Is It Selective Mutism or Is My Child Just Shy?
Aug 28, 2013 - 12:36:19 PM
Dr. Carly Orenstein Explains a Little-known Disorder and Provides Tips for Parents
Almost all children with selective mutism also have social anxiety disorders. While an inability to speak might not show up until a child is exposed to social situations - most are diagnosed between the ages of 3 and 8 - in hindsight, many of these children showed signs of severe anxiety, timidity and fearfulness as infants and toddlers but were simply thought to be shy. They are often talkative and even boisterous at home but fearful and anxious in settings where there is the expectation of social interaction and communication. Some freeze in these situations and are expressionless, withdrawn and completely mute with both peers and adults while others seem relaxed and are able to communicate with a few select children, sometimes in a whisper.
It is thought that most children with selective mutism have inherited a predisposition to anxiety. Some affected children have one or more family members with a history of selective mutism, extreme shyness or anxiety disorders. It has been hypothesized that the timidity and fearfulness that characterize individuals with anxiety disorders is caused by a low threshold of excitability in the amygdala, a part of the brain involved in controlling emotional responses. When the child is in an uncomfortable or fearful scenario, the nervous system sends danger signals to the amygdala, which sets off a protective reaction, manifested in these children as withdrawal from the social situation. About 20-30% of children with selective mutism have speech or language abnormalities that place additional stress on the child and increase the anxiety in situations where there is an expectation to speak.
Tips for Parents
"Children with selective mutism should not be expected to simply grow out of it," says Dr. Orenstein. "The earlier a child is diagnosed and treated, the better the prognosis. Left untreated, the mutism may become habitual and those around the child will stop expecting him or her to speak, reinforcing the social isolation and increasing the child's anxiety."
Dr. Orenstein advises parents who suspect selective mutism as follows:
"The most important thing for parents to realize is that selective mutism is caused by anxiety," Dr. Orenstein concludes. "Pressure to speak from parents, teachers and peers simply intensifies the child's fears and makes things worse. But with early intervention and a supportive environment, children can successfully overcome selective mutism."
Dr. Carly Orenstein is a clinical psychologist with the Morris Psychological Group in Parsippany, NJ who practices cognitive-behavior therapy with children, adolescents and adults through individual, family and group therapy. www.morrispsych.com
For advertising and promotion on HealthNewsDigest.com call Mike McCurdy at 877-634-9180 or firstname.lastname@example.org We have over 7,000 journalists as subscribers who have access to our content for their own media.