When a Child Won’t Speak
If SHYNESS or SELECTIVE MUTISM?
a young child talks freely and enthusiastically at home
but has difficulty verbalizing with non-family mem-
bers in public or social settings, she may be classified
as a child who is shy, reluctant to speak or one who has
special needs. However, there’s another possibility.

The non-speaking child may have selective mutism,
a little-known anxiety disorder that arises in the
preschool years around three to five-years-old.

Though with good intentions, parents and educa-
tors are unable to properly evaluate children who don’t
speak. They often implement a non-pressure approach
allowing children to communicate at their own pace
and comfort level. This wait-and-see approach only
exacerbates the problem and results in misunder-
standings and misclassifications which ultimately
affect the child. To prevent non-speaking children
from suffering unnecessarily, it is best for parents and
educators to work in tandem to educate themselves on
the differences in a child’s speech habits.

22 WashingtonFAMILY JUNE 2019
What is the D ifference Between
Shyness and Selective Mutism?
According to Fairfax-based licensed clinical psychol-
ogist Dr. Courtney Ferenz, “selective mutism (SM) is
an anxiety disorder, characterized by a lack of verbal
communication in specific settings.” Dr. Ferenz states
that parents describe children with SM as having a
dual personality by being “talkative at home but very
quiet or virtually silent in other settings.”
By contrast, “shyness is a personality trait, which is …
fixed and affect[s] one’s general temperament,” accord-
ing to Alexandria-based licensed clinical psychologist
Dr. Kristin Swanson. While shy children typically over-
come their inability to speak with others by warming up
a bit, the warm-up period does not work with children
who have SM. “In fact, the longer a child spends in an
environment without speaking, the harder it can be to
begin using their voice,” Dr. Swanson says.

GETTY IMAGES/PHOTODISC/DIGITAL VISION.

BY AMANDA SOCCI



Diagnosing “SM”
5 FACTORS TO CONSIDER
The child shows
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.

1 Misunderstandings
While often classified as special needs, it’s
important for parents to understand that
SM actually affects all children and not
just those with special needs. Dr. Swanson
acknowledges that children with SM may
be “misdiagnosed as having other chal-
lenges or disorders [particularly if ] a child
is unable to speak at school or may appear
frozen or disengaged … [and in] social inter-
actions, can be confused with an autism
spectrum disorder.” She stresses that “it
is important to have an accurate diagnosis
and understanding of the presenting symp-
toms to provide the best support to allow
that child to be successful.”
Dr. Ferenz cites several additional misun-
derstandings of a child who has SM including
“being oppositional or defiant … [an assump-
tion] that they are not intelligent … [and a
belief that] these children have a pervasive
developmental disorder and always behave
in this manner.”
ISTOCK/GETTY IMAGES PLUS/R_KOOPMANS
Symptoms and
Potential Treatment
Though there is no statistical evidence
to indicate whether SM affects children
based on ethnicity, it is believed SM occurs
most frequently during preschool and
early elementary age years. Dr. Ferenz
hypothesized that girls are twice as likely
to be diagnosed with SM than boys due to
the possibility that society expects girls to
be more social. Dr. Swanson states that SM
is “estimated to affect 1 in 1,000 children
referred for treatment.”
Dr. Ferenz notes that children who have
SM “have difficulty initiating conversations
and responding to questions verbally, have
poor eye contact, are slow to respond and
might appear stiff or ‘frozen’ in social situa-
tions.” Dr. Swanson expands SM symptoms to
include non-verbal communications as well.

“Kids with SM may … be hesitant to commu-
nicate with gestures, writing or pointing. It is
not only a fear of being seen or heard speaking
but of communicating in general.”
Advice for Parents
and Educators
Dr. Swanson feels strongly that parents
should be curious about how their child
The disturbance
interferes with
educational or occupational
achievement or with social
communication. 2
The duration of the
disturbance is at least
one month (not limited to the
first month of school).

3 The failure to speak
is not attributable to
a lack of knowledge of, or
comfort with, the spoken
language required in the
social situation.

4 The disturbance is not
better explained by
a communication disorder
(e.g., child-onset fluency
disorder) and does not occur
exclusively during the course
of autism spectrum disorder,
schizophrenia or another
psychotic disorder. ■
5 SOURCE: AMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION
DR . FERENZ
hypothesized that
girls are twice as likely
to be diagnosed with
SM than boys due to the
possibility that society
expects girls to be
more social.

responds in different environments and
ask questions. Consequently, parents are
the best line of defense to help identify any
possible SM symptoms by comparing their
child’s ability, preference and tendency to
speak at home in comfortable surround-
ings versus speaking with others in public,
unknown situations.

It is a great idea for parents to talk to
their child’s teachers or any adults with
whom the child spends time, including
babysitters, coaches and extracurricular
adult leaders. By talking to other adults
and understanding how a child communi-
cates outside the home, this will provide
clues as to whether the inability to speak
is caused by SM or is associated with a
different issue.

Depending on those conversations with
adults who spend time with their children,
parents are encouraged to seek formal
evaluations and help from local licensed
medical professionals experienced with
SM and national sources including the
Child Mind Institute, the SMart Center and
Thriving Minds Behavioral Health.

Dr. Ferenz and the practice where she
works, The Child and Family Counseling
Group, P.L.C. in Fairfax offers a set of 12
excellent tips for teachers and educators in
working with children who may have SM.

The list includes practical things teachers
can do to help children with SM feel more at
ease in the classroom in subtle, yet concrete
ways that minimize the risk of exposing the
other children in the classroom with sen-
sitive information about the child, while
helping that child manage her anxiety of
speaking in public.

The formative years of a child may seem
scary for the child who may have anxiety
when speaking in public and manages that
anxiety by not speaking to others in public
situations. If you suspect that your child may
have selective mutism, please keep commu-
nication open with all adults who come in
contact with your child and teacher. If your
child is formally diagnosed, she may receive
behavioral treatments from professionals to
help with verbal communications. As a last
resort, pharmacological treatments may be
available. In all cases, there is always hope! ■
Amanda M. Socci is a mother and
freelance writer living in Alexandria, Va.

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