Suffering in Silence

Selective mutism is an anxiety disorder, and it's currently one of the most misunderstood, under-diagnosed, and undertreated mental health conditions. When children with selective mutism feel expected or pressured to speak in social situations, they become terrified. Therefore, their level of anxiety significantly increases, but by remaining silent, their anxiety level slightly decreases, obtaining some relief for themselves. For these children, remaining silent is actually an ineffective coping mechanism, or a maladapted solution to create a sense of safety within themselves. Hence, their mouths freeze, and they are silent. This is temporary relief, but longitudinally, these children suffer in silence. Due to the fact that many children will display normative shy behavior or even socially anxious behavior at times, it can be challenging to discern if the child's behavior falls within normal limits or if the child actually demonstrates clinically significant behavior, signifying a selective mutism diagnosis. This can be confusing for parents, teachers, and even clinicians. This manual is meant to help clarify this distinction and will also assist you in figuring out how to seek help, ask the right questions, and what you can expect from early intervention services, school-based services, and holistic, therapeutic, and psychiatric services.