We used to know Selective Mutism by its former name: Elective Mutism. This subtle but meaningful change in diagnostic terminology reflects our improved understanding of this disorder. Children who are unable to speak to certain people and in certain situations are not defiant, oppositional, or manipulative; they are anxious.

That said, these children may not look anxious, which is what originally led psychologists to believe that their silence was “elective.” Indeed, when asked a question by a stranger, relative or friend, it may look like these children, who otherwise have adequate language skills, choose not to respond. They may stare blankly, hide behind a parent’s leg, or even take an aggressive stance by growling or hitting. It can look as though a child is being coy, rude, or defiant. For many parents, understanding that their child’s behaviour is based in anxiety is a crucially important step. It opens the door to appropriate treatment strategies and relieves tensions between parent and child since the parent no longer feels as though he or she is being deliberately defied.

As we approach October, which is also Selective Mutism Awareness Month, I thought it would be a good time to review some important facts about this frequently misunderstood disorder.

• Selective Mutism is not the same thing as “shyness.” It is a diagnosable anxiety disorder.
• Children with selective mutism want to speak but are prevented from doing so because of overwhelming anxiety.
• Not all children with selective mutism look the same. Some may be completed inhibited (e.g., motionless, expressionless) in situations that are novel or uncomfortable for them, while others may seem relaxed and at ease despite the fact that they cannot speak.
• Children with selective mutism are genetically predisposed to anxiety.
• As a result of this genetic predisposition, they often experience anxiety in other domains as well. They may experience comorbid social anxiety, separation anxiety, generalized anxiety, and so on. Comobidity is the norm, not the exception, when it comes to childhood anxiety disorders.
• Selective mutism is not the result of trauma.
• Behaviour therapy is generally very effective in treating selective mutism, although medication may also be required.
• Children don’t “grow out” of the anxiety that leads to selective mutism. As such, it is extremely important to treat the disorder as early as possible.
• Selective mutism is not a “rare” disorder. It afflicts 1 in 140 children.
• Selective mutism is commonly mistaken for oppositional defiant disorder, autism spectrum disorder, a language disorder, and others. Getting an accurate diagnosis is extremely important in order for the mutism to be treated effectively.

For more information about selective mutism and its treatment, go to www.selectivemutism.org. You will find a list of treating professionals in Canada and the USA as well as a wealth of information about this highly distressing but very treatable condition.