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Selective Mutism was, at one time, a rare disorder. However, over the years more and more children seem to be silencing themselves selectively. Due to the fact that Selective Mutism is a disorder that is not widely discussed, it is difficult to decipher whether a child is just shy, or if there is something more serious happening with that child.
Selective Mutism: What is it?
"The essential feature of Selective Mutism is the persistent failure to speak in specific social situations where speaking is expected, despite speaking in others. The disturbance interferes with educational or occupational achievement or with social communication. The disturbance must last for at least one month and is not limited to the first month of school" (Diagnostic and Statistical Manual IV, 1999). A child may also experience additional symptoms including "excessive shyness, fear of social embarrassment, social isolation, and with drawl, clinging, compulsive traits, negativism, temper tantrums, or controlling oppositional behavior, particularly at home (Diagnostic and Statistical Manual IV, 1999). Hence, a child may appear to be excessively shy and meet many of the standards listed in the diagnostic information above and not be diagnosed with the disorder of Selective Mutism. If the child does in fact meet these criteria there may be something much more serious than simply shyness going on with that child.
"Elective mutism was first identified in 1877 as 'asphasis voluntaria' and described as Elective Mutism in 1934" (Wright, 1994). In 1994, with the publication of the Diagnostic and Statistical Manual IV, Elective Mutism had a name change to Selective Mutism. Selective Mutism is found more in girls than in boys and usually develops before age five, but may not be brought to "clinical attention until entry into school " (Diagnostic and Statistical Manual IV, 1999). Selective Mutism may last anywhere from a couple of months to years at a time.
Causes of Selective Mutism:
Some of the research on what causes Selective Mutism describes biological difficulties as a cause of this disorder. Biological deficiencies combined with psychological and social problems have been indicated in some groups of selectively mute individuals. The social consequences of any disability whether it is speech, language, or intellectual may deter the child from speaking in select social situations (Nolan, 1970). It is essential to indicate whether the absence of speech is related to any biological difficulty that child may be experiencing. Therefore tests related to speech, language, and intellectual development need to be administered prior to giving the diagnosis of Selective Mutism.
Other researchers have suggested that Selective Mutism is a learned pattern of behavior. One researcher (Reed, 1963) describes two groups of selectively mute children. "One type of immature and manipulative, and their Mutism was maintained by social reinforcements such as attention from teachers and parents and the second type was described as tense and anxious, with their selective Mutism representing a speech phobia" (Kolvin, 1981).
One existing hypothesis to describe the formation of learned Selective Mutism suggest some of these children have over enmeshed relationships with their mothers that deter them from speaking with others (Krohn, 1992). Studies by Haden (Haden,1980) indicated that "mothers appear jealous of their child's interactions with others". In addition to this finding, the father is usually "ineffectual and distant, and it is hypothesized that this is the reason why the mother turns to their child" (Krohn, 1992). In essence a mother may not be consciously aware of their jealous feelings of their child's interactions with others, but may be unconsciously fostering a relationship with their child that does not allow for consistent communication or relationship building outside of the relationship between the two of them.
Lastly, another hypothesis is developed out of a psychodynamic theoretical orientation. "The theoretical premise is that children who are orally fixated wish to punish their parents. They may be maintaining a family secret, displacing hostility toward the mother, or regressing to a preverbal stage of development" (Giddian, 1997). If a child is not speaking in certain, or all, situations they may be considered orally fixated by the psychodynamically oriented theory. This last hypothesis of causation of Selective Mutism may be the least clearly stated as cause and effect, and much more difficult to identify and interpret.
Helping a selectively mute child to speak:
There are various ideas about how to help a selectively mute child to speak again. Most research indicated that a combination of behavior modification combined with some models of family therapy (structural and intergenerational models) is most effective in helping a selectively mute child to speak. One could seek counseling services for evaluation prior to diagnosing. Further, if no biological difficulties are indicated as the cause of the child being selectively mute, it would be advisable to have a more extensive evaluation done where social, family, and work/school conditions are examined.
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