Materiały źródłowe

• #1 Selective Mutism: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/selective-mutism

  Having selective mutism means some social situations cause so much fear or anxiety that you find speaking difficult or impossible. This anxiety disorder usually starts in childhood, but the effects can be lifelong. Identifying and treating this condition quickly improves its overall outlook, especially during early childhood. […] Selective mutism (SM) is a mental health condition where you cant talk in certain situations because of fear or anxiety. It usually affects young children, but it can also affect adolescents and adults. […] This condition is more than being shy, bashful or timid. SM is an anxiety disorder. It can overlap with other anxiety-related conditions and have lingering effects later in life. […] SM is fairly rare. It affects less than 1% of people (across all age groups). It almost always begins in childhood around age 5, often coming to attention soon after a child starts preschool, kindergarten or grade school. Its less common but still possible in teenagers and adults.

• #1 Selective Mutism

  https://www.asha.org/practice-portal/clinical-topics/selective-mutism/?srsltid=AfmBOopCv6ocLsUem2AO7JBa22lMEmPM-2IyZmt_wWQ7NwWSYCx_E5ge

  The onset of selective mutism typically occurs between 3 and 6 years of age, with diagnosis often occurring when the child enters school (Sharp et al., 2007). […] Patterns of selective mutism can vary greatly and can interfere with academic, educational, and/or social performance. […] As with many anxiety disorders, children with selective mutism attempt to protect themselves from the discomfort they experience by avoiding the unpleasant activity (i.e., speaking and/or communicating). Varied characteristics and behaviors associated with selective mutism are a method of self-protection but may be interpreted as deliberately oppositional (e.g., difficult or rude; Kotrba, 2015). […] Children with selective mutism are often anxious about communication demands. This anxiety may impair the child’s ability to attend to class instruction and participate fully in school or social expectations (Klein et al., 2019).

• #1 Selective Mutism: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/selective-mutism

  People with selective mutism may avoid social encounters or feel unable to talk in situations where they arent comfortable. Selective mutism makes you talk less or feel unable to talk in situations where you arent comfortable. Otherwise, you have no difficulty with talking. […] The selective in this conditions name means it only happens in certain situations (remember that its not a willful or deliberate choice not to talk). If you have SM, you have no trouble talking in comfortable situations. However, you consistently find talking difficult or impossible in uncomfortable situations. […] The symptoms can take different forms. Some people are completely unable to talk (or nearly so). Others may communicate less or in limited ways. […] SM can negatively affect your life in many ways. These can include: Social difficulties, loneliness or isolation. Developing other anxiety-related conditions or symptoms. Impacts on academic achievement or work performance.

• #1

  https://www2.hse.ie/conditions/selective-mutism/

  The main symptom of selective mutism is your child not being able to speak in some situations. If your child is not able to talk outside their home for more than 4 weeks, it could be a sign that they have selective mutism. If someone speaks to them, they may: become suddenly still […] have a frozen expression on their face […] blush or tremble […] avoid eye contact. They may appear: nervous, uneasy or socially awkward […] rude, disinterested or sulky […] clingy […] shy and withdrawn […] stiff, tense […] to have poor co-ordination […] stubborn or aggressive – they may have a tantrum later, having bottled up intense emotions. They may tell you after an episode that their throat felt closed or tight. […] Some people with selective mutism communicate a little. For example, some children may nod for 'yes’ or shake their head for 'no’. Some children might say a few words. They may speak in an unusual voice, or whisper. Sometimes they will speak through a parent, or someone they trust. Children affected more severely avoid any form of communication. Your child may have tummy aches or sleeplessness or show other signs of anxiety.

• #1 Selective mutism – NHS

  https://www.nhs.uk/mental-health/conditions/selective-mutism/

  More confident children with selective mutism can use gestures to communicate for example, they may nod for „yes” or shake their head for „no”. […] But more severely affected children tend to avoid any form of communication spoken, written or gestured. […] Some children may manage to respond with a few words, or they may speak in an altered voice, such as a whisper. […] Left untreated, selective mutism can lead to isolation, low self-esteem and social anxiety disorder. […] It can continue into adolescence and adulthood if not managed. […] A child can successfully overcome selective mutism if it’s diagnosed at an early age and appropriately managed. […] It’s important for selective mutism to be recognised early by families and schools so they can work together to reduce a child’s anxiety.

• #1 Selective mutism – Wikipedia

  https://en.wikipedia.org/wiki/Selective_mutism

  Selective mutism (SM) is an anxiety disorder in which a person who is otherwise capable of speech becomes unable to speak when exposed to specific situations, specific places, or to specific people, one or multiple of which serve as triggers. Selective mutism usually co-exists with social anxiety disorder. People with selective mutism stay silent even when the consequences of their silence include shame, social ostracism, or punishment. […] The DSM-5 describes selective mutism as a persistent difficulty with speaking in specific social settings where speech is expected, such as in school, despite being able to speak the language in other situations. The symptoms should not be too temporary and they must affect the persons ability to perform in a certain situation. […] Children and adults with selective mutism are fully capable of speech and understanding language but may be completely unable to speak in certain situations, even if speech is expected of them. This behaviour may be perceived as shyness for some or rudeness by others. A child with selective mutism may be completely silent at school for years but speak quite freely or even excessively at home. There is a hierarchical variation among people with this disorder: some people participate fully in activities and appear social but do not speak, others will speak only to peers but not to adults, others will speak to adults when asked questions requiring short answers but never to peers, and still others speak to no one and participate in few, if any, activities presented to them. In a severe form known as „progressive mutism”, the disorder progresses until the person with this condition no longer speaks to anyone in any situation, even close family members.

