Selective Mutism

Honestly, I don't know why it took me so long to come online and do some research on selective mutism. Perhaps I was simply relieved to know that Evelyn is not the only child who plays statue in certain social situations. Perhaps subconsciously I did not believe it to be a serious issue. After all, she is whispering to her teachers when asked a question, and she had no problem talking to her friends. But what I'm reading this morning yanked whatever covers I've been hiding under off, and shined the bright light of reality in my eyes.

What is selective mutism? The definition of Selective Mutism (SM) given by the American Speech-Language-Hearing Association notes: " Selective mutism (formally known as elective mutism) is a disorder that usually occurs during childhood. It is when the child does not to speak in at least one social setting. However, the child can speak in other situations. Selective mutism typically occurs before a child is 5 years old and is usually first noticed when the child starts school."

The definition describes Evelyn's situation perfectly. Going over the specific features described in the 2000 Diagnostic and Statistical Manual of
Mental Disorders (DSM-IV-TR) (pp.125-127), Evelyn got a 5 out of 5:
• Consistent failure to speak in specific social situations (in which there is an expectation for speaking, e.g., at school) despite speaking in other situations. (Check)
• The disturbance interferes with educational or occupational achievement or with social communication. (Check)
• The duration of the disturbance is at least 1 month (not limited to the first month of school). (Check)
• The failure to speak is not due to a lack of knowledge of, or comfort with, the spoken language required in the social situation. (Check)
• The disturbance is not better accounted for by a Communication Disorder (e.g., Stuttering) and does not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder. (Check. Thank God.)

Some emphasized the fact that the children with this disorder did not choose to not speak (hence the disorder was renamed from elective mutism to selective mutism). Nor do the children use speech as a power and control tool. These children are inhibited to talk because of social anxiety. This, I've come to observe on my own. When Evelyn turns into stone, it's almost like there's a barrier she cannot cross that is barring her to reach out to the other person. In these cases, her body stiffens. Her steps become shuffles, and her arms hang rigidly by her side. The loving, smiley child freezes up with a intense look on her face. She's not intentionally holding back the "thank you" or the "please", she's just... cast into stone. The material I read also pointed out that this is not just shyness in effect. It's not a phase, and it's not something a child simply grows out of. I'm on the edge of my seat now. If left untreated, the child's anxiety against social interactions may continue to build. What do I do? I scream in my brain. Wait, do I have selective mutism, too?

Then, two sentences from a webpage popped out and just about hit me over the head: "The majority of children with Selective Mutism have a genetic predisposition to anxiety. In other words, they have inherited a tendency to be anxious from one or more family members." It's all in the gene? Oh my poor children, what defective traits have I pass down to you? Since I'm the one writing this entry, let's just blame it on your dad. Then again, I think I'm the more temperamental of the two.

In any case. Like all disorders, the symptoms of every child differs and the severity varies widely. The good thing is I think Evelyn's is at the lighter end of it. Though she couldn't speak in certain situations, she's began to whisper to her teachers. She even whispered to the dentist last time we visited. A dentist she has not seen before, people! It was an event worth bragging.

Another good thing is that we've been doing many things that would combat this disorder unknowingly, such as going to regular play groups (thank God for the mothers support group!) and exposing her to various social environments. I've also, thankfully, given up on forcing her to talk to people, but ask her to whisper her response to me first, then whisper it to others. All these little things may help. But I think the road to a freely communicative Evelyn is still a long one, and we would need and seek professional, structural help. I look forward to the day when Evelyn is able to comfortably tell her imaginative stories and sing her made up songs to friends and family who adores her directly.

Reference:
American Speech-Hearing-Language Association (n.d.). Selective Mutism. Retrieved from: http://www.asha.org/public/speech/disorders/selectivemutism.htm, May 7, 2010.
Selective Mutism Anxiety Research and Treatment Center. Accessed from http://www.selectivemutismcenter.org, May 7, 2010 .