Selective Mutism: Causes, Symptoms, Treatment DSM-5 313.23 (F94.0)

A childhood disorder, Selective Mutism is distinguished by the failure to be able to speak in particular situations, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).* When the child is in social situations, such as the classroom, where he is expected to speak, he is unable to do so. However, he may be able to talk while at home. The DSM-5 classifies Selective Mutism as an anxiety disorder.

Children with Selective Mutism are frequently not diagnosed with the disorder until they enter school at around the age of five.

The DSM-5 does not link Selective Mutism as the consequence of trauma, neglect or abuse. It is not the condition known as traumatic mutism, which may occur abruptly as a response to a traumatic event, such as losing a loved one.

What was once thought of as a rare condition, Selective Mutism affects about six out of 1,000 children. Because of the misconceptions that surround the condition, many parents and other adults may believe the child is being disobedient and adversarial. In addition, children with Selective Mutism show different behaviors, which sometimes can make it difficult to diagnose. Many children have confidence in other areas except for speaking and progress normally in every other situation. Conversely, other children may be totally withdrawn and don’t have the capacity to even communicate or respond non-verbally.

*The DSM-5 is published by the American Psychiatric Association.

Signs of Selective Mutism DSM-5 313.23 F94.0

• One of the signs of Selective Mutism is the child who is usually talkative at home with his family, but changes his speaking to words with one syllable and utters or gestures in order to communicate.
• A health professional must eliminate the possibility that the child is unable to speak the language or doesn’t have the knowledge about something he’s asked about.
• The condition must be present for a minimum of a month.
• A determination will be made if the condition is causing a negative impact on school and other activities.
• The health professional must rule out other disorders, including stuttering or the lack of verbal communication during a psychotic disorder.
• He is extremely attached to parents.
• He is extremely shy.
• The child doesn’t have contact with other individuals (social isolation).
• He has emotional outbursts.

Signs That a Child Doesn’t Have Selective Mutism DSM-5 313.23 F94.0

A child may display other signs that do not indicate he has Selective Mutism. They include:

• He has never talked in any situation or environment.
• He has just recently been introduced to the language in a particular environment. It is estimated that it takes up to a half year to become comfortable with the language. When a child is learning a second language, he may go through a silent period until he becomes confident with speaking.
• The mutism occurred abruptly in every environment after a traumatic event.
• Sometimes other speech difficulties like stammering are present.

Is There Treatment for Selective Mutism DSM-5 313.23 F94.0

When the child with Selective Mutism is diagnosed early and has a treatment plan in place, the better the prognosis is for him to overcome the condition. If a child isn’t diagnosed until much later, the mutism may become a conditioned response.

Cognitive Behavioral Therapy may help the child identify the thoughts that make him anxious as they relate to the behavior. The child will work with the therapist to replace the negative thoughts he has with positive ones.

Because Selective Mutism is connected to social anxiety disorder and social phobia, doctors may prescribe antidepressants and antianxiety medications. It is believed that these anxieties are because of an imbalance of chemicals in the brain, particularly the neurotransmitter called serotonin.

Contender for Miss England Suffered from Selective Mutism DSM-5 313.23 F94.0

Kirsty Heslewood, of Hertfordshire, England, was 23 when she was crowned Miss Hertfordshire and competed for Miss England in 2012. Exuding confidence and eloquently speaking on the stage with a packed audience listening, nobody would have thought that she suffered from Selective Mutism as a child. She didn’t utter a work until she turned seven years old and began talking at school. Amazingly, she became an outspoken teenager who went into the modeling field.

Heslewood said she was clingy and held onto her mother’s legs when she was about to start her first day of nursery school. So shy, scared and all alone, she didn’t speak, although she wanted to. She continued her silence in elementary school, not speaking to friends or the teachers. The only way she communicated at school and in social situations was with signs and gestures, such as nodding her head. The only place she talked was at home with her family.

While she wanted to talk like everybody else, she couldn’t break through her silence. She tried to say only one word, but it was one of the hardest things she’d ever done—and she couldn’t. Teachers thought visiting her at home, where was talkative amongst her brothers and sisters, would be a good idea, but she froze up at the sight of them.

Heslewood’s mother wanted to show all of the people who doubted that her daughter could speak the truth. She conducted her own experiment, giving Kristy’s teacher a video of her daughter playing at home, talking constantly and making up voices for her puppets. When the video was shown at school, Kirsty was startled—she had thought it was just going to be a casual film for the students. When the students, teachers, janitors and cafeteria workers heard Kirsty talk on the video, they cheered for her. Her friends were shocked and happy to hear her speak. They kept asking her questions and talking about how she was really able to speak at home.

And, then, she answered them. When everybody knew about her secret, Kirsty said she felt she was allowed to talk.

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