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Does your child have Selective Mutism?
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Fill in your details to receive a free four video guide on helping your child with Selective Mutism
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Predisposing factors include elements of the child’s psychological and physiological makeup that cause him to be vulnerable to selective mutism. This could include an anxious or shy nature, stubbornness and perfectionism, or a family history of shyness. Many children with SM have some type of speech difficulty, including lacking confidence in their expressive language due to bilingualism.
When there is a combination of predisposing factors that heighten the child’s vulnerability to SM, along with triggers—events such as kindergarten admission or a geographical move which are challenging or unsettling for the child—the scales can tip and bring about the onset of SM.
Maintaining factors facilitate the entrenchment of the condition—potentially slowing the child’s recovery from selective mutism. For example, if SM is misdiagnosed in school as oppositional behavior, and is therefore not afforded appropriate treatment, or if there is great pressure on the child to speak which heightens his anxiety levels and paradoxically makes it harder for him to speak, then the duration of the SM may be lengthened.
It should be noted that the chart below includes a broad list of possible partial causes of SM; no one child will have more than several of the causes, and many will have no more than a couple of them. When assessing or treating a child with SM it is important not to attempt to project on the child all that has been found in research to have some association with SM, and thus to fabricate a clinical picture far more severe than the actual traits of the child who stands before you. Failing to see the mental health and personality assets along with the difficulties of the child with SM can lead to a downward spiral wherein parents feel that their child is misunderstood, which may in turn generate a defensive parental stance. Furthermore, discerning and building on the strengths of the child with SM is vital both for the child’s self-esteem and for his fortitude in overcoming SM.
Causes of SM: Predisposing and Maintaining Factors, Triggers (Adapted from Shipon-Blum 2007)
Predisposing factors:
- Child’s anxiety, shyness, timidity, hyper-sensitivity
- Family history of shyness, anxiety, or selective mutism—can include anxious parents, anxious behavior modeling by parents
- Speech impairment of child—usually expressive language
- Bilingualism and disconnectedness from the predominant culture
- Neuro-developmental disorder or delay, often auditory processing disorder
Triggers:
- School or kindergarten admission
- Frequent geographical moves
- Family moving to area with different spoken language
- Negative reactions to child talking—bullying, shouting, mocking etc.
Maintaining factors:
- Social isolation of families
- Misdiagnosis (oppositional behavior, autism, retardation)
- Lack of early and appropriate intervention
- Lack of understanding by teachers, families, psychologists
- Reinforcement by increased attention or affection
- Heightened anxiety levels caused by pressure to speak
- Ability to convey messages nonverbally
- Lack of belief in ability to overcome SM
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