{"id":119719,"date":"2020-07-09T11:00:46","date_gmt":"2020-07-09T10:00:46","guid":{"rendered":"https:\/\/www.harleytherapy.co.uk\/counselling\/?p=119719"},"modified":"2023-03-11T08:52:16","modified_gmt":"2023-03-11T08:52:16","slug":"what-is-selective-mutism","status":"publish","type":"post","link":"https:\/\/www.harleytherapy.co.uk\/counselling\/what-is-selective-mutism.htm","title":{"rendered":"What is Selective Mutism?"},"content":{"rendered":"<div id=\"attachment_119744\" style=\"width: 275px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-119744\" class=\"size-medium wp-image-119744\" src=\"https:\/\/www.harleytherapy.co.uk\/counselling\/wp-content\/uploads\/m-t-elgassier-4C_UgnRtcRg-unsplash-265x400.jpg\" alt=\"selective mutism\" width=\"265\" height=\"400\" srcset=\"https:\/\/www.harleytherapy.co.uk\/counselling\/wp-content\/uploads\/m-t-elgassier-4C_UgnRtcRg-unsplash-265x400.jpg 265w, https:\/\/www.harleytherapy.co.uk\/counselling\/wp-content\/uploads\/m-t-elgassier-4C_UgnRtcRg-unsplash-398x600.jpg 398w, https:\/\/www.harleytherapy.co.uk\/counselling\/wp-content\/uploads\/m-t-elgassier-4C_UgnRtcRg-unsplash.jpg 709w\" sizes=\"auto, (max-width: 265px) 100vw, 265px\" \/><p id=\"caption-attachment-119744\" class=\"wp-caption-text\">Photo by: M. T. Elgassier<\/p><\/div>\n<p><span style=\"color: #333399;\">by Andrea M. Darcy<\/span><\/p>\n<p>Does <a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/what-is-an-educational-psychologist.htm\">your child<\/a> stop talking entirely in certain environments? Have teachers mentioned there might be an issue? Or do you yourself struggle to speak in some situations and suffer because of it? It might be selective mutism.<\/p>\n<h2>What is selective mutism?<\/h2>\n<blockquote>\n<p class=\"p1\"><span class=\"s1\" style=\"color: #333399;\">Selective mutism means that in certain environments, or around certain people, you experience a freeze response where you can\u2019t speak, no matter how much you want to.<\/span><\/p>\n<\/blockquote>\n<p class=\"p1\"><span class=\"s1\"><strong>Also referred to as &#8216;situational mutism&#8217;, it&#8217;s most common in children,<\/strong> particularly girls and those who have recently <a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/moving-abroad-cause-depression.htm\">moved to a new country<\/a> where they must learn another language. <\/span><\/p>\n<p class=\"p1\"><strong><span class=\"s1\">And it&#8217;s <\/span><\/strong><span class=\"s1\"><strong>highly related to<\/strong> <a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/what-is-social-anxiety-disorder.htm\">social anxiety disorder,<\/a> with most children receiving a dual diagnosis.<\/span><\/p>\n<h2 class=\"p1\"><span class=\"s1\">Signs of selective mutism<\/span><\/h2>\n<p class=\"p1\"><strong><span class=\"s1\">It usually starts young, when children are between <\/span><\/strong><span class=\"s1\">ages two and four and are being introduced to new social situations like school. <\/span><\/p>\n<p class=\"p1\"><span class=\"s1\"><strong>Your child will suddenly change their behaviour <\/strong>and even\u00a0physical responses. This can look like:<\/span><\/p>\n<ul>\n<li>clinging to you or hiding behind you<\/li>\n<li>freezing their body and\/or face<\/li>\n<li>acting sulky or distracted<\/li>\n<li>being stubborn or having a tantrum when you are going to or returning from the environment they don&#8217;t like.<\/li>\n<\/ul>\n<p><strong>In older children and adolescents signs of selective mutism can include<\/strong> things like:<\/p>\n<ul>\n<li>a marked fear of making mistakes or being the centre of attention<\/li>\n<li><a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/what-is-alexithymia.htm\">unable to talk about their emotions<\/a> yet highly <a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/hyper-empathy-feel-too-much.htm\">empathic<\/a> towards others<\/li>\n<li>not eating or drinking at school so they don&#8217;t have to ask to go to the toilet<\/li>\n<li><a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/medically-unexplained-symptoms-counselling.htm\">unexplained illness<\/a> or medical symptoms like an upset stomach leading to many days off school<\/li>\n<li>refusing to do assignments that involve speaking in front of others<\/li>\n<li>not wanting to leave the house alone<\/li>\n<li>unable to call strangers such as booking an appointment.