Selective Mutism

One of the most interesting seminars I went to at the ASHA convention was about selective mutism. Selective Mutism is an anxiety based disorder that effects ones social communication. It usually appears in childhood and starts before the age of 5.

What is the criteria to have a diagnosis of selective mutism?

- Failure to speak in specific social situations

- Social communication is affected

- Duration of at least 1 month

- It is not better accounted for in another commutation disorder or mental disorder

Some characteristics you may observe of a person who has selective mutism:

- Born with a timid temperament

- Usually don't want to be noticed

- Increased vocal tension alongside anxiety when in situations that they are expected to speak

- Being mute provides comfort

Given that the above characteristics are very similar to a shy child, I believe that the following shared approaches of a selectively mute person are also applicable to a shy child, including:

- Don't look or direct speech at child when beginning to speak with them for the first time

- Don't use the word "talk" or bring attention to it; instead you could say "use your voice" or "use your words"

- Don't speak about the child infront of them

- Don't trick them into talking

- Reduce amount of expectations at first

- Use a prompt hierarchy when asking them a question:

1. Ask question and wait 5 seconds

2. Give them two options to chose from

3. Make it yes/no

A child with selective mutism should be seen by a speech-language therapist in addition to their pediatrician and psychologist.

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