Don't Worry, Mom

Coping with anxiety in families

After Newtown, Listening to Those Who Aren't Speaking

Guest Blog Post by By Kim O'Connell and Marian Moldan

Guest blog post by Kim O'Connell and Marian Moldan

In the agonizing aftermath of the Newtown massacre, we are still talking about gun control, psychosis, school security, Asperger's syndrome, and conspiracy theories. We've mourned the victims and speculated about the shooter, Adam Lanza. Yet almost nothing has been said about his tendency, like Virginia Tech shooter Seung-Hui Cho before him, toward mutism in public situations. Sadly, we are not surprised. 

Although no official diagnosis has been revealed, evidence suggests that Lanza may have suffered from selective mutism (SM), a rare anxiety disorder. As the mother of a once selectively mute child and a clinical social worker who specializes in the treatment of SM, we have an acute understanding of how this affliction affects children.  According to the psychiatric definition, selective mutism is a form of social phobia that is characterized by a child's consistent inability to speak in certain settings (usually school) despite having the ability for normal speech elsewhere (usually home). Children with SM are vulnerable to other mental health disorders such as generalized anxiety, obsessive compulsive disorder and depression. They find it harder to make friends and progress in school. Yet this condition is often ignored, ridiculed or dismissed as mere shyness.

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This may have been the case with Lanza. Recalling how he never talked during appointments, his hairstylist said, "I thought he couldn't speak." At least one classmate recalled that he "barely said a word" in school. He reportedly became nervous and fidgety when he had to talk, "as if having to speak up were painful." The difference between mere shyness and selective mutism lies in just that -- the level of pain. At Virginia Tech, before he killed 32 people and himself, Seung-Hui Cho scrawled a desperate manifesto on his bedroom wall: "Teach me how to speak, teach me how to share."

Cho, who did have a formal SM diagnosis, was bullied because of his mutism. Classmates offered him lunch money to hear him talk and told him to “go back to China.” (He was Korean-American.) A teacher even threatened to fail him for not participating verbally. For a selectively mute child, that approach is tragically wrong-headed.

We've seen it first-hand. Three years ago, at the age of three, Kim's introverted son suddenly stopped speaking at home, for hours, then days, then weeks at a time. He did not talk to the teachers and classmates at his preschool for two years. A classmate pegged him "the talk-no-talk boy."

Family members, friends and even our pediatrician said "not to worry," asserting that he would "grow out of it." They didn't see his increasing isolation or the anxiety etched on his young face. And although some observers thought he was choosing to be mute, it was clear that he was powerless to understand what was happening. "The words are locked behind a door," he once said, "and I don't have the key."

From preschoolers to teenagers, most selectively mute children share similar feelings. They want to speak. They want to have friends. They can’t reach out. They can’t connect. For thousands of hours each school year, they sit among peers and adults who rarely speak to them because they are known as the “kid who can’t talk.” When they are teased or bullied, they have no verbal means to discharge their anger. They can't alert adults if they are sick, hurt or in danger. The longer these symptoms continue without appropriate school-based and collaborative early intervention, the more entrenched they become.

Even well-meaning adults can cause problems for this population. One teen who was seen whispering to a close friend--a "baby step" toward full speech--was mischaracterized by a guidance counselor as oppositional because she wasn’t speaking to adults. Another child recounted how a teacher threatened her with lost recess time if she didn’t talk. When they feel unsupported and misunderstood, SM kids become confused, angry and ashamed.

We believe that most educators are doing the best they can. We have no doubt that Lanza's teachers, like Cho's, tried to reach him and understand him. We also know that selective mutism, like Asperger's syndrome, is by no means a predictor of depression and violence.

That said, though, we also believe that school systems could do more to take selective mutism seriously, to understand that it is a real psychological affliction that requires treatment and to know that these too-quiet kids will not always "grow out of it."

But they can get past it. Through years of therapy, and after gaining social confidence in low-pressure settings such as playdates, Kim's son finally began speaking in his last year of preschool. He is now a happy and confident kindergartener. When he is talking, people listen, just as they should have been when he wasn't.                 

The Authors: 

Kim O'Connell is a writer in Arlington, VA, who blogs about selective mutism and social anxiety at www.bloomingboy.com, and Marian Moldan is a licensed clinical social worker and special educator whose practice, Childhood Anxiety Solutions, is based in Plainview and Miller Place, NY http://childhoodanxietysws.com.

 

Resources:

Selective Mutism Yahoo Group: http://health.groups.yahoo.com/group/Selectivemutismsupportgroup/

Selective Mutism Group Website: http://www.selectivemutism.org/

Selective Mutism Foundation: http://www.selectivemutismfoundation.org/

Amy's website about anxiety disorders (including information on selective mutism): http://psychology.case.edu/research/fear_lab/index.html

 

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Amy Przeworski, Ph.D., is an assistant professor of psychology at Case Western Reserve University and specializes in anxiety disorders in children, adolescents, and adults.

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