<\/li>\n<\/ul>\n<h2>A diagnosis of selective mutism<\/h2>\n<p class=\"p1\"><strong><span class=\"s1\">For your child to be diagnosed with selective mutism, they need to:<\/span><\/strong><\/p>\n<ul>\n<li class=\"p1\"><span class=\"s1\">have struggled\u00a0 with selective speaking for at least a month<\/span><\/li>\n<li class=\"p1\"><span class=\"s1\">not have difficulty only because it&#8217;s a new language for them<\/span><\/li>\n<li>have no issues with talking in environments they are comfortable in<\/li>\n<li class=\"p1\"><span class=\"s1\">have enough of an issue it <a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/types-of-learning-difficulties.htm\">interferes with learning<\/a> and socialising <\/span><\/li>\n<li class=\"p1\"><span class=\"s1\">not have another communication issue that better explains the problem, such as stuttering or<a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/what-is-autism-spectrum-disorder.htm\"> autism.<\/a><\/span><\/li>\n<\/ul>\n<h2 class=\"p1\"><span class=\"s1\">But my child is so chatty at home <\/span><\/h2>\n<div id=\"attachment_119720\" style=\"width: 410px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-119720\" class=\"size-medium wp-image-119720\" src=\"https:\/\/www.harleytherapy.co.uk\/counselling\/wp-content\/uploads\/caleb-woods-VZILDYoqn_U-unsplash-400x266.jpg\" alt=\"selective mutism\" width=\"400\" height=\"266\" srcset=\"https:\/\/www.harleytherapy.co.uk\/counselling\/wp-content\/uploads\/caleb-woods-VZILDYoqn_U-unsplash-400x266.jpg 400w, https:\/\/www.harleytherapy.co.uk\/counselling\/wp-content\/uploads\/caleb-woods-VZILDYoqn_U-unsplash-500x333.jpg 500w, https:\/\/www.harleytherapy.co.uk\/counselling\/wp-content\/uploads\/caleb-woods-VZILDYoqn_U-unsplash-180x120.jpg 180w, https:\/\/www.harleytherapy.co.uk\/counselling\/wp-content\/uploads\/caleb-woods-VZILDYoqn_U-unsplash.jpg 709w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><p id=\"caption-attachment-119720\" class=\"wp-caption-text\">photo by: Caleb Woods<\/p><\/div>\n<p class=\"p1\"><strong><span class=\"s1\">Children with selective mutism are often easily social or even very chatty <\/span><\/strong><span class=\"s1\">when around people they are comfortable with, like<a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/dealing-with-difficult-family-members-9-important-steps.htm\"> family<\/a> and<a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/i-feel-so-alone.htm\"> friends<\/a>, and in environments that <a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/something-bad-is-going-to-happen.htm\">feel safe<\/a>.<\/span><\/p>\n<p class=\"p1\"><span class=\"s1\"><strong>This is why the issue can go undiagnosed until<\/strong> children start <a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/back-to-school-blues-parents.htm\">school,<\/a> or are otherwise presented with new environments.<\/span><\/p>\n<blockquote><p><span style=\"color: #333399;\">And note that some children with this issue aren&#8217;t totally mute or frozen even when in full anxiety. They might use a few words, or speak in a whisper, or manage to at least use gestures or nodding to communicate. But it will be a far cry from their usual self.<\/span><\/p><\/blockquote>\n<h2 class=\"p1\"><span class=\"s1\">Connected issues\u00a0<\/span><\/h2>\n<p><strong>If your child suffers from selective mutism you might also find they suffer from the following:<\/strong><\/p>\n<ul>\n<li>social anxiety<\/li>\n<li><a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/shyness-in-adults.htm\">shyness<\/a> and trouble with eye contact<\/li>\n<li>fear of being embarrassed or singled out<\/li>\n<li><a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/worry-and-anxiety-difference.htm\">worrying<\/a>, more than others their age<\/li>\n<li>hiding their feelings but <a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/why-am-i-so-oversensitive.htm\">hypersensitive<\/a> to those of others<\/li>\n<li>environment sensitivity if things are noisy or too busy<\/li>\n<li>possible physical symptoms like stomach upset and urinary infections.<\/li>\n<\/ul>\n<h2>Selective mutism in adults<\/h2>\n<p><strong>If selective mutism in childhood is not treated it can carry over into adulthood<\/strong> and heavily affect you from <a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/reach-your-full-potential.htm\">reaching your potentia<\/a>l. Adults suffer social isolation, <a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/self-compassion.htm\">low self-esteem<\/a>, and <a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/shame-definition.htm\">feelings of shame<\/a>.