What is selective mutism (SM)?

SM is an anxiety disorder, usually diagnosed in childhood, that is defined by an individual’s inability to speak in certain social situations, despite being able to speak well in other settings.

Signs and Symptoms:

  • Consistent difficulty with communicating in certain settings and situations where speaking is expected, such as in school, with teachers or peers, and in the community
  • Excessive anxiety and fear when speaking; shutting down when unable to speak
  • Able to communicate well in other settings, such as with family or at home
  • Difficulty speaking is not due to a lack of knowledge or comfort with the spoken language required in the social situation
  • Individual’s not speaking is not better explained by a communication disorder

Individuals with SM may also:

  • Struggle to make eye contact when feeling uncomfortable
  • Present as behaviorally inhibited
  • Use nonverbal communication to express their needs or answer questions (e.g. nodding, pointing, writing)

Onset, Diagnosis, and Treatment:

The onset of SM typically ranges between the ages of 3 – 6 years old, when children start attending preschool or entering other public spaces for the first time. A diagnosis is likely if the individual’s not speaking is persistent over time and causes impairment in daily functioning (e.g. being able to effectively participate in school; creating friendships with peers). Without treatment, SM can persist into adolescence and adulthood.

The good news is, SM is treatable. Daniela Nogales, LCPC, has received specialized training in PCIT for Selective Mutism (PCIT-SM), an adaptation of PCIT, and is currently working towards becoming a certified PCIT-SM therapist. PCIT-SM, developed by Dr. Steven Kurtz, is a research-tested behavioral therapy that helps children improve their verbal and non-verbal participation, as well as supports parents in learning skills to help their child learn to talk with others. Daniela offers a sessions virtually and in-person (in office, home, or school) to best support individuals and their families with SM. Call us for details and assistance with setting up and evaluation and care at (240) 252-3349.