How common is selective mutism?
Approximately 1 in 140 youth have selective mutism and 80% of children are 8 or younger. Children typically develop selective mutism from 2.7 to 4.1 years of age. Selective mutism occurs more commonly in girls than boys, with ranges estimating that it is up to 2.6 times more common in girls than boys. Selective mutism also appears to be more common in bilingual and multilingual children, as well as for children whose parents also had selective mutism.
(Bergman et al., 2002; Elizur & Perednik, 2003; Garcia et al., 2004; Kurtz, 2016)
A guiding hand for parents & educators of a child who is struggling to speak in school
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A typical child with selective mutism has a very select group of people or places with whom they speak and often displays avoidance in talking with adults and children in school and in the community.
They are vigilant about who and what is around them in an effort to make sure that others do not hear them or their voice. Children with selective mutism will likely adjust their speaking volume or behavior when someone new enters their surroundings. It is a myth that selective mutism is intentional, defiant, or willful shyness. It is not. Rather, it is a reaction to the fear they are feeling in a speaking situation.
At home, kids with selective mutism are chatty and often described as “outgoing” by their parents. Parents are often surprised when teachers report their child does not speak at school.
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Selective mutism is defined as an anxiety disorder in which there is a consistent failure to speak in specific social situations when speaking is expected (e.g. school), despite speaking in other situations (e.g., home). Selective mutism also must interfere with educational achievement or social communication and must be present for longer than 1 month (not counting the 1st month of school) and must not be due to a lack of knowledge or comfort with the spoken language or due to another disorder (communication disorder, autism, intellectual disorder).
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
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Selective mutism treatment requires a specific approach that includes gradual exposure to speaking that enables children to gain greater comfort with talking. A core facet of treatment is Parent Child Interaction Therapy for Selective Mutism (PCIT-SM) which was developed by Steven Kurtz and his team in 2002.
The treatment includes systematically introducing new speaking partners to the child with selective mutism, reducing the negative reinforcement of speaking that occurs in selective mutism, and creating a speaking environment in which positive external reinforcers and behavior-shaping experiences are present.
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While outpatient therapy of 45-min per session is the standard psychological treatment for mental disorders, selective mutism requires more. To treat phobias, providing exposure therapy for longer duration (longer than 45-min per session) and more frequently (more than once a week) increases efficacy and effectiveness. Treating phobias in the environment in which they occur also increases effectiveness (in-vivo exposure) which is why Dr. Tracey Ward and the team at Brave Seattle have created Brave Explorers Camp to help children where they are struggling most.
