Selective mutism is a rare psychological disorder that usually affects children between 2 and 5 years old, being more common in girls. Children with this disorder can only communicate with people close to them, having difficulty talking to other children, teachers or even family members.
The diagnosis of selective mutism is usually made after the age of 3, since from that age onwards the child already has the developed speech capacity and begins to demonstrate difficulty to perform some social activities.Usually the child can communicate very well with parents, siblings and close cousins, however, he has difficulty talking to other people, as well as establishing eye contact, and can be quite anxious.
It is important that selective mutism is identified and treated with the help of a psychologist and psychiatrist, because in this way it is possible to identify if there is any other associated problem that may be causing the disorder, such as hearing problems or brain disorders, allowing to better adapt the type of treatment.
Main features of selective mutism
The child with selective mutism is able to communicate well in a family environment, however he has difficulties in an environment with unknown people, in which he feels that his behavior is being observed. Thus, some characteristics that help to identify selective mutism are:
- Difficulty interacting with other children;
- Lack of communication with teachers;
- Difficulty expressing yourself, even through gestures;
- Excessive shyness;
- Social isolation;
- Difficulty going to the bathroom in an unfamiliar environment, peeing your pants, or eating at school.
Despite being more frequent in children, selective mutism can also be identified in adults and, in these cases, it is called social phobia, in which the person feels quite anxious in normal everyday situations, such as eating in public. , for example, or when thinking about establishing some type of communication. Learn how to identify social phobia.
Why it happens
Selective mutism does not have a specific cause, however it can be triggered by some situations, which may be related to some negative experience or trauma that the child has gone through, such as entering a new school, living in a very protective family environment or having very authoritarian parents. .
In addition, the development of this disorder may be related to genetic factors, since it is more common to occur in children whose parents have emotional and / or behavioral disorders, or be related to the child's personality traits such as shame, excessive worry, fear and attachment, for example.
This situation can also be influenced by the beginning of school life or the change of city or country, for example, as a consequence of the culture shock. However, in these cases it is important that the child's development is observed, as often the lack of communication is not due to selective mutism, but rather corresponds to a period of adaptation of the child to a new environment. Therefore, in order to be considered mutism, it is necessary that the characteristics of this change are present before the change or last an average of 1 month.
How the treatment is done
The treatment for selective mutism consists of psychotherapy sessions, in which the psychologist outlines strategies that stimulate the child's communication, in addition to exploring techniques that evaluate his behavior. Thus, the psychologist is able to make the child feel more comfortable in the environment so that his communication is favored.
In some cases, it may be recommended by the psychologist that the child also be accompanied by a child psychiatrist or that sessions with the family be held.
In addition, the psychologist guides parents so that treatment continues to be stimulated at home, recommending that parents:
- Do not force the child to speak;
- Avoid answering for the child;
- Praise when the child demonstrates progress in their communication skills;
- Encourage the child to do things that are more difficult, such as buying bread, for example;
- Make the child comfortable in the surroundings, in order to prevent him from feeling that he is the center of attention.
In this way, it is possible for the child to gain more confidence to communicate and not be so uncomfortable in strange environments.
When there is no response to treatment or evident improvements, the psychiatrist may indicate the use of selective serotonin reuptake inhibitors, SSRIs, which act on the brain. These drugs should only be used with the guidance of the doctor and in very well evaluated cases, as there are not many studies that prove their effect on the treatment of children with this disorder.
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Bibliography
- MELO, Sara Isabel C. Selective Mutism: Chatterbox Project. Master's Thesis, 2016. ISPA - Instituto Universitário.
- PEIXOTO, Ana Cláudia A .; CAROLI, Andréa Lúcia G .; MARIAMA, Silvia Regina. Selective Mutism: case study with interdisciplinary treatment. Brazilian Journal of Cognitive Therapies. Vol 13. 1 ed; 5-11, 2017
- SELECTIVE MUTISM ASSOCIATION. What is Selective Mutism?. Available in: . Accessed on 08 May 2020