<\/p>\n<p><strong>Sadly, others might misunderstand you and think you are<\/strong> rude or defiant. So you might also<a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/7-surprising-reasons-feeling-lonely.htm\"> feel very lonely<\/a>.<\/p>\n<p><strong>And it can make day-to-day life really difficult.<\/strong> Things like calling a doctor to make an appointment might take hours or be impossible. If you are accused of something you didn&#8217;t do you can be unable to defend yourself. And things like job interviews might be so stressful you simply avoid them.<\/p>\n<h2 class=\"p1\"><span class=\"s1\">Myths about selective mutism<\/span><\/h2>\n<p>So what myths about selective mutism do you need to know?<\/p>\n<h3 class=\"p1\"><span class=\"s1\" style=\"color: #993366;\">1. My child is being defiant. <\/span><\/h3>\n<p class=\"p1\"><span class=\"s1\"><strong>Absolutely not. A child with selective mutism really can\u2019t speak in certain situations no matter how much they want to.<\/strong> No amount of shaming or punishment can \u2018make\u2019 them speak, but it can certainly make them feel far worse than they already do. <\/span><\/p>\n<h3 class=\"p1\"><span class=\"s1\" style=\"color: #993366;\">2. My child must have been abused.<\/span><\/h3>\n<p class=\"p1\"><span class=\"s1\"><strong> Research has found no direct link between selective mutism and<\/strong><a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/i-think-i-was-abused-as-a-child.htm\"> abuse<\/a> or <a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/how-can-i-remember-childhood-trauma-abuse.htm\">trauma<\/a>. While it is true that child abuse or trauma can lead to children suddenly not speaking, post-traumatic speaking issues mean a child stops talking in an environment they used to have no problems in.<\/span><\/p>\n<h3 class=\"p1\"><span style=\"color: #993366;\">3. They are choosing not to speak, I&#8217;m sure of it.\u00a0<\/span><\/h3>\n<p class=\"p1\"><span class=\"s1\"><strong>This condition was originally called \u2018elective mutism\u2019 due to a misunderstanding (that still can persist)<\/strong> that sufferers don\u2019t want to speak. But again, this isn\u2019t the case. The brain of sufferers seems to enter an anxiety-triggered &#8216;freeze&#8217; mode beyond their control.\u00a0<\/span><\/p>\n<h3><span style=\"color: #993366;\">4. It&#8217;s a sign a child has intellectual difficulties.\u00a0<\/span><\/h3>\n<p><strong>To the contrary. Many children with selective mutism have an above average<\/strong> IQ and sense of perception and observation. They are very aware of other people&#8217;s feelings, more so than others of their age, and are more likely to have a strong moral compass.<\/p>\n<h2 class=\"p1\"><span class=\"s1\">Is it selective mutism or autism?<\/span><\/h2>\n<div id=\"attachment_119743\" style=\"width: 410px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-119743\" class=\"size-medium wp-image-119743\" src=\"https:\/\/www.harleytherapy.co.uk\/counselling\/wp-content\/uploads\/20792671139_0912f21307-400x400.jpg\" alt=\"what is selective mutism\" width=\"400\" height=\"400\" srcset=\"https:\/\/www.harleytherapy.co.uk\/counselling\/wp-content\/uploads\/20792671139_0912f21307-400x400.jpg 400w, https:\/\/www.harleytherapy.co.uk\/counselling\/wp-content\/uploads\/20792671139_0912f21307-150x150.jpg 150w, https:\/\/www.harleytherapy.co.uk\/counselling\/wp-content\/uploads\/20792671139_0912f21307.jpg 500w, https:\/\/www.harleytherapy.co.uk\/counselling\/wp-content\/uploads\/20792671139_0912f21307-200x200.jpg 200w, https:\/\/www.harleytherapy.co.uk\/counselling\/wp-content\/uploads\/20792671139_0912f21307-50x50.jpg 50w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><p id=\"caption-attachment-119743\" class=\"wp-caption-text\">By: <a href=\"https:\/\/www.flickr.com\/photos\/lochthyme\/20792671139\/\" target=\"_blank\" rel=\"nofollow noreferrer\" \">Andrea Koerner<\/a><\/p><\/div>\n<p><strong><a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/what-is-autism-spectrum-disorder.htm\">Autism spectrum disorder<\/a> and selective mutism share some characteristics. Both<\/strong> diagnoses see a child experience bouts of not speaking and of being sensitive to their environments.