Selective mutism: what is it, characteristics and treatment

Selective mutism is an unusual psychological disorder that affects children between the ages of 2 and 5, being more common in children. Children with this disorder only manage to communicate with people nearby, making it difficult to talk to other children, teachers or even people from the family.

The diagnosis of selective mutism is generally carried out after the 3 years of age, since, as of this age, the child has developed the capacity to speak and experience difficulties in carrying out certain social activities. Normally, the child manages to communicate very well with the priests, brothers and cousins ​​nearby, but it presents difficulties to talk with other people, as well as to establish eye contact, which can generate anxiety.

It is important that selective mutism be identified and treated with the help of a psychologist and psychiatrist, so that it is possible to determine if there is any other associated problem that could be causing the disorder, such as hearing problems or brain disorders, which allows better adapt the type of treatment.

Main characteristics of selective mutism

The child who has selective mutism manages to communicate well in a family environment; however, he presents difficulties to do so in an environment with unknown people, in which he feels that his behavior is being observed. In this way, some characteristics that help to identify selective mutism are the following:

• Difficulty interacting with other children;
• Lack of communication with teachers;
• Difficulty to express oneself, even by means of gestures;
• Excessive shyness;
• social isolation;
• Difficulty going to the bathroom in unfamiliar environments, walking in pants, or eating at school.

Although it is more frequent in children, selective mutism can also be identified in adults; In these cases, you receive the name of social phobia, in which the person feels quite anxious in normal day-to-day situations, such as eating in public or thinking about establishing some type of communication with another person, for example. Learn more about social phobia.

why does it happen

Selective mutism does not have a specific cause; however, it can be triggered due to certain situations, which could be related to some negative experience or trauma from the past, such as entering a new school, living in a very overprotective family environment or having very authoritarian patterns.

Asimism, the development of this disorder may be related to genetic factors, as it is the most common that occurs in children whose parents have emotional and behavioral disorders, or be associated with personality traits of the child, such as vergüenza, excessive worry, fear attachment, for example.

This situation can also be influenced by the beginning of school life or changes in the country, for example, as a consequence of the cultural shock. However, in these cases it is important that the development of the child be observed, because many times the lack of communication is not due to selective mutism, as well as a period of adaptation of the child to a new environment. For this reason, for it to be considered mutism, it is necessary that the characteristics of this alteration are present before the change or during an average of a month.

How is the treatment performed?

The treatment for selective mutism consists of psychotherapy sessions, in which the psychologist brings strategies that stimulate the child’s communication and, in addition, also explores techniques to evaluate their behavior. So, the psychologist manages to make the child feel more comfortable in the surroundings, favoring their communication.

In certain cases, the psychologist can recommend that the child also has the follow-up of a child psychiatrist and that family sessions are held.

Asimismo, the psychologist indicates that the treatment continues to be stimulated at home, recommending that the priests carry out the following:

• Do not force the child to speak;
• Avoid answering for el niño;
• Praise him when he shows progress in his communication capacity;
• Encourage him to do things that are more difficult, like buying bread, for example;
• To make you feel comfortable in the environments, with the purpose of avoiding that you feel that you are the center of attention.

In this way, it is possible that children acquire more confidence to communicate and do not feel so uncomfortable in foreign environments.

When there is no response to the treatment and no obvious improvements, the psychiatrist may indicate the use of selective serotonin reuptake inhibitors, the SSRIs, which act at the brain level. These medicines can only be used under the guidance of the doctor and in very well evaluated cases, because there are not enough studies to understand their effect in the treatment of children with this disorder.