Do you know a child who does not speak, speaks to a select few or
barely whispers?
This child may suffer from an anxiety disorder called;
Selective Mutism


By Dr. Elisa Shipon-Blum, CEO and Executive Medical Director,
Selective Mutism Group Childhood Anxiety Network, SMG~CAN

Selective Mutism is a childhood anxiety disorder characterized by a
child's inability to speak in select social settings, such as
school, but is able to talk normally in settings where he/she is
comfortable, secure and relaxed.

Selective Mutism is more common than autism and affects 3.5/500
children, yet so few have heard of Selective Mutism that many
treating professionals are unaware how to evaluate and assess the
disorder. Many children are misdiagnosed as being autistic.
Teachers are also not sure how to help the child in the classroom
setting. As a result, children are often misdiagnosed with other
disorders such as; autism, learning disabled, oppositional or `just
shy'.

Over 90% of children with Selective Mutism also have social phobia
or social anxiety. This disorder is quite debilitating and painful
to the child. Children and adolescents with Selective Mutism have
an actual FEAR of speaking and social interactions where there is an
expectation to talk.

Not all children manifest their anxiety of speaking the same way.
Some may be completely mute and unable to speak to anyone in a
social setting, while others may be able to speak to a select few or
perhaps whisper to others. Some children may stand motionless with
fear, as they are confronted with specific social settings. They may
freeze, be expressionless, unemotional and may be socially isolated,
while other, less severely affected children, may `look' relaxed,
carefree and socialize with one or few children but are unable to
speak.
Why does a child develop Selective Mutism?
The majority of children with Selective Mutism have a genetic
predisposition to anxiety, specifically, social anxiety. Often,
these children show signs of severe anxiety, such as separation
anxiety, frequent tantrums and crying, moodiness, inflexibility,
sleep problems, parental separation issues, and extreme shyness from
infancy on.
Approximately 20-30% children with SM have subtle speech and
language abnormalities and/or from bilingual families.

In addition, a large proportion of children have sensory integration
disorder (DSI) that causes them to shut down only exacerbating
anxiety.

There is NO evidence that the cause of Selective Mutism is related
to abuse, neglect or trauma.

When are most children diagnosed as having Selective Mutism?
The average age of diagnosis is between 3 -8 years old. Thought to
be `just shy' it is not until children enter school, and there is an
expectation to perform, interact and speak, that Selective Mutism
becomes more obvious. * If mutism persists for more than a month, a
parent should mention this to their physician.

Why is it so important for a child with SM to be diagnosed when
he/she is very young?
Because Selective Mutism is an anxiety disorder (#1 mental illness
among children) if left untreated, it can cripple a child for life
and, unfortunately, curb the way for an array of academic, social
and emotional repercussions.


How is Selective Mutism Treated?
The main goal with treatment is to lower anxiety , increase self-
esteem and increase social confidence and communication in social
settings. Emphasis should never be on `getting a child to talk.'
ALL expectations for verbalization should be removed. Present
treatment consists of behavioral therapy to progress communicatively
and `unlearn' mute behavior with or without the use of medication.
It is important to realize that with proper diagnosis and treatment,
the prognosis for overcoming Selective Mutism is excellent , however
if left untreated it often leads to years of suffering and social
withdrawal.


There will be a Selective Mutism Conference in Parsippany, New
Jersey at the Sheraton Parsippany on Oct 2-3, 2004.
For more information, visit the SMG~CAN website at:
www.selectivemutism.org or contact us: sminfo@... or
215-887-5748

*SMG~CAN is a division of the 501(c)3 nonprofit organization, the
Childhood Anxiety Network, Inc. (CAN)