What is SM?
Selective Mutism is a disorder that is so underrecognized, many mental health professionals are unaware of it. SM is an anxiety disorder in which individuals do not speak in certain settings (e.g., school) or with certain people (e.g., adults), despite having no language, speech, or communication problems in other settings (American Psychiatric Association, 2013). It occurs in about 1% of individuals, usually beginning in preschool years (APA, 2013). Oftentimes, parents are shocked to learn that their child who is a “chatterbox” at home has literally never spoken to their teacher. Individuals with SM appear to “freeze” in response to anxiety and are not able to get out their words. Obviously, this can have serious implications, such as not being able to make new friends, participate in school or work, or be able to advocate for themselves in an emergency situation.
Because SM is not well known, many people who are working with a child, teen, or adult who is not speaking have no idea what to do. The treatment for SM is not at all common sense, so oftentimes these individuals and their families struggle to find strategies that work.
What is the Treatment for SM?
Treatment for SM involves increasing comfort for the individual to be able to speak in a variety of settings. Rather than forcing them to talk, we either set up their environment to make it seem “safer” to talk, or we help them practice talking ranging from comfortable to uncomfortable settings. Basically, we’re trying to help them unfreeze when they want to talk.
There are several evidence-based treatments for SM. For younger kids, Parent-Child Interaction Therapy (PCIT-SM) is a research-backed treatment. PCIT-SM involves coaching parents, teachers, and other important adults in the child’s life in a set of skills that makes the child more likely to talk. For older kids, teens, and adults, likely exposure therapy will be used to help the individual practice speaking and increase their confidence in talking even when they are uncomfortable. Several practices offer “intensives” in which SM children and their families learn therapy skills over the course of a few days.
To find a qualified therapist or intensive program, go here.
What Resources are Available for SM?
The following resources are appropriate either for families or individuals starting SM treatment to supplement their learning, or for families who are currently unable to engage in therapy/treatment.
· The first thing I recommend to any family is to complete Selective Mutism University, a free, online course that covers the basics of SM and PCIT-SM treatment and provides handouts and videos
· Florida International University’s MINT Lab offers several handouts
· Kurtz Psychology offers research articles on PCIT-SM
· The Selective Mutism Questionnaire (SMQ) and School Speech Questionnaire (SSQ) can be completed by parents and teachers to determine a child’s level of speaking (which should be interpreted by a mental health professional)
· Natasha Daniels offers a YouTube video on SM
· Speech-language pathologist Anna Biavata-Smith has several SM videos on YouTube
· Dr. Ali Mattu discusses his experience with SM and social anxiety in a video
· Outloud is a podcast dedicated to discussing SM content
· Look out for parent support/resource groups, such as the Facebook group Selective Mutism Georgia
Starting the journey toward helping your child (or yourself) bravely speak to others can be intimidating and overwhelming! I hope these resources will show that you are not alone and there is hope and help!
Please comment below with other resources for SM!
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596