<\/p>\n<p><span class=\"s1\"><strong>A main difference is that<a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/what-is-an-autism-test.htm\"> children with autism<\/a> can have<\/strong> speech challenges even in environments they feel most safe in, such as around family. And they will also have other issues like hand flapping or rocking and repetitive behaviours. <\/span><\/p>\n<p><span class=\"s1\"><strong>Children with selective mutism, on the other hand, in the right<\/strong> environment where they feel comfortable, will appear like any other child.<\/span><\/p>\n<p><strong>This said, a child with autism can have selective mutism,<\/strong> in that certain environments always cause them to stop communicating. But if the mutism is due to autism, then it will diagnosed just as that.<\/p>\n<h2>Treatment for selective mutism<\/h2>\n<p><em>There are several forms of treatment to help, and the right treatment plan depends on age and related issues.\u00a0<\/em><\/p>\n<p><strong>Treatment generally focuses on <\/strong><a href=\"https:\/\/www.harleytherapy.co.uk\/counselling\/global-pandemic-anxiety.htm\">lowering anxiety<\/a> around talking rather than pushing for speech.<\/p>\n<p><strong>This can include things like<\/strong> &#8216;stimulus fading&#8217;, where your child talks with you or someone else they are comfortable with, another person is introduced, and you eventually leave. Or &#8216;shaping&#8217;, which introduces speech in stages like reading aloud, then interactive reading games, then talking activities, and finally a conversation. (Learn more about such treatments on the <a href=\"https:\/\/www.nhs.uk\/mental-health\/conditions\/selective-mutism\/\">NHS Selective Mutism page<\/a>).<\/p>\n<p><strong>Older children, adolescents, and adults will be<\/strong> offered <a href=\"https:\/\/www.harleytherapy.co.uk\/cognitive-behavioural-therapy-london.htm\">cognitive behavioural therapy<\/a>. It helps you challenge your thoughts, and understand just how your they are affecting your feelings, your body, and your behaviours.<\/p>\n<p><span style=\"color: #800080;\"><strong>Ready to help your child or yourself? Browse our hand selected team of <a style=\"color: #800080;\" href=\"https:\/\/www.harleytherapy.co.uk\/psychiatrists-london.htm\">London-based psychiatrists<\/a>, <a style=\"color: #800080;\" href=\"https:\/\/www.harleytherapy.co.uk\/child-psychologist-london.htm\">child psychologists<\/a>, and<a style=\"color: #800080;\" href=\"https:\/\/www.harleytherapy.co.uk\/therapists.htm\"> psychotherapists<\/a> now, who are committed to finding a treatment plan that works for you.\u00a0<\/strong><\/span><\/p>\n<hr \/>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>by Andrea M. Darcy Does your child stop talking entirely in certain environments? Have teachers mentioned there might be an issue? Or do you yourself struggle to speak in some situations and suffer because of it? It might be selective mutism. What is selective mutism? Selective mutism means that in certain environments, or around certain [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":119720,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","_lmt_disableupdate":"yes","_lmt_disable":"no","footnotes":""},"categories":[21,296],"tags":[3,318,115,162],"class_list":["post-119719","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-anxiety-and-stress","category-parenting","tag-anxiety","tag-children","tag-parenting","tag-social-anxiety","has_thumb"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.3 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>What is Selective Mutism? - Harley Therapy\u2122 Blog<\/title>\n<meta name=\"description\" content=\"Is your child unable to speak in certain situations like school or at church? 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It might be selective mutism\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.harleytherapy.co.uk\/counselling\/what-is-selective-mutism.htm\" \/>\n<meta property=\"og:site_name\" content=\"Harley Therapy\u2122 Blog\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/harleytherapy\" \/>\n<meta property=\"article:published_time\" content=\"2020-07-09T10:00:46+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-03-11T08:52:16+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.harleytherapy.co.uk\/counselling\/wp-content\/uploads\/caleb-woods-VZILDYoqn_U-unsplash.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"709\" \/>\n\t<meta property=\"og:image:height\" content=\"472\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Andrea M. 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