Selective Mutism What is selective mutism? Selective mutism, previously known as elective mutism, is a disorder characterized by a refusal to talk in almost all social situations, including school. A child with selective mutism speaks freely to family members inside the home, but out of the home often becomes silent and maintains muteness despite enticements, threats, criticism, and peer pressure. In preschool and kindergarten, children with selective mutism may not be identified as having a problem because their teachers see them as overly shy. The criteria for a diagnosis of selective mutism include: Refusal to talk in almost all social situations, including school. Has the ability to speak and comprehend spoken language. Usually speaks to specific people, often one or both parents and sometimes peers. Has normal hearing and intelligence. Refusal to talk began in the preschool years. Mutism is not caused by another mental or physical disorder. How to you treat selective mutism? Over the past twenty five years I have treated many children with selective mutism. The prevailing opinion is that selective mutism is a symptom of anxiety, most likely, social anxiety. Therefore, I begin by educating parents about the nature of anxiety disorders and about various treatments available for such disorders. In my experience, cognitive-behavioral treatment approaches, designed to decrease anxiety in social situations over a long period of time, produce the greatest improvement. Anti-anxiety medications and, more recently, neurofeedback, have been used with some success in combination with behavioral therapy. I strongly recommend that parents and teachers avoid any coercive practices or pressures designed to force a child with selective mutism to speak. These children should be included in all peer group activities and should only be encouraged to speak in the context of nonthreatening interpersonal relationships whether in the classroom or at home. Return to Providers: Thomas DuHamel, Ph.D. 155 NE 100th St., Suite 306 Seattle WA 98125 206.361.6884     Copyright © 2009-2012, ABCD, Inc.