• #1 What is Selective Mutism?

  https://selectivemutismcenter.org/what-is-selective-mutism/

  It is important to understand that some children with Selective Mutism may start out with mutism in school and other social settings. Due to negative reinforcement of their mutism, misunderstandings from those around them, and perhaps heightened stress within their environment, they may develop mutism in all settings. These children have progressive mutism and are mute in/out of the home with all people, including parents and siblings. […] It is common for many children with Selective Mutism to have a blank facial expression and never seem to smile. Many have stiff or awkward body language when in a social setting and seem very uncomfortable or unhappy. […] Children with Selective Mutism often have tremendous difficulty initiating and may hesitate to respond even nonverbally. This can be quite frustrating to the child as time goes by. The childs nonverbal communication may go on for many years, becoming more ingrained and reinforced unless the child is properly diagnosed and treated.

• #1 Symptoms of selective mutism beyond failure to speak in children and adolescents

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11564403/

  The Diagnostic Features and Associated Features to Support the Diagnosis of SM sections of SM in DSM-5 include additional clinical features such as high levels of social anxiety, withdrawal, externalizing behaviors, and impairments in communication skills. […] These clinical features reflect the findings that (social) anxiety is a central phenomenon in the majority of children with SM, and that also additional symptoms beyond anxiety (e.g. externalizing behavior, delayed speech development) may occur in affected children. […] SM causes severe impairments in academic and social functioning, typically emerges during preschool age and can last for several years. […] Our results suggest that children and adolescents with SM experience multiple symptoms, with an average of M=4.74 symptoms from different categories.

• #1 Selective Mutism | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/s/selective-mutism.html

  Some children with selective mutism may show additional signs, such as: Anxiety, Social withdrawal, Excessive shyness, Obsessive compulsive disorder, Depression, Developmental delay, Communication disorders, Elimination (urine or stool) disorders. […] With treatment, a child is likely to stop having selective mutism. With no treatment, the speaking problems are more likely to continue. […] Selective mutism is when a child cant speak in certain settings, but can speak fine in others. For example, a child may not be able to speak at school, but can speak with no problem at home. It is called selective mutism because the child is only mute in select situations. Its a rare childhood condition. It can cause problems with school and social situations. […] With treatment, most children overcome selective mutism.

• #1 Selective mutism – Wikipedia

  https://en.wikipedia.org/wiki/Selective_mutism

  Selective mutism is strongly associated with other anxiety disorders, particularly social anxiety disorder. In fact, the majority of children diagnosed with selective mutism also have social anxiety disorder (100% of participants in two studies and 97% in another). Some researchers therefore speculate that selective mutism may be an avoidance strategy used by a subgroup of children with social anxiety disorder to reduce their distress in social situations. […] The incidence of selective mutism is not certain. Due to the poor understanding of this condition by the general public, many cases are likely undiagnosed. Based on the number of reported cases, the figure is commonly estimated to be 1 in 1000, 0.1%. However, a 2002 study in The Journal of the American Academy of Child and Adolescent Psychiatry estimated the incidence to be 0.71%.

• #1 Selective Mutism: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/selective-mutism

  In children, SM can affect how they do in school, socialize and make friends. It can also cause children to avoid talking even when its important. […] If you have SM as an adult, it can continue to have negative effects. SM can keep you from making friends or developing relationships (social, work, romantic, etc.). It can also affect how you do at school or at work. […] For many people, the symptoms seem to disappear by adulthood. The symptoms can still be there, but shift and look more like another anxiety disorder (especially social anxiety disorder). […] The outlook for SM is good overall, especially with early diagnosis and treatment. When diagnosed and treated in early childhood, most people with SM can overcome or learn to cope with it, so it doesnt affect their lives as much (or at all).

• #1 Guide to Selective Mutism in Children – Child Mind Institute

  https://childmind.org/guide/parents-guide-how-to-help-a-child-with-selective-mutism/

  It’s important that everyone in a child’s life be involved with treatment because SM is a disorder that other people tend to adapt to, which can actually make it harder to treat. […] Kids with SM get too much practice not talking. […] As part of a comprehensive treatment program, it is extremely important to get a child’s school on board with treatment. […] Behavioral treatment is the gold standard for treating selective mutism, but medication can be helpful for kids with the disorder who aren’t making sufficient gains with therapy alone. […] Experts don’t know how many children with selective mutism will grow out of the disorder. But what we do know is that treating it becomes much harder the older a child is, so it is extremely important not to put off treatment. […] Selective mutism is more common among children who speak a second language. Being bilingual doesn’t cause SM, but for kids who already have an anxious temperament, being expected to use a language they are less comfortable with can put them at additional risk. […] Treating older kids with SM is more complicated because they have lived with the disorder for longer, but there is still excellent help available for them.

• #1 Long-term outcomes of selective mutism: a systematic literature review | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-023-05279-6

  The recovery rates in the cohort and case-control studies, which all had clinical based samples, ranged from 46% to 100%. The majority (190/243, 78%) of the subjects in these studies had shown moderate or total improvements in SM symptoms by the end of the follow-up periods. […] Five of the six cohort and case-control studies that examined other psychiatric disorders at follow up found moderate rates of anxiety disorders. […] The studies that were reviewed reported different methods for treating SM. It should be noted that this review focused on papers with a follow-up period of at least two years and this meant that the review did not include all the studies that examined treatment. […] The long-term recovery rates for SM were relatively good in the reviewed studies, but other disorders, mainly anxiety disorders, were common later in life. Early detection and treatment are needed to prevent symptoms persisting and other psychiatric disorders from developing.

