Many years ago, early in my clinical training, a couple brought their 7-year-old daughter to see me. The parents were perplexed. The girl, whom I'll call Emily, was rambunctious at home, but would never utter a word anywhere else.
Emily had an unremarkable developmental history. She had experienced no unusual traumas. At home, she was a very happy child. At school, whenever anyone would speak to her, she would hang her head and her hair would fall forward, obscuring her face.
My clinical supervisor suggested the child might have elective mutism. Very little was known about this childhood disorder at the time, but it was assumed that for some reason, the child refused to speak. Even though Emily's behavior patterns clearly fit the descriptions in the literature, I couldn't buy the implication that she was being obstinate. Nothing in her behavior at home, or in her mannerisms that I observed, suggested that she was oppositional.
Today, Emily would be diagnosed with selective mutism. The subtle, but significant, change of words from elective to selective represents a major advance in how we think about the condition. Selective mutism is a variant of social anxiety disorder in which a child, who is normally capable of speech, is unable to speak in given situations, or to specific people.
Emily made progress even though I knew very little about what I was doing at the time. She had wonderful parents who accepted her struggles while also helping her gradually take tiny steps out of her comfort zone.
October is Selective Mutism Awareness Month, and I thought this would be a good time to discuss briefly some facts and myths about the disorder:
I will be writing more about selective mutism in the near future. For now, though, here are some additional resources on this topic:
Copyright 2011 Barb and Greg Markway