Ellie began preschool when she was 4 years old. Each morning, she picked out her own clothes and packed a small purse filled with her favorite toys to bring with her. When she got to school, her friends and teachers greeted her, but Ellie never responded. Instead, she entered the classroom and stood motionless until someone directed her to an activity. She followed instructions, but was never engaged. Her teachers gave her time to warm up to the new environment, but after two months of school, Ellie still did not speak one word.
Her teachers were baffled. They recalled observing Ellie during a visit to her Manhattan home before school started. Although a bit shy in their presence, Ellie was quite animated — singing and dancing, telling stories to her mother, and playing peek-a-boo with her younger brother. In the classroom, her teachers couldn’t get her to utter one word. Most of the time, they said she appeared “like a frozen statue.” They contacted her parents to express their concerns.
Ellie’s behavior did not make sense to her parents, and they blamed the teachers for her silence.
“What they described just wasn’t our Ellie. At first, we thought she was just very shy, and it would pass as she felt more secure, but then we realized it was more serious than that,” remembers her mother. “We thought something traumatic must have happened at school to make her stop speaking. We mistakenly blamed her teachers for a lack of patience and understanding.”
At first, Ellie’s parents and teachers did not realize she was suffering from a childhood anxiety disorder called “selective mutism.”
While relatively rare (affecting approximately seven out of 1,000), children diagnosed with selective mutism are unable to speak and communicate effectively in uncomfortable social situations, yet they speak in familiar settings in which they are relaxed. The child speaks proficiently in at least one setting, usually at home with parents or siblings. Most children who are selectively mute also experience social anxiety or have social phobia.
Mutism is highly functional for the child because it protects her from the perceived challenge of social interaction, thereby reducing anxiety. The extreme fear associated with communicating in public can paralyze a child and negatively affect her social, emotional, and physical health.
“In the beginning, Ellie said it felt like the words were stuck in her throat, choking her to the point that she got sick,” her mother recalls. “It was emotionally and socially devastating.”
While Ellie’s parents first attributed their daughter’s strange behavior to her teachers, another Manhattan family, Linda and Ron, misinterpreted their 3-year-old son’s silence as manipulation and defiance.
“We didn’t understand why Philip wouldn’t answer us when we were out in public,” recalls Linda. “At home, we couldn’t get him to stop talking. On the playground or at other events with extended family, he refused to speak. We tried everything, but nothing worked. We thought he was being disrespectful and stubborn because at home, we couldn’t get him to be quiet.”
This is one of the many myths associated with selective mutism. Most selectively-mute children want to talk, but their anxiety is debilitating. In school, they are usually excessively shy and, generally, do not speak to teachers or peers. They may also have a fear of social embarrassment, or exhibit withdrawal, clinginess, compulsive traits, and depression.
In an attempt to control anxiety, selectively-mute children may avoid eye contact, fidget, demonstrate awkward body language, or remain immobile or expressionless when they feel uneasy.
The term “selective mutism” — which implies that the behavior is not willful or defiant, but rather unable to be controlled by the child in select situations — was coined in 1994 and included in the Diagnostic and Statistical Manual of Mental Disorders.
In treatment
Ellie’s mother is thrilled with her daughter’s progress during the past six months.
“With the help of Ellie’s doctor, therapist, and teacher, she is making small and steady strides. There is one close friend at school who she whispers to now. Overall, the other kids in the class are very supportive. They accept her and don’t even seem to notice that she doesn’t speak.”
Philip’s parents have him in therapy, but do not want him on medication.
“Putting him on drugs is the last resort. We have a much better understanding of his needs and will continue to work with him. He’s in play therapy twice a week, which seems to be helping,” his mother reports hopefully. “We want him to feel secure before he starts school in a couple of years.”
Ellie and Philip are fortunate to have parents who did not continue to excuse their young children’s behavior as shyness or defiance. The longer the mutism persists, the more a child relies on it as it develops into a conditioned response to social anxiety. If left untreated, selective mutism can have negative consequences throughout a child’s life, including increased anxiety, depression, poor performance and/or underachievement in school and work.
By helping children lower anxiety levels, boost self-esteem, and provide comfortable social interactions on a regular basis, selectively mute children will gradually build the confidence and skills necessary to succeed in real world settings. Their silence will eventually be broken, and they will be on their way toward developing healthy social, emotional, behavioral and academic functioning.
Laura Varoscak-DeInnocentiis is an educator and freelance writer. Her articles appear regularly in Family Publications and have won editorial awards from Parent Publications of America. She holds master’s degrees in writing, education and psychology. Laura lives in Bay Ridge, Brooklyn, and is the proud mom of two sons, Henry and Charlie.