• #1 Selective Mutism: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/selective-mutism

  When SM goes undetected or untreated, the outlook is less positive. It isnt dangerous, but the negative effects can be significant. People with SM often experience anxiety and depression. Some struggle with social situations and feel lonely or isolated. It can also affect their education, career and other important parts of their lives.

• #1 Selective Mutism in Adults – Leaf Complex Care

  https://leafcare.co.uk/blog/selective-mutism-in-adults/

  For adults and children with selective mutism, navigating social interactions can be incredibly challenging. People may experience a deep-seated fear of judgment or embarrassment, making initiating or responding to conversations in specific situations difficult. Understanding and patience from those around them are crucial in providing support. With the right interventions by mental health professionals, such as therapy and gradual exposure to anxiety-inducing situations, individuals with selective mutism can learn to manage their anxiety and improve their ability to communicate effectively, leading to enhanced social interactions and overall well-being. […] Selective mutism has common signs, including a persistent inability to speak in specific situations, such as at work or in social gatherings, even though the individual may talk fluently in familiar environments like home or with close friends. Adults with selective mutism might also avoid eye contact, display extreme nervousness, or use gestures and nonverbal communication as their primary expression. Additionally, they may struggle to initiate or participate in conversations, leading to social isolation and frustration or embarrassment.

• #1 What is Selective Mutism?

  https://selectivemutismcenter.org/what-is-selective-mutism/

  Most children are diagnosed between 3 and 8 years old. […] If mutism persists for more than a month, a parent should bring this to the attention of their childs physician. […] Our findings indicate that the earlier a child is treated for Selective Mutism, the quicker the response to treatment, and the better the overall prognosis. If a child remains mute for many years, his/her behavior can become a conditioned response where the child literally gets used to non-verbalizing. […] Because Selective Mutism is an anxiety disorder, if left untreated, it can have negative consequences throughout the childs life and, unfortunately, pave the way for an array of academic, social and emotional repercussions such as worsening anxiety, depression and manifestations of other anxiety disorders, social isolation and withdrawal, poor self-esteem and self-confidence, school refusal, poor academic performance, and the possibility of quitting school. […] It is important to realize that with proper diagnosis and treatment, the prognosis for overcoming Selective Mutism is excellent!

• #1 Selective mutism – NHS

  https://www.nhs.uk/mental-health/conditions/selective-mutism/

  With appropriate handling and treatment, most children are able to overcome selective mutism. […] But the older they are when the condition is diagnosed, the longer it will take. […] Treatment does not focus on the speaking itself, but reducing the anxiety associated with speaking. […] This starts by removing pressure on the person to speak. […] They should then gradually progress from relaxing in their school, nursery or social setting, to saying single words and sentences to one person, before eventually being able to speak freely to all people in all settings. […] As well as these environmental changes, older children may need individual support to overcome their anxiety.

• #1 Selective Mutism: Symptoms, Causes, & Treatment

  https://thriveworks.com/help-with/children-teens-adolescents/selective-mutism/

  Selective mutism does go away with treatment (and sometimes on its own). It is not a lifelong condition instead, it typically lasts from a few weeks (on the shorter end) to a few years (on the longer end). The sooner a child gets proper treatment, the sooner they can recover from their selective mutism and go on to develop healthy relationships with others. […] When a child with selective mutism is diagnosed early and a treatment plan is put in place, the better the prognosis is for them to overcome the condition.

• #1 Selective Mutism | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/s/selective-mutism.html

  Selective mutism is when a child cant speak in certain settings, but can speak fine in others. For instance, a child may not be able to speak at school, but can speak with no problem at home. It’s called selective mutism because the child is only mute in select situations. Its a rare childhood condition. It can cause problems with school and social situations. […] A child with selective mutism may find certain social situations very stressful. This may cause anxiety so severe that the child feels unable to speak. Selective mutism is not caused by a childs willful refusal to speak. […] Selective mutism often starts in very young children, around ages 2 to 4. But it may not be recognized until a child starts school. […] The main sign of selective mutism is a month or more of failure to speak only in certain social situations. The problem is not due to another communication disorder, such as autism. And it is not due to not knowing the spoken language.

• #2 Selective mutism – NHS

  https://www.nhs.uk/mental-health/conditions/selective-mutism/

  Selective mutism is an anxiety disorder where a person is unable to speak in certain social situations, such as with classmates at school or to relatives they do not see very often. […] It usually starts during childhood and, if left untreated, can persist into adulthood. […] A child or adult with selective mutism does not refuse or choose not to speak at certain times, they’re literally unable to speak. […] The expectation to talk to certain people triggers a freeze response with feelings of anxiety and panic, and talking is impossible. […] In time, the person may learn to anticipate the situations that provoke this distressing reaction and do all they can to avoid them. […] Selective mutism can start at any age, but most often starts in early childhood, between age 2 and 4. […] The main warning sign is the marked contrast in the child’s ability to engage with different people, characterised by a sudden stillness and frozen facial expression when they’re expected to talk to someone who’s outside their comfort zone.

• #2 Selective mutism – Wikipedia

  https://en.wikipedia.org/wiki/Selective_mutism

  Selective mutism is strongly associated with other anxiety disorders, particularly social anxiety disorder. In fact, the majority of children diagnosed with selective mutism also have social anxiety disorder (100% of participants in two studies and 97% in another). Some researchers therefore speculate that selective mutism may be an avoidance strategy used by a subgroup of children with social anxiety disorder to reduce their distress in social situations. […] The incidence of selective mutism is not certain. Due to the poor understanding of this condition by the general public, many cases are likely undiagnosed. Based on the number of reported cases, the figure is commonly estimated to be 1 in 1000, 0.1%. However, a 2002 study in The Journal of the American Academy of Child and Adolescent Psychiatry estimated the incidence to be 0.71%.

