What is it about ?
Selective mutism is a form of abnormal behavior characterized by the fact that the child refuses to speak in certain social situations. It is called “selective” because speaking occurs quite normally in other situations. It is believed that a combination of causes is at the root of the problem. The child’s temperament and anxiety certainly play a role. This problem can also sometimes suggest psychological trauma or a developmental disorder that has not yet been diagnosed (eg autism). Some family members of these children also often have anxiety disorders. It is important to understand that a child who suffers from selective mutism wants to speak, but does not dare or cannot do so.
In whom and how often does it occur?
This disorder occurs in 2 to 8 people per 1000. It mainly affects children aged 5 to 7 years, mainly when they enter daycare or start school. This silence is more common in girls than in boys. Most of the time, it develops in multilingual children of foreign origin.
How to recognize it?
Your child talks at home but refuses to do so elsewhere. The disorder usually starts gradually, and is often associated with a new situation, such as starting daycare, school, etc. for the first time. More or less 7 in 10 silent children also have other psychological problems, such as anxiety (for example the difficulty of separating from parents when entering school, a child who still wets the bed, ADHD, tics and loss of stool in abnormal situations (eg in pants, on the floor, etc.) In general, these children are particularly shy and perfectionists.
How is the diagnosis made?
The doctor will be able to make a diagnosis after hearing the story from parents and educators. If the problem only manifests itself at school at the beginning of the school curriculum, we always wait a little before making the diagnosis, because the problem may very well disappear on its own after a little time. The doctor will always make the diagnosis after consulting with a psychiatrist or a child psychiatrist (child psychiatrist).
What can you do ?
Prepare your child well for the changes that will take place in their lifestyle, such as the first few days of school, nursery or daycare. Ask if everything went normally. If you are told of problems, always try to talk about them openly, both with the caregivers and with the child. Never allow the situation to persist without assistance. The longer you wait, the harder it will be to find a solution to the situation. Call on psycho-medico-social centers (PMS centers).
What can your doctor do?
The doctor will always ask for an examination by a child psychiatrist. Several treatments are possible, such as speech therapy, play therapy (ludotherapy), behavior therapy or family therapy. These approaches require the cooperation of family, teachers, educators and daycare staff. Treatment with drugs will only be offered if these approaches are unsuccessful. These children may then be prescribed antidepressants (eg fluoxetine). But due to the long duration of treatment, side effects and the lack of official approval for this indication in children, this treatment is certainly not a first choice.
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