According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), selective mutism is diagnosed in individuals who fail to speak when expected to during social interaction. He or she may speak normally at home and with immediate family with ease, but usually not with even close friends or extended family. This failure to speak or interact is often due to high social anxiety. Children with this disorder will refuse to speak at school, making it difficult for their teachers to measure how well they are learning and if they’re on track with their grade level. Sometimes individuals with selective mutism try to overcompensate for this hindrance by using unspoken or nonverbal means, such as pointing and writing, to communicate.
Criteria Used to Diagnose Selective Mutism DSM-5 312.23 (F94.0)
- The individual fails to speak when spoken to or expected to in social situations, like at school
- This shortcoming interferes with the individual’s education, occupation, or social interaction
- The failure to speak lasts for at least a month
- The failure to speak is not due to a lack of understanding of or comfort with the spoken language required in a given social interaction
- The deficiency can not be better explained by a communication disorder and does not occur exclusively during the course of a psychotic disorder (e.g., schizophrenia or autism)
An individual diagnosed with selective mutism may also be very shy, be fearful of social embarrassment or social isolation, be clingy and temperamental, or abnormally negative. There may also be an associated communication disorder and almost always an anxiety disorder, such as (and most commonly) social anxiety disorder.
Who is at Risk of Developing Selective Mutism DSM-5 312.23 (F94.0)?
Selective mutism is a somewhat rare disorder, point prevalence ranging between 0.03% and 1%, depending on the sample’s age and the setting (e.g., general population vs. clinic). Additionally, there aren’t any known variations in prevalence of the disorder among different sexes or races; however, the disorder is more likely to develop in young children than any other age group. Furthermore, the following are possible risk and predictive factors of selective mutism:
- The individual’s parents are excessively shy and/or have social anxiety
- The individual’s parents are overwhelmingly protective or controlling
- The individual has social anxiety disorder, which may have shared genetic factors with selective mutism
Development and Course of the Disorder
Selective mutism typically sets in before the age of 5, but may go unnoticed until the child starts school, where there is an abundance of social interaction and functioning tasks (e.g., reading aloud or singing along). Clinical reports suggest that most of those affected by the disorder outgrow it over time, although the exact longitudinal course is unknown. And in some instances, the selective mutism will wane but an anxiety disorder may remain.
Harmful Effects of Selective Mutism
The disorder may lead to social impairment, as children may find themselves unable to interact with other children due to their anxiety.
- The disorder may lead an individual into social isolation.
- An individual may suffer academically because they don’t communicate with teachers about their needs or concerns.
- An individual may be teased by their peers, hindering their social functioning even more
Our Favorite Mute Characters
There are actually a good amount of famous television and movie characters that don’t say a single word or rarely speak throughout the duration of their role. However, these characters prove to be just as endearing and sometimes even more loveable:
Norma Romano from Orange is the New Black: Norma never speaks in the show, with the exception of a couple outbursts that always shock the rest of the characters. Instead, she communicates using a pen and a notepad—a likely action taken by those with selective mutism. Even in silence, Norma proves to be a loyal, committed friend throughout the show.
Mr. Bean in Mr. Bean and Mr. Bean’s Holiday: Mr. Bean is a nearly silent character, using many hand motions and other forms of communication to interact with people he comes in contact with. This aligns with some individuals who suffer from selective mutism, as they try to overcompensate their lack of spoken word with other forms of communication.
Lanny in Lizzie McGuire: Matt, Lizzie’s obnoxious younger brother, is often shown clowning around with his good friend Lanny. The only thing is, Matt does all the talking—still, the two friends combine their efforts to pull pranks on Lizzie and her friends. It appears that Lanny is unable to speak around Matt even though he is one of his best friends, a characteristic of selective mutism. Thankfully, this doesn’t affect their friendship and they make due anyway.