• #2 Selective Mutism | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/s/selective-mutism.html

  Selective mutism is when a child cant speak in certain settings, but can speak fine in others. For instance, a child may not be able to speak at school, but can speak with no problem at home. It’s called selective mutism because the child is only mute in select situations. Its a rare childhood condition. It can cause problems with school and social situations. […] A child with selective mutism may find certain social situations very stressful. This may cause anxiety so severe that the child feels unable to speak. Selective mutism is not caused by a childs willful refusal to speak. […] Selective mutism often starts in very young children, around ages 2 to 4. But it may not be recognized until a child starts school. […] The main sign of selective mutism is a month or more of failure to speak only in certain social situations. The problem is not due to another communication disorder, such as autism. And it is not due to not knowing the spoken language.

• #2 Silence and related symptoms in children and adolescents: a network approach to selective mutism | BMC Psychology | Full Text

  https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-022-00956-9

  Silence in certain situations represents the core symptom of selective mutism (SM). However, it is unclear what additional symptoms are part of this disorder. […] Silence appears to have been confirmed by analysis as a core symptom of SM. Additional anxiety-related symptoms, such as avoidance behavior or motor inhibition associated with freezing, seem to co-occur with silence. […] The symptoms of SM appear to be distinguishable from those of SAD, although there seems to be overlap in terms of difficulty speaking in situations outside the home. […] Silence in certain social situations (e.g., in school) with unimpaired speech production in other social situations (e.g., at home) represents the core symptom of selective mutism (SM). […] Given that SM shares numerous features with anxiety and social anxiety in particular and has a high co-incidence with other anxiety disorders (especially SAD), it seems reasonable to assume that additional anxiety-related symptoms occur together with silence as well. […] The two communities of SM potentially indicate different mechanisms of silence.

• #2 What is Selective Mutism?

  https://selectivemutismcenter.org/what-is-selective-mutism/

  It is important to understand that some children with Selective Mutism may start out with mutism in school and other social settings. Due to negative reinforcement of their mutism, misunderstandings from those around them, and perhaps heightened stress within their environment, they may develop mutism in all settings. These children have progressive mutism and are mute in/out of the home with all people, including parents and siblings. […] It is common for many children with Selective Mutism to have a blank facial expression and never seem to smile. Many have stiff or awkward body language when in a social setting and seem very uncomfortable or unhappy. […] Children with Selective Mutism often have tremendous difficulty initiating and may hesitate to respond even nonverbally. This can be quite frustrating to the child as time goes by. The childs nonverbal communication may go on for many years, becoming more ingrained and reinforced unless the child is properly diagnosed and treated.

• #2

  https://link.springer.com/article/10.1007/s00787-024-02415-9

  Understanding the symptoms of a mental disorder is essential for accurate diagnosis or selecting appropriate treatment targets. Despite this, there is a surprising lack of systematic research on the symptoms of selective mutism (SM). While the DSM-5 defines failure to speak as the only core symptom of SM, sparse research suggests that children with SM may experience additional symptoms. […] The symptoms reported were categorized using qualitative content analysis (QCA) and examined for frequency and association with symptom severity. Ten different symptom categories were identified, with fear, freezing, and avoidance/security behaviors being the most prevalent. On average, parents reported M=4.74 (SD=2.37) symptoms from different symptom categories. Only fear was found to be related to symptom severity of SM. As the findings suggest that SM encompasses various symptoms beyond failure to speak, a more sophisticated understanding of SM as a mental disorder with multiple symptoms seems essential.

• #2 Selective mutism – NHS

  https://www.nhs.uk/mental-health/conditions/selective-mutism/

  More confident children with selective mutism can use gestures to communicate for example, they may nod for „yes” or shake their head for „no”. […] But more severely affected children tend to avoid any form of communication spoken, written or gestured. […] Some children may manage to respond with a few words, or they may speak in an altered voice, such as a whisper. […] Left untreated, selective mutism can lead to isolation, low self-esteem and social anxiety disorder. […] It can continue into adolescence and adulthood if not managed. […] A child can successfully overcome selective mutism if it’s diagnosed at an early age and appropriately managed. […] It’s important for selective mutism to be recognised early by families and schools so they can work together to reduce a child’s anxiety.

• #2

  https://link.springer.com/article/10.1007/s10578-023-01512-1

  To establish the diagnosis in terms of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the nonspeaking behaviour should be persistent (i.e., have a duration of longer than 1 month) and hinder the child significantly in its functioning at school and during social interactions with others. […] Across various clinical and non-clinical samples, between 0.3% and 1.9% of the children have been found to meet the full classification criteria of SM, but it is good to be aware that just like other mental health problems selective non-speaking behaviour is situated on a continuum, implying that there are also children displaying less severe symptoms of the disorder. […] In psychiatric classification systems, SM is currently considered as an anxiety disorder. […] A large number of studies have demonstrated that anxiety is a prominent symptom of children with SM.

• #2 Long-term outcomes of selective mutism: a systematic literature review | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-023-05279-6

  Selective mutism (SM) is a childhood onset anxiety disorder, and the main symptom is not speaking in certain social situations. Knowledge about the duration and long-term outcomes of SM have been lacking and the aim of this systematic literature review was to address this gap in the literature. We investigated how long SM symptoms persisted as well as other psychiatric outcomes associated with SM in later life. […] The current understanding is that SM symptoms persist throughout life to some extent, but most people with childhood SM do not fulfil the diagnostic criteria by the time they reach late adolescence or adulthood. […] Most subjects with SM recovered from this disorder during adolescence, but anxiety disorders were common in later life. Early detection and treatment are needed to prevent symptoms from persisting and other psychiatric disorders from developing.

