Selective Mutism

© Donna Williams

In response to:

What is Selective Mutism?

Selective Mutism is a psychiatric disorder most commonly found in children, characterized by a persistent failure to speak in select settings, which continues for more than 1 month. These children understand spoken language and have the ability to speak normally. In typical cases, they speak to their parents and a few selected others. Sometimes, they do not speak to certain individuals in the home. Most are unable to speak in school, and in other major social situations. Generally, most function normally in other ways, although some may have additional disabilities. Most learn age-appropriate skills and academics. Currently, Selective Mutism, through published studies, appears to be related to severe anxiety, shyness and social anxiety. Selective Mutism may be associated to a variety of things, but the exact cause is yet unknown.

These children may respond, or make their needs known, by nodding their heads, pointing, or by remaining expressionless or motionless until someone correctly guesses what they want. The majority of these children express a great desire to speak in all settings, but are unable to due to anxiety, fear, shyness and embarrassment. Many do participate in activities non-verbally. The withdrawn behavior is not usually obvious until the child begins school. Sometimes, even then, the child is viewed as shy and it is assumed that the shyness is temporary and will be outgrown. By the time Selective Mutism is recognized, if it is recognized, the child has usually experienced at least 2 years in which no verbalization has become a way of life. The behavior becomes increasingly difficult to change because of the lapse of time without intervention.

Is There a Relationship Between Selective Mutism and Autism?

No. Selective Mutism is sometimes erroneously mistaken for Autism. The striking difference between the two is that Autistic individuals have limited language ability, while individuals experiencing Selective Mutism are capable of speaking and normally do so in comfortable situations.

And now... from me.....

My name is Donna Williams.

I am diagnosed with 'Autism' and I work with a huge range of very different people with the label all around the world.

'Autism' is not one thing, it is made of many different things for different people and improving the lives of people with 'Autism' involves addressing all the components contributing to someone's Developmental Disability.

Some people with 'Autism' only have an information processing problem. Others alsohave any of a number of other conditions including Tourette's, Obsessive Compulsive Disorder, Bipolar, Depression, Social Phobia, Avoidant Personality, Exposure Anxiety, Dyslexia, Scotopic Sensitivity, Tinitus, L/R hemisphere integration problems, learning disabilities, Epilepsy, Gut/Immune problems, articulation problems, receptive or expressive aphasia, other auditory or visual receptive language processing problems etcand as a result of any combination of severe cases of these things in infancy , their development is generally so much more disrupted and effected than in those for whom such onset of any of these things is later, in childhood. Many know no other reality and can be severely effected.

Many never speak. Other's never shut up but have dysfunctional speech. Some are a combination between the two.

Some only chatter to themselves or their mirror reflection and some have been heard to speak but not with anyone else.

Some speak socially with some people but only in a barely audible whisper. Some mutter or whisper to themselves so obscurely they are often not understood or heard to have spoken.

I work with many non-verbal people, some who use typed communication or a voice communicator.

To my surprise, they sometimes tell me that what stops them speaking is extreme anxiety making it impossible for them to dare speak. Some of these people are terrified of allowing the social connection (Exposure Anxiety), other's however, are terrified of failure, of being imperfect at something they've never tried or practiced, afraid others might stare or laugh. When I hear this, I hear these people speak of a severe version of Selective Mutism. Sure, the standard definition is that those with Selective Mutism can usually communicate with those they are familiar with, but equally, if someone had this so severely, they struggled even to do that, do we then merely decide that these non-verbal people couldn't possible share a problem with their 'so much more 'normal' counterparts'. If we ignore these people, we will continue to believe these people are somehow 'brain damaged' rather than in the grip of a severely disabling anxiety disorder, an anxiety disorder which has been found to have treatments, treatments which those in the Autism field never hear about because they are told their child cannot have Selective Mutism because THIER child is Autistic and therefore 'disabled', unlike the 'normal' children with Selective Mutism. But what if a child with Selective Mutism also had severe Tourette's, Bipolar or OCD since infancy? Would this child look so 'normal'? What if the gut/immune function of this same child under this terrible burden began to collapse and it developed food intolerances or food allergies, nutrient deficiencies, toxicity issues and fatigue with the effects this has on the ability to keep up with incoming information. Would this Selectively Mute child now suddenly no longer have SM? After all, it would now be a very disabled and, dare we say it, 'disabled' child? I think I'm making my point. This is not to attack the sanctity of your group in its safe separatism from those with 'Autism', just to say, please, those with 'Autism' can sometimes be very 'normal' children who have developed differently often as a result of a variety of other burdens and one of those, for some of these people, may be Selective Mutism.

I have also heard from many people with Asperger's Syndrome, some of whom have been diagnosed with Social Phobia and Avoidant Personality. Some of them have had Selective Mutism.

I am writing to you in the hope you will understand that having 'Autism' does not mean SOME of these people do not also have Selective Mutism. And for some of these people, the main aspect of their lack of speech, if we listen to what they themselves tell us in their typed communication, is extreme anxiety making it impossible for them to connect to thier voice.

Those with Tourette's have avoided facing that their label also had its most severely disabled end of the spectrum and until recently did not acknowledge this condition could occur in early infancy and if severe enough could severely effect development.

Those in the Bipolar and Depression and Obsessive Compulsive Disorderfields have only recently understood these conditions can occur in infants and if severe can severely effect development.

Those with Hearing Impairment were for a long time judged as learning disabled and have now taken a long time to accept that some learning disabled people also happen to be deaf.

In the Autism field, there has been a long avoidance in acknowleging the high functioning end of their spectrum, people sometimes so mildly effected they can sometimes 'pass for normal'.

I write to you as the head of a society for Selective Mutism and ask you and those like you to not exclude from your group, those people labelled with the umbrella term of 'Autism' who may also, among other conditions compounding the severity of their 'Autism' have Selective Mutism as one of the major factors contributing to their lack of speech.

To exclude this group is to deny them and their families access to the information available regarding recommendations and treatment for this condition; a condition which like any other, can co-occur in any person labelled Diabetic, Epileptic, Cerebral Palsied, or 'Autistic' for that matter.

Thank you so much for listening and for your open mindedness.