Selective Mutism

Overview, Causes, & Risk Factors

Selective mutism is a condition in which a person who is usually fluent in speech won't speak in specific situations. Selective mutism primarily affects children.

What is going on in the body?

The majority of people who exhibit selective mutism appear to have some type of acute situational anxiety

generalized anxiety disorder

panic disorder

post-traumatic stress disorder

phobias

obsessive compulsive disorders

',CAPTION,'Anxiety Disorders');" onmouseout="return nd();">anxiety disorder. A person who has this condition usually has a full understanding of language in most situations. In other cases, though, they appear as if they have a total lack of language where one would expect oral speech, such as in school. This condition may extend over a period of time, at least 1 to 2 months and longer. This occurs in the absence of any specific medical problem that may prevent speech.

What are the causes and risks of the condition?

The cause of selective mutism is not clear. Possible causes include:

immigrant family background

significant early childhood trauma

injury that affects the mouth

anxiety

possible history of speech disorders early in childhood or delayed onset of speech

Symptoms & Signs

What are the signs and symptoms of the condition?

Symptoms of selective mutism include:

refusing to talk in one or more social situations, including school

a speech disturbance that interferes with achievement in work or school when the condition lasts at least 1 month or more

Selective mutism does NOT appear to be related to:

lack of familiarity with the spoken language

degree of comfort with speaking in social situation

communication disorders, such as stuttering or aphasia

pervasive developmental delay, schizophrenia, obsessive-compulsive disorder, or other psychotic disorder or attention deficit disorder

Diagnosis & Tests

How is the condition diagnosed?

Diagnosis of selective mutism is usually by physical examination. Tests include cranial CT scans, x-rays, dental exams, or examination by specialists. A neurologist or an ear, nose, and throat specialist may rule out other causes of lack of speech. A speech therapist and a psychologist can assess communication skills and mental state.

Prevention & Expectations

What can be done to prevent the condition?

There is no specific way to prevent selective mutism at this time. Reducing childhood emotional trauma or stress may reduce this and other mental disorders.

What are the long-term effects of the condition?

Most episodes of selective mutism may only last 2 to 3 months and cause short-term educational or occupational disabilities. Long-term effects may include other behaviors or problems that can have a long-term impact on education and employment.

What are the risks to others?

Selective mutism is not contagious and cannot be spread to others.

Treatment & Monitoring

What are the treatments for the condition?

Treatment for selective mutism may include anxiety

depression

eating disorders such as anorexia nervosa and bulimia

alcohol and drug abuse problems

',CAPTION,'Cognitive Behavioral Therapy');" onmouseout="return nd();">cognitive-behavioral therapy. In behavioral treatment or therapy a person can work through situations that may cause selective mutism. Family therapy may also help the family resolve issues that may contribute to selective mutism. Therapy also offers support for those experiencing selective mutism. Medications for anxiety or social phobias may be given.

What are the side effects of the treatments?

Some medications may cause drowsiness, sleep disorders, irritability, and stomach upset.

What happens after treatment for the condition?

Normal oral speech generally returns in a short time. The person may require further psychological or psychiatric care for any other conditions that are present.

How is the condition monitored?

Progress in speech therapy and anxiety

depression

eating disorders such as anorexia nervosa and bulimia

alcohol and drug abuse problems

',CAPTION,'Cognitive Behavioral Therapy');" onmouseout="return nd();">cognitive-behavioral therapy will assist in monitoring selective mutism. Oral speech progress in a variety of settings will also help in monitoring selective mutism. Any new or worsening symptoms should be reported to the healthcare provider.