• #2 What Is Selective Mutism and How Is It Treated?

  https://www.expressable.com/learning-center/speech-and-language-issues/what-is-selective-mutism-and-how-does-it-impact-children

  For selective mutism to be diagnosed, these symptoms must last for more than one month. That time period shouldn’t include a situation when it may be expected that your child wouldn’t talk right away, such as the start of a new school year. […] Children with selective mutism have these feelings daily. While every child with selective mutism is different, many find it difficult to speak in school. When children can’t communicate with teachers, it can lead to poor academic performance. […] These socially anxious feelings don’t just extend to their interactions with adults. Some children with selective mutism have trouble talking with kids their own age. […] The earlier a child is diagnosed with selective mutism, the better. Children often respond positively to early intervention. The longer a child goes without a diagnosis, the later treatment starts. Early treatment can help prevent selective mutism from lasting into adulthood. […] Delaying treatment for selective mutism can cause: Worsening anxiety, Depression and other anxiety disorders, Social isolation and withdrawal, Poor self-esteem and self-confidence, School refusal, poor academic performance, and the possibility of quitting school, Problems in the workplace.

• #2

  https://mentalhealthcenterkids.com/blogs/articles/selective-mutism-in-children

  Selective mutism can appear typically around the time kids engage in social interactions outside of the home environment. Usually, they affect those entering school age. […] Selective mutism is an anxiety disorder that affects a small percentage of the population, around 1-2% of the population. Individuals with this condition consistently fail to speak in specific social situations, such as school, despite being able to do so comfortably with family members. […] Over time, the avoidance behaviors can become reinforced as the child learns that avoiding speaking makes them less anxious. As a result, their silence becomes a habit that is difficult to break. […] Although selective mutism can vary widely in its duration (how long it lasts), research shows that most kids tend to outgrow it spontaneously for unknown reasons. Regardless, early treatment is important, which includes CBT and parent support.

• #2 Navigating selective mutism in children – CHOC – Children’s health hub

  https://health.choc.org/navigating-selective-mutism-in-children/

  Selective mutism is a rare childhood anxiety disorder where a child cannot speak in certain situations. This often happens in public settings, like at school, or around specific people, such as teachers, peers or extended family members. Children with selective mutism can often communicate in situations or settings where they feel safe and relaxed, like at home with caregivers. The condition is often noticed when a child is around 3 to 4 years of age, but children may not be diagnosed until they begin going to school. […] Children with selective mutism may go long periods without speaking at school, which can be mistaken for shyness. This can make it harder to do well in school, interact with others, and keeps them from asking for help or participating in activities that rely on the child speaking, like playdates with peers. Treatment can really help children with selective mutism.

• #2 Selective Mutism

  https://www.asha.org/practice-portal/clinical-topics/selective-mutism/?srsltid=AfmBOopCv6ocLsUem2AO7JBa22lMEmPM-2IyZmt_wWQ7NwWSYCx_E5ge

  The onset of selective mutism typically occurs between 3 and 6 years of age, with diagnosis often occurring when the child enters school (Sharp et al., 2007). […] Patterns of selective mutism can vary greatly and can interfere with academic, educational, and/or social performance. […] As with many anxiety disorders, children with selective mutism attempt to protect themselves from the discomfort they experience by avoiding the unpleasant activity (i.e., speaking and/or communicating). Varied characteristics and behaviors associated with selective mutism are a method of self-protection but may be interpreted as deliberately oppositional (e.g., difficult or rude; Kotrba, 2015). […] Children with selective mutism are often anxious about communication demands. This anxiety may impair the child’s ability to attend to class instruction and participate fully in school or social expectations (Klein et al., 2019).

• #2 Selective mutism: causes, symptoms, and treatments – The Diamond Rehab Thailand

  https://diamondrehabthailand.com/what-is-selective-mutism/

  Symptoms of selective mutism are usually first noticed when a child starts interacting with people outside their family, such as when they start kindergarten or school. The telltale sign of selective mutism is a significant contrast in the child’s ability to engage with different people. The child may be talkative with their family but exhibit sudden stillness or frozen facial expression when speaking to a person they don’t know e.g. a teacher, distant relative. The main symptoms of selective mutism are listed below: Anxious, uneasy, or awkward around others, Unpleasant, apathetic, or moody, Clingy, Shy and reclusive, Stiff, tight, or disorganized, Aggressive or stubborn, throwing fits when kids return home from school, or becoming irate when parents question them. […] Selective mutism can persist well into adulthood, but it is unclear how many adults have this condition. […] Selective mutism affects the quality of life among adolescents and adults, too. They may not be able to become fully independent or they lack qualifications due to their inability to participate in college life and job interviews.

• #2 How to Recognize Selective Mutism :: The Baker Center For Children and Families

  https://www.bakercenter.org/selective-mutism1

  When confronted by fearful social situations, like birthday parties or being in class, children with selective mutism will experience enhanced feelings of danger and their body will react to these signals. Their ability to speak is inhibited as a result. […] Diagnosing and treating selective mutism as early as possible is one way to maximize a child’s potential for positive treatment outcomes. […] While struggling with selective mutism, kids will have significant challenges forming social relationships, participating in academic activities, and asking for help when they need it. […] The longer that a child is inhibited by selective mutism in their life, the more challenging it will be to address it effectively later. […] If left untreated, selective mutism can lead to worsening anxiety, social isolation and withdrawal, school refusal, and possible symptoms of depression.

