Selective mutism in adults is not well-known but it is a serious communication anxiety disorder. It can affect people of different ages, impeding their capability to speak in some social situations despite being completely able to speak in other situations. Most of the time, this disorder is diagnosed in childhood, but it may persist into adulthood, affecting the patient’s quality of life and resulting in many social problems.

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A severe anxiety disorder, where a person is unable to speak in certain social situations, for example with classmates or distant relatives. Usually, selective mutism starts during childhood, if left untreated, it can continue to adulthood. Individuals with selective mutism are not choosing to not speak but are unable to speak. The expectation to talk to certain people triggers a freeze response with feelings of panic making talking impossible. 



Selective Mutism 

Leaf complex care group. (n.d.). Selective Mutism in Adults. Leaf Complex Care. https://leafcare.co.uk/blog/selective-mutism-in-adults/

Selective Mutism in Adults Reference 

Definition: Selective Mutism (SM) is an anxiety disorder which often appears in early childhood, characterized by the PERSISTENT failure to engage in speech in specific social situations where speech is typically expected, despite technically possessing the full capability (the necessary physical structures and speech motor processes) to being able to speak and hear. 

Selective Mutism often co-exists with Social Anxiety Disorder (SAD). 

The DSM-IV-TR criteria for Selective Mutism specifies that this persistent failure to speak should not be attributed to these following reasons: 

1) An organic inability rooted in the individual's language capability (e.g. comprehension, in-fluency in language, etc) 
2) Another communication disorder (e.g. stuttering) 
3) A diagnosis of another psychotic disorder (e.g. Pervasive Development Disorder, Schizophrenia, etc) 

Please note that a comprehensive and uniform theory about the etiology, assessment, and treatment of SM does not exist; Historically, varying definitions and criteria have been applied to individuals with SM, and so this provided definition and diagnostic criteria may not be yet as inclusive as it can be. 

Image citation: Journal of American Academy of Psychology. Factors That May Influence Speech and Social Inhibition., 17 Feb. 1995, www.sciencedirect.com/science/article/abs/pii/S0890856709635930. Accessed 22 June 2023.

Definition and Diagnostic Criteria of Selective Mutism 

Reference for An Overview on Selective Mutism

The risk factors for children to develop selective mutism include:

* Experiencing peer victimization.  
* Family history of selective mutism.
* Abuse or trauma.
* Moving to a country with a foreign native language.
* Family conflicts.

Risk Factors for Selective Mutism

These are possible treatments for selective mutism, these treatments include:

* Shaping.
* Medications.
* Stimulus fading.
* Desensitisation.
* Graded exposure.
* Speech Therapy.
* Behavioural therapy.
* Cognitive Behavioral Therapy.
* Positive and negative reinforcement.


Treatment for Selective Mutism

Selective mutism is relatively rare. It develops in fewer than 1% of the population of all age groups. Selective mutism starts most of the time at age 5. It begins to be noticed by people when the child starts school or kindergarten. It is less common for this disorder to occur in Adolescence or adulthood, but there is a possibility. It develops in females double the times of males.

The Prevalence of Selective Mutism 


Some circumstances or situations might trigger selective mutism. These triggers might cause a person with selective mutism to refuse to speak. Some people might have specific triggers. Triggers may vary over time. Some of these triggers are:

* Going to noisy or overcrowded places.
* Meeting strangers.
* Being around people who stand too close or invade personal space.
* Going to Novel places.
* Facing novel or unsuccessful situations.
* Being around others who behave aggressively or speak loudly.
* Going to places that remind the patient of upsetting events.
* Meeting people with certain physical characteristics, such as being very tall.
* Facing negative nonverbal cues or gestures.


Selective Mutism Triggers

The following psychological disorders co-occur with selective mutism the most:

* Social anxiety disorder. 
* Separation anxiety.
* Phobias.
* Post-traumatic stress disorder (PTSD).
* Autism spectrum disorder.
* Other anxiety disorders.


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