Red Flags Bermuda
BIRTH TO AGE SIX
Selective mutism is the persistent inability to speak in specific situations where speaking is expected, despite being able to speak in other situations.
This difficulty must last beyond one month and must not be limited to the first month of school or daycare. Selective mutism typically emerges when children are two to five years old. Despite this early age of onset, children with this disorder are most commonly identified when they first enter daycare or school, when a lack of verbal communication is first observed outside of the home. Research suggests that selective mutism occurs in up to two per cent of children in elementary school and occurs one and half to two times more often in girls than in boys. The most common profile of children with selective mutism are those that speak freely at home, are less comfortable speaking freely outside of the home — for example, at the grocery store, or at a restaurant — and least comfortable speaking at school. Factors that contribute to the development of selective mutism include a shy or anxious temperament, a family history of anxiety or shyness, speech and language challenges, adjustment to a new culture, and limited social interactions with peers outside of school.
If a child is experiencing any of the following behaviours, consider this a red flag:
► Does not speak in a specific situation, for more than one month, excluding the first month of school or daycare
► Clear discrepancy in the quality and quantity of spoken language between the home and other environments
► Relies heavily on nonverbal communication in certain situations; for example, pointing, nodding, and other gestures
► Speaks “through” the parents in public situations such as whispering to them instead of conversing directly to others
► Reluctance to speak to teachers, students, principals or school secretaries
► Avoids speaking and will respond with averted gaze, blushing or other symptoms of anxiety
► Speaks quietly or privately to other children, but not to adults
► May express a fear of being heard or seen speaking in specific situations
► Covers mouth when speaking so others cannot see his or her lips moving
► Experiences accompanying somatic symptoms, particularly when going into unfamiliar environments where speaking is required