Mason was an ordinary kid at home. He shared with me in an interview that he loved to “play, run, sing, and dance,” but in social settings, Mason felt “turned off” and found it difficult to speak. After some assessments, his parents learned that he did not have autism. It was during this process that a psychologist diagnosed Mason with Selective Mutism, a rare anxiety disorder affecting approximately 0.03% to 1% of the population, primarily in children. Today, Mason is a 24-year-old psychology student and works as a full-time paraprofessional with children who have disabilities. His Selective Mutism remains a significant aspect of his life, creating challenges in nearly every social situation he encounters.
What Is Selective Mutism?
Selective Mutism is an anxiety disorder where a child, like Mason, seems completely normal in familiar environments, such as home. (Adults can also be diagnosed.) However, in more social contexts, like school, parents and teachers often begin to notice the signs. Selective Mutism is sometimes mischaracterized as mere shyness or defiance, but it is neither. Unfortunately, some children with undiagnosed Selective Mutism are told that they will simply outgrow their “shyness” or reluctance to engage.
Symptoms of Selective Mutism
The primary symptoms of Selective Mutism include speaking freely at home and with family while becoming nonverbal due to anxiety in public situations or around unfamiliar individuals. Another symptom is experiencing intense fear or shutting down entirely when unable to communicate. Additional signs may include relying on gestures, writing, or having a trusted individual speak for them, as well as difficulty making eye contact and presenting as behaviorally inhibited.
How Selective Mutism Is Diagnosed
The journey to diagnosis can be challenging. According to the NCBI, a comprehensive assessment often involves input from parents, teachers, and various health professionals, including audiologists, psychiatrists, psychologists, and speech/language pathologists. Emily shared that her son went from preschool to third grade before he was accurately diagnosed. They tried various methods to help him, including rewards for speaking. It wasn’t until she conducted online research that she began to understand the reasons behind her son’s silence.
Treatment Options for Selective Mutism
Once diagnosed, treatment typically includes play therapy, behavioral therapy, family therapy, and sometimes medication to manage anxiety. Emily noted that therapy alone wasn’t sufficient for her son, so they added medication to his treatment plan, which made a significant difference. In contrast, Mason did not engage in therapy or take medication. Additionally, children may qualify for a 504 plan in public schools to support their specific needs.
Impact on Daily Life
Selective Mutism often co-occurs with other forms of anxiety, particularly social anxiety. Emily expressed concern for her son’s safety and well-being, especially in situations like needing to use the restroom at school or reporting an injury. Mason described the challenge of being himself and often finds himself practicing what to say aloud, grappling with feelings of being a social outcast. He has shared his diagnosis with others but worries about being judged and misunderstood. He explained, “We live in a world that relies on communication. Having the ability to speak, yet struggling to do so, feels like being trapped in your own mind.”
What Selective Mutism Is Not
Emily emphasized that Selective Mutism is not simply a child being “defiant” or “attention-seeking.” The misconception that a child is manipulative or deliberately misbehaving when they don’t speak is common. Mason clarified that having Selective Mutism is not just about being “shy” or “quiet.” He stressed that it is not a choice, and there are times when he is physically unable to speak, which does not indicate rudeness or aloofness. He also pointed out that just because he has Selective Mutism doesn’t mean he lacks understanding or intelligence.
Despite the challenges they face, Emily and her family feel “happy, proud, and at peace” as her son learns to advocate for himself. They found it difficult to locate professionals who truly understood the disorder and provided the right support. Mason believes that his determination to find his voice has been vital to his progress. He expressed, “Nothing has helped me more than pushing myself.”
Mason has also channeled his experiences into a poignant poem, which he graciously allowed me to share: “My name is Mason I said in my head/But they looked at me strangely and walked away instead/So, I sit here all alone, just staring all about/I don’t know why, but my words just won’t come out.” Although both Mason and Emily’s son continue to face obstacles, they are learning to navigate life more courageously.
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Summary
Selective Mutism is a rare childhood anxiety disorder characterized by a child’s inability to speak in social settings despite being verbal at home. It is often misunderstood as shyness or defiance, leading to delays in diagnosis and treatment. Symptoms include severe anxiety in public situations and reliance on non-verbal communication. Treatment usually involves therapy and sometimes medication. Families navigating this condition often face challenges but can find ways to support their loved ones in advocating for themselves.