Often in our daily lives, we meet children, greet them, and ask how they are doing, but sometimes the child may not respond to any question, no matter how long we talk. Many people may think the child has a language delay, while parents often confirm that their child has a completely normal language ability, yet speaks only with them. This is a case of elective mutism, a psychological speech disorder affecting children aged 2 to 10 years.

Studies show that girls are more prone to elective mutism than boys, at a ratio of 7 girls to 3 boys per 1000 children. It is an anxiety disorder that prevents the child from speaking in specific social situations, such as classrooms, public places, or social interactions, while they may speak freely with family members or close friends. Some children speak only with a twin or a single preferred person. This disorder may last for months, affecting academic performance and making social interactions difficult. If it continues beyond age 10 without treatment, it may become chronic and harder to manage.

Causes of Elective Mutism

1. Improper treatment of the child: excessive strictness or overindulgence, weak family social interactions, low self-confidence, or extreme shyness caused by inappropriate upbringing.
2. Speech and language disorders: such as stuttering or speech difficulties, which expose the child to socially challenging situations, increasing anxiety.
3. Family problems or a feeling of instability and insecurity in the child’s environment.

Signs and Symptoms

Specialists can differentiate elective mutism from autism or language delays, especially since the child often has normal or above-average intelligence and can express emotions well. Many are creative in activities like drawing. Key signs include:

• Silence around strangers despite encouragement to speak, while speaking freely with family.
• Silence in anxiety-inducing situations, such as being left with others without a parent.
• Avoidance of school, public places, or family gatherings, and preference for being alone for long periods.
• Excessive tension or irritability in minor situations.
• Increasing duration of silence over time and gradually reducing social contacts.
• Excessive anxiety compared to peers.
• Preference for routines and resistance to change, which provides a sense of security.
• Sensitivity to noisy and crowded environments.

Treatment

1. Psychological Therapy:

Cognitive Behavioral Therapy (CBT) is highly effective, focusing on educating the family, supporting the child, encouraging speech, increasing self-confidence, solving social problems gradually, and modifying the surrounding environment. This therapy is available at Cedra Center.

2. Speech Therapy:

Aims to encourage language practice, address speech disorders like stuttering or lisps, using gradual techniques such as breathing exercises, whispering, pronunciation, and language practice. This is also provided at Cedra Center.

3. Medication:

Clinical studies indicate that selective serotonin reuptake inhibitors (SSRIs), such as Prozac, can help accelerate recovery and improve social and academic performance, though medication alone is not a complete treatment. Therefore, integrated therapy (psychological – speech – medical) is considered the best approach.

Conclusion:

Accurate diagnosis by qualified specialists is the first step in treating elective mutism. Effective treatment requires a comprehensive plan, including psychological therapy, speech therapy, and family support, to achieve meaningful improvements in the child’s social and educational life.