Is a child just shy, or is there something more going on? This is the pressing question. Should we be concerned and establish interventions to help the child, or simply give him encouragement and more time to mature?
Misunderstanding shy behavior contributes to the lag between showing symptoms of selective mutism (SM) and actually receiving the appropriate diagnosis and treatment for the disorder. It is heartbreaking to find out, after years of being told that your child is just shy and will outgrow it in time, that your child actually has a severe anxiety disorder and that appropriate treatment could have spared them years of suffering. (Read more on treatment here.) Since many professionals are not familiar with selective mutism, parents are often reassured that the child will outgrow the shy behavior, or the child may be misdiagnosed as having developmental delays, oppositional disorders, or autism spectrum disorder.
Introverted vs. Inhibited
Some children are introverted, meaning that they prefer quiet time and solitary activities over noise and crowds. This is not quite the same thing as behavioral inhibition. Children who are inhibited actually experience fear and distress when met with unfamiliar people and situations and tend to withdraw to cope with their feelings.
Many people don’t recognize the difference between introversion and inhibition. In both cases the child is described as “shy” but the underlying reason for the avoidance of social contact is very different. Whereas introverted children simply prefer solitude but may choose to participate socially without any distress, inhibited children often desire social interactions but these situations cause anxiety and stress. If these inhibited children become severely distressed, they may begin to actively avoid socializing, creating a cycle of avoidance that leads to an anxiety disorder. Certainly, children can display social anxiety without becoming mute. But, how do we know when they have crossed the line?
Although there are many factors that contribute to the development of SM, there are a few common threads. Most children with SM exhibit behavioral inhibition at an early age and go on to develop anxiety in certain social situations. At times, anxiety overwhelms these children, their muscles tense, and they literally cannot speak when they are expected to. As this scenario is repeated hundreds and thousands of times, a child finds it increasingly scary, difficult, and even impossible, to speak in certain situations.
Children with SM may appear to adhere to rigid “rules” surrounding their speaking which baffles their parents and others. For example, the child speaks outside the school but not inside, the child speaks to other children but not to adults, the child speaks to his mother freely except when other people are nearby that might overhear.
The inhibited and quiet behavior children with SM display in some situations is usually in stark contrast to the bubbly, energetic, and talkative behavior that they exhibit at home. Many parents are shocked to find out from a school teacher that their child doesn’t speak a word in school since the child speaks so easily at home. My own daughter’s personality and ability to talk seemed to flip off and on like a switch. Buttercup could be laughing, smiling and joking in the car, but the moment we walked into the grocery store she would stiffen, stare blankly, completely ignore anyone who tried to engage her, and lean in close to whisper into my ear if she wanted to tell me something.
A few children with SM do warm-up in social situations and will participate normally, yet persist in being mute. This makes it look as if the child is being defiant and manipulative and is choosing not to speak. Although these children don’t exhibit social anxiety, they have developed a persistent fear, perhaps even a phobia of speaking which they cannot overcome by themselves.
When to Seek Help
- The child does not warm-up and begin to speak after being in a new situation for over a month.
- Other kids identify the child as “the kid who doesn’t talk.”
- The pattern of silence is consistent – never speaks at school, speaks to a friend at home but not at church, speaks to family members but nobody else, will only speak to parents when nobody else is around.
- The child seems extremely distressed about social situations and tries to avoid places and events where they are expected to speak.
- The child “freezes” or “shuts-down” when speaking is expected.
- The child’s muteness is becoming more pervasive.
- The child is unable to ask to use the restroom, report illness, ask for help, or report bullying.
If possible, seek a diagnosis from a professional who is familiar with selective mutism. (See a list of treating professionals here.) Otherwise, provide the professional with resources that explain selective mutism, since many have never heard of SM. The Selective Mutism Association (US-based) and the Selective Mutism Information and Research Association (UK-based) websites are great resources. If there are other developmental concerns, neuropsychiatric testing may be indicated. Selective mutism often occurs alongside other conditions.
Identifying and appropriately treating selective mutism will not turn a shy child into an extroverted child, rather it will uncover the child’s authentic personality that is hidden behind the anxiety. The goal is not to change the child, but for the child to develop coping skills to move through the anxiety, instead of avoiding it. Inhibition may be part of a child’s temperament, but being mute is not a fixed trait. With the right help, children with SM can work through their fears and reach their full potential.