What is Selective Mutism in Adults: All You Need to Know

Most people have been nervous or forgotten what they wanted to say in a social situation. But, what if you were so anxious in social settings that you couldn't speak at all? This is known as selective mutism.

While selective mutism is usually diagnosed in children, it can persist into adulthood as well. Individuals with this condition are unable to speak or communicate in certain social settings, such as at work, during events, or in school. When it is left untreated, selective mutism can affect one's personal and professional life.

In this article, we help you understand this condition better, and know what you can do to help a loved one if they have been diagnosed with selective mutism.

Also read: How Does Therapy Help With Anxiety?

What is selective mutism?

Selective Mutism is a severe anxiety disorder; generally, it manifests first in childhood and, if untreated, may persist into adulthood. It occurs when an individual can communicate in one setting but is unable to do so during other social situations. 

Typically, this inability to communicate occurs in newer settings, where there may be unfamiliar people around them. For example, an individual may be fine talking to others at home but is unable to speak to others at a social event, such as parties or a festival. 

If selective mutism goes untreated, it can lead to various other consequences later in life, such as low self-esteem, problems in school or at work, social anxiety, and even social isolation. Thus, it is important to seek effective treatment of selective mutism as soon as possible. 

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Selective mutism in adults symptoms

Most commonly, selective mutism is diagnosed among school-age children, as that is when their inability to communicate in specific social settings becomes apparent. However, while children as young as two to four years of age can be diagnosed with selective mutism, this condition may also persist into adulthood.

Identifying early signs of selective mutism is key. Here are the symptoms one should look out for:

• Speaking comfortably in some situations, such as at home, but not in other settings.
• Communicating non-verbally, such as using gestures rather than speaking.
• Showing signs of, or expressing a desire to speak, but holding back due to embarrassment, fear, or nervousness.
• Shying away from or avoiding unfamiliar people and being reluctant to speak, especially for children between two and four years of age.
• Refusing to speak, even when prompted
• Whispering or making only non-verbal sounds
• Having a limited vocabulary in specific situations
• Having difficulty initiating or maintaining a conversation
• Having a strong fear or anxiety about speaking in specific situations
• Being aggressive or stubborn with frequent temper tantrums 
• Avoiding eye contact 

For a formal diagnosis, these symptoms should last for at least one month. Other communication disorders and difficulties, such as not knowing the language, should also be ruled out. 

Also read: Supporting a Loved One with Anxiety

Causes and Risk Factors of Selective Mutism

The exact cause of selective mutism is not known, but it is believed to be a combination of genetic and environmental factors. Researchers have found that selective mutism tends to run in families, and that people who have a close relative with the condition are more likely to develop it themselves. Additionally, people who have experienced significant stress or trauma, such as abuse or neglect, may be more likely to develop selective mutism.

How to Diagnose Selective Mutism

Although selective mutism is often perceived as a rare childhood disorder, it can persist into adulthood. For adults to be diagnosed with selective mutism, symptoms must be present for at least one month and should significantly interfere with their functioning in social settings or at work. 

Symptoms of selective mutism and social anxiety disorder overlap significantly among adults. Individuals may fear speaking to unfamiliar people and going to unknown places. This condition can keep adults from attending social situations, leading them to isolate themselves completely, which can lead to a lot of distress. 

Hence, although adults may recover from the symptoms of selective mutism, they will continue to deal with its psychological effects. If you think that you have signs of selective mutism, a therapist, or a psychiatrist will be able to help you get the right diagnosis through clinical assessments that are made specifically for adults. 

How to Cure and Treat Selective Mutism

Treatment of selective mutism is most effective at the earlier stages of this condition. Hence, it is crucial to seek professional help as early as possible. Generally, treatment for selective mutism may include psychotherapy, medication, or a combination of both.

Psychotherapy

Behavioural therapy techniques, such as Cognitive Behaviour Therapy, are found to be the most effective in treating selective mutism. CBT techniques used in treating selective mutism include:

Graded exposure: Individuals are asked to identify situations that cause them the least anxiety, and these situations are tackled first. With graded exposure, it is easier to set realistic goals and expectations.

Desensitisation: Using this technique, individuals slowly start getting used to their anxiety triggers by experiencing them directly. 

Reinforcement: With positive reinforcement, it is easier to relieve anxiety in social situations. For example, your mental health practitioner may ask you to use positive coping statements instead of engaging in negative self-talk when you are in uncomfortable or unfamiliar situations that trigger your selective mutism symptoms. 

Shaping: Using only positive reinforcement, desired behaviours are rewarded. For example, if individuals attempt to talk to unfamiliar people, they may be rewarded with their favourite snacks or activity. 

Please note that these techniques can only be carried out by a trained and qualified therapist. 

Medication for selective mutism

While there are no specific medications for selective mutism, they are supplementary to ongoing treatment for adolescents and adults. Additionally, they can help with symptoms of other co-occurring mental health conditions.

Also read: The Benefits of Mindfulness in Treating Depression and Anxiety

With early treatment, selective mutism can be addressed effectively. Selective mutism may be rare in adults, but it is important to know its signs so that you know when to seek help for yourself or a loved one.

Sources:

1. https://www.verywellmind.com/what-is-selective-mutism-3024702 
2. https://www.nhs.uk/mental-health/conditions/selective-mutism/ 
3. https://www.cedars-sinai.org/health-library/diseases-and-conditions---pediatrics/s/selective-mutism.html 

Conclusion

It is important to remember that selective mutism is a real condition that can greatly impact a person's life. If you or a loved one is struggling with selective mutism, it is important to seek professional help. With the right treatment and support, individuals with selective mutism can learn to speak in social situations and lead a fulfilling life.

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Frequently Asked Questions about Selective Mutism

What activities are good for selective mutism?

Activities such as interactive games like Simon Says and charades, role play, creative arts, musical instruments, and storytime can help. These build confidence and encourage verbal communication gradually in a supportive setting.

How can I make someone with selective mutism comfortable?

Create a relaxed environment by removing pressure to speak. Use reassurance, encourage fun activities, allow nonverbal engagement initially, praise any social participation, and avoid showing surprise when they speak to foster trust and reduce anxiety.

How long does it take to overcome selective mutism?

The time varies widely; younger children might improve within months, while older or severe cases could take years. Treatment usually focuses on anxiety reduction and gradual exposure through therapies like cognitive behavioral therapy. Many achieve long-term improvement.

What are the behavioral techniques for selective mutism?

Techniques include role play, video self-modeling, stimulus fading, shaping speech gradually, positive reinforcement, and incremental exposure to speaking situations. These methods reduce anxiety and increase verbal interaction step-by-step.

What is the sliding technique for selective mutism?

Also known as fading, this involves gradually introducing a feared person or setting alongside someone the child trusts. Step-by-step, the isolated person’s involvement increases as the child gains comfort speaking at their own pace.