Christine and her daughter were shopping in the grocery store. Suddenly, Christine met her friend whom she had not seen for a long time, and she asked her friend: Wow! Who is this cute little girl? What's your name beautiful? The little girl froze, seemed frightened, cried, and hid behind her mother's arm. She was unable to answer this simple, seemingly easy question. A few seconds of silence prevailed, and Christine scolded her child, thinking that she had deliberately misbehaved.

Do you think Christine's behavior was correct? Have you ever thought about why your child talks to you and suddenly in some situations remains silent with others? Why does he choose to point at things rather than speak so often?

If you think that your child is misbehaving or that this is dictated by his temperament and stubbornness, then you are wrong! The matter is beyond his control, and your child suffers from Selective Silence Disorder, you must take care of it and try to treat him as soon as possible.

If your child suffers from Selective Silence Disorder, this means that social situations cause him fear and anxiety, making him find it difficult or impossible to speak. This disorder often begins in childhood and its effects may remain for life, so diagnosing the condition at an early age and treating it can help alleviate the effects and symptoms. 

Read on, my butterfly, until you learn, as in this article we will discuss everything related to selective silence, its symptoms and causes, and how to deal with it and treat it.

Selective Silence Disorder Overview

It is also called selective mutism, and it is a mental disorder in which the child afflicted with it cannot speak in specific situations with his schoolmates or strangers, because of his feelings of fear and anxiety, while he speaks comfortably at home with the family. It usually affects children in childhood and can It continues with them into adolescence and adulthood.

The word “selective” in the name of this disorder indicates to us that silence occurs in certain situations, that is, your child can surprise you and speak in other situations, but as we said previously, this silence is an unintentional act.

This condition is more of a disorder than shyness, and it can sometimes overlap with other conditions related to anxiety and may last a lifetime.

Selective Silence Disorder Prevalence

The occurrence of selective silence disorder is rare, affecting less than 1% of children approximately at the age of five, and usually the child's diagnosis of this disorder is not noticed until the stage of going to kindergarten or school and interacting with others.

It affects teenagers and adults at a small and rare rate, but it is still possible.

Selective Silence Disorder Causes

The child suffers from selective silence due to the anxiety and fear he experiences in the presence of strangers. This silence may be due to his fear of others’ ridicule, judgment, and ignoring of him. Some children may also feel anxiety and panic from noise and crowded places.

The underlying causes of selective silence disorder have not yet been identified, but some researchers have suggested that the disorder is linked to several factors that lead to the development of its symptoms, including:

Big changes in life

New stations and moving from one environment to another cause anxiety and tension in the child, and he is busy thinking about how he will go to school, make new friends, and engage in the new environment.

Mental disorders 

The chances of a child developing selective silence are higher if he suffers from other mental disorders, such as:

• Separation anxiety
• Social phobia
• Obsessive-compulsive disorder
• Autism spectrum disorder
• Post-traumatic stress disorder

Genetic factors

Heredity and genetics may play a role in a child developing selective silence disorder, as this disease runs in families.

Bilingualism in children

A child who speaks more than one language may have difficulty communicating with others other than his mother tongue, contributing to anxiety and fear of talking with others.

The nature of the surrounding environment

The child may be influenced by his family and acquire anxious behavior from them. The family environment, which is characterized by tension and anxiety, will affect the child and push him to feel fear and panic and it will become difficult to talk to others.

It must be noted that selective silence is not linked to the child going through a mental trauma or a painful experience. Our disease is different from the loss of the ability to speak after exposure to trauma, as the child loses the ability to talk to everyone, even at home and in all situations.

At the end of the article, you will be familiar with everything related to selective silence, its symptoms, treatment, and how to deal with it, so continue reading, my dear.

Selective Silence Symptoms 

Speech may be impossible for your child in certain situations, but in other situations, he can talk comfortably.

Symptoms vary from person to person, as for some people talking may be difficult, for others it is impossible, and others may communicate less.

Behavioral symptoms

You must be patient and consider your child as these behaviors are beyond his control. Behavioral symptoms of silence that appear in your child include the following:

• The child refuses to go to school
• He feels unable to speak and is slow to respond
• The child prefers to use sounds that are widely understood and consist of only one word, such as: yes, uh, hmmm, no.
• Writes responses, points to things, mumbles, stutters, and whispers.
• The child gets angry, cries, and acts aggressively and violently when he is forced to talk or interact
• He avoids situations that highlight him and draw attention to him, such as playing in front of others
• The child clings to his parents and clings to them, speaking to them in whispers, gestures, or in a low voice when other people are present.
• The child avoids eye contact with others
• It is difficult for a child to ask for help from others, even in emergencies, such as telling the teacher that he wants to go to the bathroom.
• The child remains silent and does not speak to others, such as his schoolmates or teachers, even though he speaks normally and comfortably with his family at home.
• He avoids participating in any social activities

