Selective Mutism Definition
Selective mutism, also known as situational mutism, is an anxiety disorder that affects a person’s speech skills in specific social settings. It usually cooccurs with other anxiety disorders and social phobias. People with selective mutism are often talkative with family members and close friends but unresponsive at school, college, or work.
Contrary to misconceptions, adults and children with selective mutism don’t refuse to speak. Instead, they temporarily lose their ability to speak due to extreme social anxiety in overwhelming social situations. With proactive support from a mental health professional, individuals with selective mutism symptoms can overcome challenges and gain social skills.
Causes and Risk Factors
There is no universal cause behind selective mutism. However, there are potential factors that make people more likely to develop selective mutism. Most adults and children with selective mutism are found to have inherited predispositions to anxiety disorder. This is related to the over-excitability of the amygdala, a brain area responsible for setting the fight-or-flight response in possibly threatening situations. However, individuals with selective mutism experience a fight-or-flight response in ordinary situations.
Psychological and Emotional Factors
Selective mutism in adolescents and adults is often linked to the person’s overall psychological and emotional well-being. In many cases, individuals with selective mutism also have other mental health challenges.
Selective mutism can cooccur with the following mental health challenges:
- Anxiety or panic disorder
- Depression
- Obsessive-compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)
Developmental History and Trauma
In some cases, social and environmental factors can contribute to the development of selective mutism in adolescents and adults. Traumatic mutism is a specific form of selective mutism that involves difficulty speaking due to certain distressing experiences. The following circumstances in a person’s development can lead to selective mutism that preserves in adulthood:
- Childhood trauma
- History of physical or sexual abuse
- Abusive relationships with family members
- Bullying from peers
- Living in extreme poverty
Social Anxiety and Communication Disorders
The main factor for developing selective mutism is social anxiety or phobia that triggers a fight-or-flight response in overwhelming environments. While the individual can communicate in familiar settings (at home), they lose their ability to speak under pressure, so they may find it hard to communicate with educators, employers, and co-workers. Selective mutism is also connected to other challenges affecting communication skills, including the following:
- Autism spectrum disorder
- ADHD
- Auditory processing disorder
- Speech and language difficulties
Signs of Selective Mutism in Adults
The early onset of selective mutism usually occurs between the ages of two and four, and it tends to start interfering with the person’s life when they begin engaging with individuals outside of their immediate families at school. Without early professional treatment, selective mutism can persist throughout adolescence and adulthood.
The anxiety symptoms in adults with selective mutism can affect their interpersonal relationships and performance in the workplace.
Below is a list of the common symptoms of selective mutism in adults:
- Avoiding eye contact
- Poor coordination, stiffness, and tension
- Irritability and disinterest in uncomfortable social situations
- Shyness and social withdrawal
- Clinginess and fear of judgement
- Using gestures instead of speech (for example, nodding for “yes” and shaking head for “no”)
Diagnosis and Assessment
Early assessment and diagnosis constitute the first step towards receiving adequate treatment and improving communication skills. Healthcare professionals can diagnose selective mutism based on the patient’s description of their symptoms. As an adult, you are likely to obtain a selective mutism diagnosis if you fit the following behavioural criteria:
- Inconsistent language and communication challenges that affect one’s ability to speak in specific environments (such as classes, the office, or public places)
- Speech and language difficulties that persist for more than two months
- Inability to speak that cannot be explained by other mental, behavioural, or communication challenges
Challenges in Diagnosing Selective Mutism in Adults
Selective mutism is typically associated with a person’s childhood and school-age years. Children with selective mutism are often perceived as shy or defiant, which prevents them from receiving early treatment. Without adequate support, individuals with selective mutism may struggle with communication challenges in university and the workplace.
Since selective mutism is relatively rare and under-researched, it can often be mistaken for other mental health challenges, learning disabilities, and speech and language disorder. Furthermore, the social stigma may prevent adults from seeking professional help.
Coping Strategies for Adults with Selective Mutism
Adults with selective mutism need tailored strategies and accommodation to master their communication skills and reach their full potential in all spheres of life. Below is a list of the most effective methods for overcoming symptoms of selective mutism.
Self-Awareness and Understanding Triggers
In addition to professional assistance from mental health experts, individuals with selective mutism can control their speech difficulties through effective self-help techniques. It is important to become aware of one’s own triggers (such as crowded rooms, noisy environments, or public places) and try to avoid overstimulating situations. Some individuals benefit from sensory toys or bringing headphones to overwhelming environments.
Cognitive-Behavioural Therapy (CBT)
Cognitive behavioural therapy is considered the most efficient method of treating selective mutism. This form of psychotherapy helps individuals gain a better understanding of their thoughts, emotions, and behaviours. CBT is particularly beneficial for adults because it can examine their unhelpful thinking patterns that lead to communication struggles and give them resources to overcome signs of anxiety.
Communication and Advocacy with Family and Friends
Finally, healthy communication and advocacy from family members and friends are crucial for coping with selective mutism. Adults can greatly benefit from the understanding and non-judgemental approach of loved ones. They should never feel pressured or expect repercussions for not speaking.
The Importance of Support and Empathy
People with selective mutism need empathy, support, and adequate accommodations in their community. Your peers, coworkers, and employers should educate themselves on the effects and adapt their everyday expectations to your needs.
Individuals with selective mutism can improve their communication skills through positive reinforcement, such as small incentives and praise for their efforts. By gradually improving their self-esteem, people can overcome their anxiety and lead successful lives.
Support with Unique Community Services
At Unique Community Services, we provide compassionate support to people with selective mutism and take a person-centred, humanised approach to assisting individuals and dismantling social stigma. Our impact-driven clinicians help the people we serve overcome selective mutism and avoid social isolation.
The Unique Community Services team strives to maximise independence and social integration through tailored strategies and positive reinforcement. Our dedicated clinicians follow personalised care plans and prioritise every individual’s privacy, dignity, and personal boundaries. We deliver compassionate care services in your own home, allowing you to stay in your familiar surroundings and close to your loved ones.
Our expert team delivers CQC-regulated care to individuals in Leeds and Manchester. Contact us now, and we will create a tailored care plan catering to your unique needs.