• #2 Guide to Selective Mutism in Children – Child Mind Institute

  https://childmind.org/guide/parents-guide-how-to-help-a-child-with-selective-mutism/

  The good news is that selective mutism is very treatable with the right care. Kids with SM respond best to behavioral therapy that is focused on helping them learn to speak in new settings, during new activities and with new people. […] Children with SM should never be pushed to speak. The pace of treatment should be gradual, and children shouldn’t be asked to do something that is too difficult for them. Instead, treatment should follow specialized behavior therapy techniques that prompt speech and then reinforce successful speaking experiences with lots of labeled praise and small incentives. This careful progression helps children gain confidence and prepares them for experiences that get progressively more challenging. […] For a treatment program to be effective, kids need to learn how to speak in everyday situations — not just in the doctor’s office.

• #2 What Is Selective Mutism | Causes, Signs, Symptoms In Adults & Children

  https://cpdonline.co.uk/knowledge-base/mental-health/what-is-selective-mutism/

  Children are usually diagnosed between the ages of 3 and 8 years old. The quicker the response to treatment, the better the overall prognosis. With effective treatment, most children can overcome selective mutism. How long it takes will depend on the age at which they are diagnosed, as the older the child is, the longer the treatment will be needed. […] The effectiveness of treatment may depend on whether or not they have additional learning and communication needs or anxieties and how long they have had selective mutism. Treatment will usually focus on reducing the anxiety associated with speaking rather than the speaking itself. […] It is important to remember that with a proper diagnosis and treatment, the prognosis for overcoming selective mutism is very good.

• #2 Selective mutism – NHS

  https://www.nhs.uk/mental-health/conditions/selective-mutism/

  With appropriate handling and treatment, most children are able to overcome selective mutism. […] But the older they are when the condition is diagnosed, the longer it will take. […] Treatment does not focus on the speaking itself, but reducing the anxiety associated with speaking. […] This starts by removing pressure on the person to speak. […] They should then gradually progress from relaxing in their school, nursery or social setting, to saying single words and sentences to one person, before eventually being able to speak freely to all people in all settings. […] As well as these environmental changes, older children may need individual support to overcome their anxiety.

• #2

  https://www2.hse.ie/conditions/selective-mutism/

  Selective mutism is an anxiety disorder. It is an intense fear (phobia) of talking in certain situations. Selective mutism mainly affects children, but it can continue into adulthood. A person with selective mutism usually speaks freely in some situations, but not in others. For example, a child may talk at home but does not speak in preschool or school. They may talk to close family members but they may be silent around other people. A person with selective mutism does not refuse to speak – they simply cannot speak in some situations. They want to talk but their fear and anxiety stops them. […] Selective mutism usually begins between ages 2 and 4, but it can start at any time. Selective mutism is usually first noticed when a child starts to mix with people outside their family. This could be when they go to preschool or school.

• #2 What is Selective Mutism?

  https://selectivemutismcenter.org/what-is-selective-mutism/

  Most children are diagnosed between 3 and 8 years old. […] If mutism persists for more than a month, a parent should bring this to the attention of their childs physician. […] Our findings indicate that the earlier a child is treated for Selective Mutism, the quicker the response to treatment, and the better the overall prognosis. If a child remains mute for many years, his/her behavior can become a conditioned response where the child literally gets used to non-verbalizing. […] Because Selective Mutism is an anxiety disorder, if left untreated, it can have negative consequences throughout the childs life and, unfortunately, pave the way for an array of academic, social and emotional repercussions such as worsening anxiety, depression and manifestations of other anxiety disorders, social isolation and withdrawal, poor self-esteem and self-confidence, school refusal, poor academic performance, and the possibility of quitting school. […] It is important to realize that with proper diagnosis and treatment, the prognosis for overcoming Selective Mutism is excellent!

• #3 Selective Mutism: Symptoms, Causes, & Treatment

  https://thriveworks.com/help-with/children-teens-adolescents/selective-mutism/

  If your child doesnt talk to other people or speak in certain settings, specifically at school, they might have selective mutism. This can be concerning, and your feelings are valid; however, know that your child can improve their behaviors through therapy. […] Selective mutism is defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), as an anxiety disorder, characterized by a consistent failure to speak in social situations in which there is an expectation to speak (e.g., school) even though the individual speaks in other situations. The failure to speak has significant consequences on achievement in academic or occupational settings or otherwise interferes with normal social communication. […] Selective mutism in children is common. According to the Selective Mutism Association, 1 in 140 children has selective mutism, with signs typically showing around ages 2-4. And, importantly, in the majority of cases (90%), children with selective mutism also have social phobia, as reported by the Selective Mutism Center.

• #3 Guide to Selective Mutism in Children – Child Mind Institute

  https://childmind.org/guide/parents-guide-how-to-help-a-child-with-selective-mutism/

  Children with selective mutism (SM) are talkative at home but unable to speak in more public settings, including school. […] When children are unable to speak around certain people or in certain settings, they may have an anxiety disorder called selective mutism (SM). It is common for kids with SM to be very chatty at home with family but silent at school. Parents typically start noticing signs of SM when a child is three or four years old. The disorder might not be diagnosed until they are school-aged, when their problems with speaking become more apparent. […] A child with SM might go a whole year or more in a classroom without speaking once to their teachers, counselors or peers. Typically, kids with SM are mild-mannered and polite in classroom settings, so their silence can be misinterpreted as shyness and never addressed as a possible barrier to their learning. Additionally, pediatricians may tell parents that the “shyness” will pass and discourage families from seeking treatment.