Physical symptoms

Your child may exhibit some physical symptoms when in the presence of strangers, including:

• The child suffers from dry mouth and cold hands
• Feels short of breath
• The baby's heartbeat accelerates
• He shivers and his face turns red
• The child shows tension and fear
• The child's expression of pain freezes
• The child feels colic

Selective Silence Complications

Neglecting your child and delaying his treatment will negatively affect his life in various ways and lead to serious consequences, including:

• Academic achievement declined due to his inability to communicate with those around him, including teachers and classmates
• Symptoms worsen to other psychological and physical conditions associated with anxiety, such as social anxiety disorder, depression, developmental delay, language problems, obsessive-compulsive disorder, and panic disorder.
• The child feels lonely, and isolated, has social difficulties, and does not participate in school and daily activities.

Things That Frighten a Selective Silence Child

Many things cause concern for your child with selective silence, and you must pay attention to them, as your child may not interact or talk in these situations:

• Noisy and crowded places
• Unfamiliar places that he has never visited before
• Places associated with sad memories or where you may be exposed to an unenviable situation
• Strangers getting too close to your child or intruding on his personal space
• Talking loudly or aggressively and violently with your child
• The presence of strangers
• Certain physical characteristics of others, for example, being tall
• Unfriendly behavior patterns
• Completely new situations
• Situations in which your child faced unsuccessful experiences

We have mentioned some of the things that excite your child, and they differ from one child to another and change with time.

Selective Silence Diagnosis

Your child's diagnosis depends on knowing his medical history and performing a physical examination to ensure that he does not have problems with hearing and speech.

Mental health and medical care providers such as psychologists and psychiatrists diagnose the disease with the help of speech-language pathologists who rule out other conditions.

Your child is diagnosed with selective Silence based on specific symptoms and behaviors. Providers ask questions about your and your child's experience and inquire about other factors that could worsen the condition.

The psychiatrist uses a diagnostic manual, checklists, screening questionnaires, or other tools to help determine whether your child meets the criteria for selective Silence.

The fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes five criteria that your child must meet to be diagnosed with selective silence. These criteria are:

• Your child does not speak in certain social situations and does not find it difficult to talk to you at home
• Your child’s educational, social, and professional life is affected
• Your child's inability to speak for more than a month
• Your child's difficulty speaking is not because he does not understand other people's language
• Your child's difficulty speaking is not caused by another disorder, such as stuttering, autism, schizophrenia spectrum disorder, or psychosis.

Selective Silence Treatment

Dear mother, when you discover your son’s strange behavior and do not ignore it and take him to a specialist and he is diagnosed with selective silence, you will have saved yourself and your child a lot of time and suffering, as early treatment contributes to obtaining good results, the child’s rapid recovery, and the reduction of symptoms and perhaps their complete disappearance. The treatment aims to reduce the stress and fear that the child suffers from in the first place, and then help and encourage him to talk.

The treatment plan for selective silence begins with psychotherapy and speech therapy, and the doctor may resort to using medications. Here we will explain the common treatment methods used by most doctors in detail:

Treating children's mental health

The first step in treating selective silence is mental health treatment, i.e. cognitive behavioral therapy, which is one of the best methods used, as the doctor tries to overcome the anxiety and tension that causes the child to be silent, and trains him to talk to people outside the home, and many methods involve cognitive behavioral therapy, including:

1. Encouraging the child to make eye contact with others and speakeasy words, step by step, until he can speak and communicate verbally fluently.
2. Motivating the child to face his fear by exposing him to situations that arouse his anxiety, such as talking to strangers, but in a safe and comfortable environment, and training him to deal with these situations.
3. Praise and encourage the child when he shows any improvement or positive behavior, even if it is simple, during the treatment journey, to contribute to increasing his self-confidence.

Studies have shown that the majority of children with selective silence who received cognitive behavioral therapy for more than five years were able to talk comfortably outside the home and that the symptoms of the disorder decreased or disappeared completely.

Speech therapy

This step is done with the help of a speech therapist or speech specialist, to train the child on correct pronunciation, teach him how to speak, and practice conversations with other children.

Medications 

In some severe or chronic cases, as well as cases that have not improved with other treatment methods, it may become necessary to use medications, but under the supervision of a doctor. The most common medications used are antidepressants and selective serotonin reuptake inhibitors. They treat the disease and can treat disorders associated with anxiety.

Selective Silence Prevention

Unfortunately, experts do not understand the basic causes of selective silence, so there are still no studies that help us reduce its occurrence or prevent it. Indeed, the incidence of it does not exceed 1%, but any child, male or female, is at risk of contracting it.

The Difference Between Autism and Selective Silence

Autism is considered a developmental disease, not a psychological one. The biggest and distinctive difference between autism and selective silence is that selective silence involves difficulty communicating only with schoolmates or strangers due to fear and anxiety in certain situations, while one can speak and communicate comfortably in other situations or at home with his family. As for autism, the child faces difficulty in speaking with all the people around him, even his parents and family members, permanently.

