Q: My child has selective mutism - he doesn't speak in school. Should he have therapy, or should we wait for the SM to pass of its own accord?
A: It is true that in most cases, SM eventually wanes within a few years; however, while it lasts the child suffers. He is misunderstood, and unable to express who he truly is. He is different than other children and he misses out on valuable early social and learning experiences. Once the SM has passed, the child's self esteem and self image may have been damaged by his failure to speak, and may cause lingering social anxiety and withdrawal. In rare instances, the SM stays with the child, and can develop into a generalized anxiety disorder. For all these (and more) reasons, early intervention is vital. The treatment we recommend is effective and pleasant, and it enables the child to move onto a more normative developmental channel, in which he can communicate and be understood wherever he may be.
Q: Is selective mutism caused by family secrets or abuse?
A: There is absolutely no evidence in any standardized research that SM is caused by abuse or secrets. It is thought to most often be caused by social anxiety, sometimes coupled with other factors for example speech difficulties (including bilingualism and pronunciation difficulties) and perfectionism.
Q: Is SM related to Autism or PDD?
A: No it is not. Autism is a developmental communication disorder that affects the child's ability to interact across all settings. SM is usually anxiety based, and a child with SM communicates normally in certain settings such as the home. With appropriate intervention, SM is usually overcome within a few months, while PDD is a lifelong disorder.
Q: What type of treatment is recommended for SM?
A: Behavioral therapy or cognitive - behavioral therapy are most often recommended, which are designed to enable the child to speak, utilizing small steps and maintaining a manageable level of anxiety. Ideally, the treatment should take place in the setting in which the child fails to speak - usually the kindergarten or school. Cognitive components of therapy are more prominent in therapy with older children and teens, Together with therapy for the child, families and educational staff are important components of the intervention, each with their own interventions in order to facilitate fast and effective improvement.
S.P. Over the last few years we had been battling with kindergarten and school staff and psychologists who were certain that D. was abnormal and needed to be in a special education institution. The moment I saw D. talk to Ruth in a ball game they were playing together, I knew there was hope. (He had never spoken to a non-family adult before.)
Now, one year on, after therapy with Ruth in our home and his school, D. is thriving in a regular class. He speaks to every one and excels in his studies. He is still shy, but he is a regular kid!
N.S. T. didn't speak during three years of kindergarten. In her final kindergarten she was punished for not speaking and thoroughly misunderstood. After one home session, Ruth told the kindergarten staff that T. was a normal child! That was one of the happiest days of my life. Ruth worked with T. with professionalism and sensitivity, and now T. is one of the biggest chatterboxes in her class!