It feels like a recurring nightmare. You’re in class, and your teacher calls on you. You know the answer, but you struggle to push the words out of your mouth. A virtually inaudible whisper, if anything, escapes your lips. You. Simply. Cannot. Speak. This was a reality for Shannon Thompson, a twenty-one-year-old retail worker in Ballymena, Ireland, when she was in high school. To make matters worse for Thompson, teachers did not understand what she was going through. They would make her stand up to answer questions, and when she did not answer, they would yell at her. Thompson, like many other children, has selective mutism.
According to the DSM-V, selective mutism is a condition in which a person fails to speak in certain social situations, such as when one is in school, but is able to speak normally in other situations, such as when one is with his or her immediate family (American Psychiatric Association, 2013). The onset of selective mutism is usually during childhood, and may continue into adulthood if left untreated. People with selective mutism do not refuse to speak; speaking is simply impossible for them in some situations. Selective mutism affects one in 140 children, and is mostly observed in girls and migrant children (NHS Choices, 2016).
Thompson’s selective mutism developed during the summer after second grade. She did not really interact with her friends and had difficulty talking to them after she returned to school. Thompson would have her friend, Megan, relay her answers to the teacher in class, rather than directly answer questions (Ireland, 2016). If the teachers had known about Thompson’s condition, they would have been better able to accommodate her in the classroom.
Brianna Russo, a patient, is also misunderstood within her social circles. In the article, “Selective Mutism In Kids Can Be Treated A Number of Ways,” Russo stopped talking to adults when she turned three years old. Russo was able to talk to family members, but not to people at school. People mistook Russo’s behavior as rude. At a play date, the father of one of Russo’s friends would not let her walk down the stairs until she talked to him. He did not understand that Russo was not giving him “the silent treatment,” but rather was unable to speak to him. According to Dr. Gary Swanson, a physician in the Department of Psychiatry at Alleghany General Hospital, children with selective mutism, like Russo, are having a “freeze response” (Simbra, 2016). Essentially, the person is petrified, or “frozen,” like an animal in headlights.
Selective mutism can be a very hard illness to distinguish. According to Alison Wintgens, the “national adviser for selective mutism at the Royal College of Speech and Language Therapists,” it is very easy to confuse selective mutism with shyness, as Sabrina Branwood’s parents have done (John-Baptiste, 2015). However, although it may take time for shy people to get acclimated to a social group or situation, they eventually talk within those social groups. People with selective mutism, however, are consistently unable to do so. According to Carl Sutton, the founder of the support group, iSpeak, untreated selective mutism may result in other anxiety disorders, such as agoraphobia, or a fear of being in public spaces (John-Baptiste, 2015). According to Dr. Maria Simbra, a medical journalist, selective mutism is treated with therapy and rewarding a patient when he or she speaks or makes an attempt to speak (Simbra, 2016). Sometimes, if the anxiety is overpowering, drugs such as Prozac, sertraline, or Zoloft are used to treat the condition. Children like Russo are subjected to hypnosis to treat the condition.
Untreated selective mutism can carry on to adulthood. In the article, “Selective Mutism: ‘I have a phobia of talking,’” Sabrina Branwood, a thirty-five-year-old woman, talks about her experience with selective mutism, which she has had since she was a child. Branwood had difficulty talking to her grandmother after her grandmother’s stroke because she was so anxious. Today, when people ask her questions, she has difficulty thinking. She feels trapped by her mutism. Branwood describes living with selective mutism as “living your life in a box,” where you can see and hear people, but you cannot communicate with them. Branwood states, “I’ve missed out on so much I wanted to do, like having lots of friends and going lots of places without needing my family to take me” (John-Baptiste, 2015). Communication is difficult for Branwood, especially when people do not understand what she is going through. She is seen as stubborn or rude. When Branwood was in school, she did not get a lot of support from her special education teacher, who felt that it was all in her head. Branwood currently relies on her family and uses an app on her tablet to communicate. Branwood still lives with selective mutism today because her mother failed to notice it at home when she was a child, as she spoke normally with her family. Branwood’s mother states, “”It makes me feel as though I failed as a mum… because I didn’t spot the signs. But I had never heard of the condition (John-Baptiste, 2015).”
Raising awareness of and openly talking about selective mutism is crucial in order to accommodate children in society who currently live with the condition and to prevent the condition from getting worse in adulthood.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Ireland, K. (2016). ‘Teachers made me stand up and would shout at me when I didn’t say a thing.’ Belfast Telegraph. Retrieved from http://www.belfasttelegraph.co.uk/life/features/teachers-made-me-stand-up-and-would-shout-at-me-when-i-didnt-say-a-thing-34777228.html.
John-Baptiste, A. (2015). Selective mutism: ‘I have a phobia of talking.’ Retrieved from http://www.bbc.com/news/magazine-33507287
NHS Choices. Selective Mutism. (2016). Retrieved from http://www.nhs.uk/conditions/selective-mutism/Pages/Introduction.aspx
Simbra, M. (2016). Selective Mutism In Kids Can Be Treated A Number Of Ways. Retrieved from http://pittsburgh.cbslocal.com/2016/06/22/selective-mutism-in-kids-can-be-treated-a-number-of-ways