Dealing with Selective Silence

You may feel disappointed if your child does not talk in certain situations, even if you ask him to talk, and disappointment can turn into frustration if your child expresses his refusal to talk by using tantrums, screaming, violence, or any other behavior.

We go back and remind you, my dear, that selective silence is a mental illness and your child does not fault it, because it is beyond his control.

Indeed, your child cannot control it, but you can control how you deal with your child and his symptoms.

You must be wondering: What can I do to help my child with selective silence? Here we mention the most important things that you should keep in mind:

Help your child feel comfortable and safe

Do not force your child to talk in situations in which he may feel afraid and stressed, and involve him more in activities that do not require talking, such as drawing or solving puzzles, as a first step in integrating the child with others without putting pressure on him.

Explain your child's condition to the teachers and that his abstention from talking is not his will, and seek their help in encouraging and motivating your child and praising him for positive behaviors. It is preferable not to talk about the problem he is suffering from in front of him, as this may make him feel embarrassed, exacerbate the problem, and increase his feelings of anxiety and tension.

Reduce your son's fear and anxiety

Encourage your child to communicate in ways that make him feel comfortable, help him become more comfortable in social meetings, and then talk to him in private.

Be patient and give your child enough time to talk

Be patient and give your child time to talk comfortably. Talking and answering instead of him will give him the feeling that he is doing something bad, and this exacerbates the symptoms and makes it difficult for him to overcome anxiety and fear of talking.

Make sure to make him know the importance of thinking before talking and responding as well.

Praise your child's efforts

Praise your child when he talks or reacts, even if it is simple, and reward him, so that he knows that his speech has a positive impact, importance, and meaning.

Avoid using punishment as a motivation

Do not punish your child for a sin he did not commit. A child who is punished because he cannot talk will find it more difficult to talk because of his feelings of fear and anxiety.

Do not worry, Madam. Children with selective silence disorder and no other problems perform well in all areas of life, and there is no need to place them in special education classes.

In conclusion, dear reader, selective silence is a disorder that makes your child unable to talk in certain situations due to anxiety, tension, and fear. You need to know that your child with this disorder is not bad-tempered or disobedient to your commands, but rather what happens to him is something he cannot control.

If you suspect that your child is infected, talk to his doctor or caregiver so that you can discuss available treatments early, save yourself trouble, and obtain positive results. Through your support and encouragement, your child will be able to learn to speak and talk without giving up and letting fear and stress rob him of his voice.
You are not in this alone. Many women are now fighting to treat their children from Selective Silence Disorder. Do not panic, have patience and faith in your child, and join the caravan of people who have overcome this disorder.

From our team...all love to you, my butterfly.

Frequently Asked Questions about Selective Silence Disorder

What is the difference between autism and selective mutism?

The biggest difference is that selective silence involves difficulty communicating only with schoolmates or strangers due to fear and anxiety in certain situations, while he can speak and communicate comfortably in other situations or at home with his family. As for autism, the child has difficulty speaking with all the people around him. 

Can selective silence be prevented?

Unfortunately, experts do not understand the basic causes of selective silence, so there are still no studies that help us reduce or prevent its occurrence.

How long does selective silence disorder last?

According to studies conducted, it appears that for many people who suffer from selective silence, the symptoms disappear when they become adults, but the symptoms may remain persistent and present and change to appear as symptoms of another anxiety disorder, such as social phobia.

What can I do to help my child with selective silence disorder?

Help your child feel comfortable, praise his slightest efforts, and reward him for any positive reaction he makes

When do I suspect that my child has selective silence?

When your child does not talk in certain social situations, and does not find it difficult to talk with you at home. When your child’s educational, social, and professional life is affected and your child is unable to talk for a period exceeding a month, and when your child’s difficulty speaking is not caused by the fact that he does not understand the language of others and is not caused by another disorder, such as stuttering, or because he suffers from autism, schizophrenia spectrum disorder, or psychosis.

Is it beneficial to punish a child with selective silence disorder?

No, do not punish your child for a sin he did not commit. A child who is punished because he is unable to speak will find it more difficult to speak because of his feelings of fear and anxiety.

What triggers a selective silence child?

Noisy, crowded, unfamiliar places that he has never visited before

Strangers getting too close to your child or intruding on his personal space, talking loudly or aggressively and violently with your child, the presence of strange people, certain physical characteristics of others, such as being tall, unfriendly behavior patterns, completely new situations, and situations in which your child has had unsuccessful experiences.

Does selective silence go away on its own?

No, this disorder does not disappear on its own, so you must resort to treatment as soon as possible so that your child can overcome his fear and anxiety and obtain effective results.

Written by: Haidy Soliman

Translated by: Ph. Marah Mohamad

Sources:

Anxiety Canada

Verywell mind

Cleveland clinic