This week’s blog post was requested by a reader, one of my favourite ways to prompt an article. By chance, I also happened to read a book recently where the hero had mutism, and I’m not sure it was handled accurately or believably. To be honest, I didn’t finish the book (because of said reasons, but then again, the author probably didn’t expect many psychologists to read her book), so I can’t tell you if my questions were answered, but the whole experience reinforced the justification to explore selective mutism for writers.
A rare diagnosis, Selective mutism (SM) is generally considered a childhood disorder, largely because of its onset in the early years. When encountering other individuals in social interactions, children with SM do not initiate speech or reciprocally respond when spoken to by others. These children will speak in their home in the presence of immediate family members but often not even in front of close friends or relatives.
SM is considered an anxiety disorder. In fact, more than 90% of children with SM also have social phobia or social anxiety, and some experts have suggested SM is simply a manifestation of social anxiety. In essence, the child is unable to speak and communicate effectively in select social settings, such as school, but they are able to speak and communicate in settings where they are comfortable, secure, and relaxed.
Children and adolescents with SM have an actual fear of speaking and of social interactions where there is an expectation to speak and communicate. Many children with SM have great difficulty responding or initiating communication in a nonverbal manner; therefore, social engagement may be compromised in many children when confronted by others or in an overwhelming setting where they sense a feeling of expectation.
Let’s look what you are likely to see in a child with SM (before exploring mutism in older age groups).
Over 90% of children with SM have social anxiety (in fact, SM is often diagnosed along with Social Phobia). They are uncomfortable being introduced to people, being teased or criticized, or being the center of attention. You may see a fear of bringing attention to himself/herself, perfectionism (afraid to make a mistake), or eating issues (embarrassed to eat in front of others). This disorder is quite debilitating and painful for the child, as essentially, it is social situations that trigger their stress response. Mutism (a variation of the ‘freeze’ in the fight, flight or freeze response) is their way of managing an extremely frightening experience. In the case of children with SM, the fearful scenarios are social settings such as birthday parties, school, family gatherings, routine errands, etc.
It’s likely this anxiety is a product of a genetic programming, meaning your character’s anxious symptoms were present at a young age. Very often, these children show signs of severe anxiety, such as separation anxiety, frequent tantrums and crying, moodiness, inflexibility, sleep problems, and extreme shyness from infancy on.
It is common for many children with SM to have a blank facial expression and never seem to smile. Many have stiff or awkward body language when in a social setting and seem very uncomfortable or unhappy. Your character may turn their head, chew or twirl their hair, avoid eye contact, or withdraw into a corner.
But humans are delightfully diverse, meaning not all children manifest their anxiety in the same way. Although some may be completely mute and unable to speak or communicate to anyone in a social setting, others may be able to speak to a select few or perhaps whisper. A less severely affected character may look relaxed and carefree, and be able to socialize with one or a few children. Consider the degree of selective mutism your character will demonstrate.
It’s not surprising that SM often results in social impairment. This is particularly so as they grow older and extended social relationships become more central in their lives. As peers begin dating and socializing more, children with SM may become progressively more isolated.
The catch is that most children with SM want friends, and need friends. They are still the intrinsically social being all humans are. Sadly, because they are quiet, atypical children, teasing by peers is common.
Children with SM often refuse to speak at school, leading to academic or educational impairment. You may see your character withdraw, play alone or not play at all, hesitate in responding (even nonverbally), or have difficulty following a series of directions or staying on task. Academically, children with SM will often under-perform (despite average or above average intelligence), as teachers often find it difficult to assess skills.
They are Normal Kids in the Right Environment
It is important to realize that the majority of children with SM are as normal and as socially appropriate as any other child when in a comfortable environment (what a wonderful contrast for a writer to explore!). Parents will often comment how boisterous, social, funny, extremely verbal, and even bossy and stubborn these children are at home.
A small caveat of this sub-heading is that sensory processing difficulties have been suggested as an underlying reason for mutism, meaning your character may be sensitive to sounds, lights, touch, taste and smells. Also, some children with SM have subtle speech and/or language abnormalities. In most of these cases, the children have inhibited temperaments (prone to shyness and anxiety), and the added stress of the speech/language disorder or processing disorder may cause the child to feel that much more anxious and insecure in situations where there is an expectation to speak.
As the child grows up…
A proportion of children with SM recover their capacity to speak across multiple social situations, although it’s likely that anxiety will continue to manifest in other forms, or some social anxiety will persist. For those whose mutism continues though, their behaviour will become more ingrained and reinforced unless the child is properly diagnosed and treated (which is the case for one character who has been living in my head for some time).
Your character’s environment will forge the protective and risk factors for their trajectory. Research has found that social inhibition on the part of parents may serve as a model for social reticence and SM in children. Furthermore, parents of children with SM have been described as overprotective or more controlling, a useful observation when building your story world.
What about traumatic mutism?
The biggest stereotype surrounding SM is the presence of a trauma history, when in fact, studies have shown no evidence that the cause of SM is related to abuse, neglect or trauma.
The essential difference is that children who suffer from SM speak in at least one setting and are rarely mute in all settings. What’s more, children with SM have inhibited temperaments and demonstrate social anxiety. On the other hand, children with traumatic mutism usually develop mutism suddenly in all situations. An example would be a child who witnesses the death of a grandparent or other traumatic event, is unable to process the event, and becomes mute in all settings.
These same points relate to adulthood. The book I read had a hero suffering with mutism following a diagnosis of Post-Traumatic Stress Disorder. The clear link about why his experience of combat and war has rendered him mute was not clearly articulated, but like I said, I didn’t finish the book. The salient point though is that mutism is rare, and as an author, you need to consider why your character is choosing not to speak. As a highly social and verbal species, the choice not to speak is a significant one, and the motivation and consequences need to be thoroughly examined. Nail that and you’ve got yourself a true-to-life character your readers will want to spend time with.
What do you think? Have you got a character with Selective Mutism? Have you come across one in a story or movie? I love hearing from you, connecting with others is why I write. You can comment below, or connect with me on Facebook, Twitter or Instagram.
Have a wonderful week,
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