issues. When SM and language disorder occur together the language disorders cause the mutism symptoms to be much worse than otherwise.

• Environmental factors

There is no evidence that trauma could cause Selective Mutism however if the child has experienced some stressful conditions, they could be contributing to the already existing Selective Mutism anxiety. It could also be controlling and over protecting parents or putting high expectations on the child making him more anxious. It could also be environmental factors at school which could be enforcing the SM if the child is not engaging in group activities or has trouble making friendships etc. It becomes harder for the child to engage if they are use to not engaging in school.

For e.g., during covid times we were in a lock down situation with no going out and no social interactions. I noticed my daughter’s Selective Mutism become more prevalent after the lock down was opened as a young child they forget the social world and going back into it was quite stressful for her.

When should I consult a psychologist?

A child who displays these characteristics consistently would be suspected as a Selective mutism child. A formal diagnosis from a qualified psychologist is required –

1. When the child can talk easily at home however consistently fails to talk in other settings where it is required to speak in order to fulfil their daily needs e.g. School.
2. Lack of speaking leads to impairment in education/ social and occupational setting.
3.  It is within acceptable levels if the child shows lack if verbal communication in the first few months of school. However, if the child exhibits impairments in daily functioning at a school setting for more than a month then it needs further investigation.
4. Bilingual children – it has been noted that children who are expected to use more than one language may not feel comfortable in the other language. They either associate anxiety with the other language and go mute when expected to speak in it or they associate stress and anxiety with speaking in general and hence they are at more risk to Selective Mutism. Make sure language is not the barrier. It needs to be taken into consideration that bilingual kids can be slower to develop language and should not be mistaken with Selective mutism.
5. The disturbance is not better explained by a communication disorder (e.g., child-onset fluency disorder) and not occur exclusively during autism spectrum disorder, schizophrenia, or another psychotic disorder.

Could my child have other issues along with Selective Mutism?

Children who have Selective Mutism 80% of the time have another anxiety disorder. The most common disorder which comes along with Selective Mutism is Social Phobia. This is a high probability and it generally a rule and not an exception to have another anxiety.

The difference between the two anxieties is –

Selective Mutism	Social Phobia / Social anxiety disorder
Consistent failure to speak in certain situations while they can speak fluently in other situations.	Persistent fear in performing routine social interactions caused by significant anxiety, fear, self-consciousness, and embarrassment because you fear being scrutinized or judged by others.

The psychologist may discuss with you and decide which phobia to treat first. Generally, the treatment for both is very similar.

Other common comorbid anxiety disorders include separation anxiety disorder, generalized anxiety disorder and specific phobias (Dummit et al., 1997).

 Selective Mutism frequently occurs in conjunctions with other communication delays, weakness, or disorders. This is generally due to the lack in the experience in expressing the language.

1. Children with Selective mutism may speak in shorter sentences, less detailed descriptions and more simplistic narrations.
2. Some may have a funny voice as the vocal cords have not been trained. They maybe using more whispers or low volumes.

Hence, it is important to get a Speech and Language development assessment done by a therapist. A better speech and language ability will give them more confidence to speak in different situation.

It is believed that some children with Selective Mutism may have subtle hearing disabilities (probably 75% of the children with Selective Mutism) and are unable to process the sounds. (Muchnik, 2013). This will make their condition worse. It is also important to rule out if the child has any hearing issues which could be adding to the issues. A loss in hearing could also lead to reduced verbal communication.