Children's selective mutism Causes and treatment

Selective mutism is a complex child anxiety disorder that is characterized by the child's inability to speak and communicate effectively in social environments, such as school. The mutism pattern can vary greatly from one child to another. Some children never speak outside the home, others whisper and some speak only with known people.

The child does not choose not to speak in all situations, but select the situations and people with whom he communicates verbally. Children with selective mutism generally do not speak at school, which interferes with their academic, educational and/or social performance. In this psychology-online article we explain the child selective mutism, its causes and treatment.

1. Main characteristics of selective mutism in children
2. Child selective mutism symptoms
3. Child selective mutism: Causes
4. How selective mutism is cured

Main characteristics of selective mutism in children

Many of the features of child selective mutism can be attributed to anxiety, these characteristics are as follows:

• Temperamental inhibition: They are shy and cautious children in new and little familiar situations.
• Symptoms of social anxiety: approximately 90% of children with selective mutism have social anxiety. They feel uncomfortable when they are presented to people or when they are the center of attention, they are perfectionists (fearful of making mistakes), they can present shy bladder syndrome and feeding problems (shame of eating in front of others).
• They are social: Most children with selective mutism want friends and need them. This differentiates selective mutism from other disorders, such as autistic spectrum disorders. Most children with selective mutism have appropriate social skills, but others do not need help to develop them
• Physical appearance: Some children with selective mutism have an inexpressive, frozen -looking face and rigid and clumsy body language with absence of visual contact when they feel anxious. This is especially notable in younger children at the beginning of the school year or when an unknown person is approaching. The older the child, it is less likely to show a Rigid and frozen body language. In addition, the more comfortable a child is in an environment, it is less likely to be seen anxious. For example, the little boy who feels comfortable and adapted to school, even if he does not speak, may seem relaxed, despite the fact that mutism is still present. A hypothesis is that the sympathetic response intensified causes muscle tension and vocal strings paralysis.
• Comorbid anxiety disorders: separation anxiety, compulsive obsessive disorder, trichotylomania, generalized anxiety disorder, specific phobias, panic disorder.

Child selective mutism symptoms

• Physical symptoms: Mutism, stomach pain, nausea, vomiting, joint pain, headaches, chest pain, breathing difficulty, diarrhea ..
• Emotional: When the child is small, it may not seem upset by mutism since the classmates accept it more. As children grow up, Internal confusion begins to appear together with negative anxiety aspects.
• Development delays: A proportion of children with selective mutism has delays in development. Some have multiple delays and present the diagnosis of an autistic spectrum disorder, such as the generalized developmental disorder, Asperger or Autism. Delays include motor, communication and/or social development.
• Common symptoms: Up.
• Behavioral: They are inflexible and stubborn children, bad. They can also present dramatic humor, episodes of crying, abstinence, evasion, denial and procrastination. These children need internal control, order and structure, and may have difficulties with changes or transitions. Some can act in a silly or negative way either at school, at parties ... This is because they have developed inappropriate adaptation mechanisms to combat their anxiety.
• Communication difficulties: Some children may have difficulty responding nonverbally to others, that is, they cannot point or nod in response to a question of the teachers or answer thanks. For many to say hello or goodbye it is very difficult. But this is situational. The same child can respond verbally and adequately when it is comfortable. These communication problems translate into great difficulties in social interactions.

Child selective mutism: Causes

A single cause of selective mutism in children has not been identified and its causes are said to be multifactorial. Some of the following factors can coexist and play an important role in the development of selective mutism:

• Associated Anxiety Disorders: As social phobia, separation anxiety and compulsive obsessive disorder.
• Hereditary or genetic component.
• Environmental factors How to live in an isolated area in which there are few opportunities for social interaction, an environment where avoidance behaviors or environments are reinforced in which fearful or anxious behaviors or behaviors are observed.
• Shy temperament and even extremely in children.
• Difficulties or delays in processing: For some children with selective mutism, sensory processing difficulties are the underlying reason of their mutism. In larger and more crowded environments there are multiple stimuli, like a class, the child feels some expectation of that environment, a sensory defensive occurs and begins to increase anxiety producing the mode of “freezing”.

How selective mutism is cured

The main objective of therapy is to reduce anxiety levels, increase the basis of self -esteem and confidence in social interaction. With lower levels of anxiety, greater confidence and the appropriate use of techniques, communication will improve as the child progresses in verbal and nonverbal communication. Treatments must be individualized, but most children are treated through a combination of several therapies. Some of these therapies are:

Behavioral therapy

Positive reinforcement and desensitization techniques are behavioral treatments for children with selective mutism, since they reduce the pressure that the child feels when speaking. The emphasis should be understood to understand the child and his anxiety. Introducing the child to social environments in a protected way, that is, without feeling threatened, it is the best way to gain confidence. For example: parents can take their child to school when there are few people around.

At first, small groups of children are a good option and as the child increases their trust while speaking can be included in the group more children, the teacher, etc. The positive reinforcement for verbalization must be introduced, only when, it is expected to be useful.

Play therapy, psychotherapy and other psychological approaches

They can be effective if all the pressure for verbalization is eliminated and emphasizes the child to relax. Facing mutism in a non -threatening way is very important. These children are scared and the approach should be to help them identify their level of fear in a specific situation. Make them see that you understand them and that you are there to help them, take away a very big pressure.

Cognitive behavioral therapy

Trained therapists in TCC They help children modify their behavior by helping them redirect their fears and concerns in positive thoughts. Most children with selective mutism care because others listen to their voice, ask them questions about why they don't talk and try to force them to speak.

This article is merely informative, in psychology-online we have no power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

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