• #3 Navigating selective mutism in children – CHOC – Children’s health hub

  https://health.choc.org/navigating-selective-mutism-in-children/

  Signs and symptoms of selective mutism can include: A child may feel at ease speaking at home but may be unable to talk in public or around strangers because of anxiety. Struggling with eye contact when feeling uncomfortable. A child may use non-verbal communication, such as pointing, writing or head nods/shakes to respond. A child might communicate through a trusted individual, such as whispering to a caregiver or friend at school. […] Selective mutism often occurs with other anxiety disorders, particularly social anxiety. A diagnosis of selective mutism may be given when speech difficulties continue to occur, making daily functioning more challenging, such as in school or forming friendships due to public speaking challenges. Additional signs may include: the inability to speak even to familiar adults in the presence of others; difficulty talking with peers in school; appearing “shut down” or “paralyzed” when unable to talk; or using gestures and facial expressions instead of words to communicate.

• #3 What is Selective Mutism?

  https://selectivemutismcenter.org/what-is-selective-mutism/

  Not all children manifest their anxiety in the same way. Some may be completely mute and unable to speak or communicate to anyone in a social setting, others may be able to speak to a select few or perhaps whisper. 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. Less severely affected children may look relaxed and carefree, and are able to socialize with one or a few children but are unable to speak and effectively communicate to teachers or most/all peers. […] When compared to the typically shy and timid child, most children with Selective Mutism are at the extreme end of the spectrum for timidity and shyness. […] The majority of children with Selective Mutism have a genetic predisposition to anxiety. In other words, they have inherited a tendency to be anxious from one or more family members. Very often, these children show signs of severe anxiety, such as separation anxiety, frequent tantrums and crying, moodiness, inflexibility, sleep problems, and extreme shyness from infancy on.

• #3 Symptoms of selective mutism beyond failure to speak in children and adolescents – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38536490/

  Understanding the symptoms of a mental disorder is essential for accurate diagnosis or selecting appropriate treatment targets. […] While the DSM-5 defines failure to speak as the only core symptom of SM, sparse research suggests that children with SM may experience additional symptoms. […] In this study, we provided n = 86 parents of children and adolescents with SM (3-18 years) with a symptom definition appropriate for the target group. Additionally, parents were asked an open-ended question about any other symptoms they had observed in their children, beyond the failure to speak. The symptoms reported were categorized using qualitative content analysis (QCA) and examined for frequency and association with symptom severity. Ten different symptom categories were identified, with fear, freezing, and avoidance/security behaviors being the most prevalent. On average, parents reported M = 4.74 (SD = 2.37) symptoms from different symptom categories. Only fear was found to be related to symptom severity of SM. As the findings suggest that SM encompasses various symptoms beyond failure to speak, a more sophisticated understanding of SM as a mental disorder with multiple symptoms seems essential.

• #3

  https://link.springer.com/article/10.1007/s10578-023-01512-1

  In particular, symptoms of social anxiety disorder appear to be highly prevalent in children with SM. […] The evidence to support this notion comes from three lines of research. […] The second research line has indicated that similar risk and vulnerability factors seem to be involved in the aetiology of SM as in other anxiety disorders. […] The third and final research line is concerned with treatment: just like in other anxiety disorders, evidence indicates that cognitive-behavioral interventions are particularly effective for treating children with SM. […] In spite of all the support for the notion that SM is an anxiety disorder, there are also echoes in the psychological literature suggesting that the condition is more heterogeneous in nature. […] Given this evidence, Kearney and Rede concluded that SM is a complex and multifaceted disorder that possibly can better be conceptualized as a neurodevelopmental problem.

• #3 What is Selective Mutism?

  https://selectivemutismcenter.org/what-is-selective-mutism/

  Most children are diagnosed between 3 and 8 years old. […] If mutism persists for more than a month, a parent should bring this to the attention of their childs physician. […] Our findings indicate that the earlier a child is treated for Selective Mutism, the quicker the response to treatment, and the better the overall prognosis. If a child remains mute for many years, his/her behavior can become a conditioned response where the child literally gets used to non-verbalizing. […] Because Selective Mutism is an anxiety disorder, if left untreated, it can have negative consequences throughout the childs life and, unfortunately, pave the way for an array of academic, social and emotional repercussions such as worsening anxiety, depression and manifestations of other anxiety disorders, social isolation and withdrawal, poor self-esteem and self-confidence, school refusal, poor academic performance, and the possibility of quitting school. […] It is important to realize that with proper diagnosis and treatment, the prognosis for overcoming Selective Mutism is excellent!

• #3 What Is Selective Mutism and How Is It Treated?

  https://www.expressable.com/learning-center/speech-and-language-issues/what-is-selective-mutism-and-how-does-it-impact-children

  For selective mutism to be diagnosed, these symptoms must last for more than one month. That time period shouldn’t include a situation when it may be expected that your child wouldn’t talk right away, such as the start of a new school year. […] Children with selective mutism have these feelings daily. While every child with selective mutism is different, many find it difficult to speak in school. When children can’t communicate with teachers, it can lead to poor academic performance. […] These socially anxious feelings don’t just extend to their interactions with adults. Some children with selective mutism have trouble talking with kids their own age. […] The earlier a child is diagnosed with selective mutism, the better. Children often respond positively to early intervention. The longer a child goes without a diagnosis, the later treatment starts. Early treatment can help prevent selective mutism from lasting into adulthood. […] Delaying treatment for selective mutism can cause: Worsening anxiety, Depression and other anxiety disorders, Social isolation and withdrawal, Poor self-esteem and self-confidence, School refusal, poor academic performance, and the possibility of quitting school, Problems in the workplace.

• #3 What is Selective Mutism? | Anxiety Canada

  https://www.anxietycanada.com/disorders/selective-mutism/

  The longer children miss out on important academic and social learning opportunities, the more likely they are to be impacted. […] Specifically, older children and teens may have difficulties with peer relationships, additional anxiety disorders such as social or generalized anxiety disorder, or depression.

• #3 Symptoms of selective mutism beyond failure to speak in children and adolescents

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11564403/

  The Diagnostic Features and Associated Features to Support the Diagnosis of SM sections of SM in DSM-5 include additional clinical features such as high levels of social anxiety, withdrawal, externalizing behaviors, and impairments in communication skills. […] These clinical features reflect the findings that (social) anxiety is a central phenomenon in the majority of children with SM, and that also additional symptoms beyond anxiety (e.g. externalizing behavior, delayed speech development) may occur in affected children. […] SM causes severe impairments in academic and social functioning, typically emerges during preschool age and can last for several years. […] Our results suggest that children and adolescents with SM experience multiple symptoms, with an average of M=4.74 symptoms from different categories.

• #3 Selective Mutism in Adults – Leaf Complex Care

  https://leafcare.co.uk/blog/selective-mutism-in-adults/

  For adults and children with selective mutism, navigating social interactions can be incredibly challenging. People may experience a deep-seated fear of judgment or embarrassment, making initiating or responding to conversations in specific situations difficult. Understanding and patience from those around them are crucial in providing support. With the right interventions by mental health professionals, such as therapy and gradual exposure to anxiety-inducing situations, individuals with selective mutism can learn to manage their anxiety and improve their ability to communicate effectively, leading to enhanced social interactions and overall well-being. […] Selective mutism has common signs, including a persistent inability to speak in specific situations, such as at work or in social gatherings, even though the individual may talk fluently in familiar environments like home or with close friends. Adults with selective mutism might also avoid eye contact, display extreme nervousness, or use gestures and nonverbal communication as their primary expression. Additionally, they may struggle to initiate or participate in conversations, leading to social isolation and frustration or embarrassment.

• #3 What Is Selective Mutism | Causes, Signs, Symptoms In Adults & Children

  https://cpdonline.co.uk/knowledge-base/mental-health/what-is-selective-mutism/

  Children are usually diagnosed between the ages of 3 and 8 years old. The quicker the response to treatment, the better the overall prognosis. With effective treatment, most children can overcome selective mutism. How long it takes will depend on the age at which they are diagnosed, as the older the child is, the longer the treatment will be needed. […] The effectiveness of treatment may depend on whether or not they have additional learning and communication needs or anxieties and how long they have had selective mutism. Treatment will usually focus on reducing the anxiety associated with speaking rather than the speaking itself. […] It is important to remember that with a proper diagnosis and treatment, the prognosis for overcoming selective mutism is very good.

• #3 Navigating selective mutism in children – CHOC – Children’s health hub

  https://health.choc.org/navigating-selective-mutism-in-children/

  If you think your child has selective mutism, get a full evaluation to receive a diagnosis. This assessment should review when your child is verbal and non-verbal and identify any co-existing conditions, like other anxiety disorders. It’s important to rule out other potential causes such as communication disorders. Only experienced professionals can diagnose selective mutism. While its exact cause is not known, selective mutism is sometimes linked to anxiety disorders, shyness and avoidance of speaking situations. […] Selective mutism responds well to behavioral therapy, which focuses on encouraging speech in many different situations. Treatment should slowly move forward, making sure not to push children too far. Specialized tools will help improve speech and support successful experiences, building confidence for difficult situations. Involvement of everyone in the child’s life is key, as adjusting to the disorder can get in the way of progress. Instead of “rescuing,” caregivers should support coping strategies taught in treatment. While anxiety may not disappear entirely, the child’s ability to manage distress will improve.

• #3 Selective mutism in children & teens | Raising Children Network

  https://raisingchildren.net.au/guides/a-z-health-reference/selective-mutism

  If your child is old enough, they might tell you when or why they feel anxious. […] Its common for children with selective mutism to have another anxiety disorder like social anxiety, separation anxiety or generalised anxiety. […] If your child doesnt speak outside your home for more than 3 months, they need professional help. […] Children who get professional help in their preschool and early school years often recover from selective mutism more quickly than those who dont. Without professional help, theres a chance that speaking difficulties might not completely go away or might persist into adulthood. […] The stepladder approach and other graded exposure therapies are an essential part of treatment for selective mutism. […] If your child has language delay, theyll get speech therapy to build their language skills. […] With regular practice at home, at school and in the community, children with selective mutism can overcome speaking difficulties. But it can take time up to several years. Even when your child does start to speak, theyll need support to build speaking confidence in all situations.

• #4 What Is Selective Mutism and How Is It Treated?

  https://www.expressable.com/learning-center/speech-and-language-issues/what-is-selective-mutism-and-how-does-it-impact-children

  For selective mutism to be diagnosed, these symptoms must last for more than one month. That time period shouldn’t include a situation when it may be expected that your child wouldn’t talk right away, such as the start of a new school year. […] Children with selective mutism have these feelings daily. While every child with selective mutism is different, many find it difficult to speak in school. When children can’t communicate with teachers, it can lead to poor academic performance. […] These socially anxious feelings don’t just extend to their interactions with adults. Some children with selective mutism have trouble talking with kids their own age. […] The earlier a child is diagnosed with selective mutism, the better. Children often respond positively to early intervention. The longer a child goes without a diagnosis, the later treatment starts. Early treatment can help prevent selective mutism from lasting into adulthood. […] Delaying treatment for selective mutism can cause: Worsening anxiety, Depression and other anxiety disorders, Social isolation and withdrawal, Poor self-esteem and self-confidence, School refusal, poor academic performance, and the possibility of quitting school, Problems in the workplace.

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