Mutism: Therapy and Consequences

The entire linguistic, cognitive, social and emotional development is affected by mutistic behavior. This has consequences for personality development, ego identity and self-confidence. The affected person has difficulties at school, in training or at work and is partly avoided by other people.

Therapy for mutism

Mutism requires multifactorial therapy that takes several aspects into account. There are hardly any experts in this field. Therapy is usually speech, psychotherapy, family therapy, and/or psychiatry. In mutistic adolescents and adults, additional pharmacological treatment with antidepressants may be indicated.

Experts say that the earlier one intervenes, the greater the chances of success. Otherwise, the disorder may manifest itself more strongly, persist for years, and extend into adulthood. Parents who notice that their child has communication problems should therefore not shy away from going to the practice of an experienced pediatrician and adolescent doctor.

Signs of mutism in children

Parents should be alert to the following signs in the child:

  • The child does not speak in certain situations, but speaks at home and with familiar people.

  • At home, the child is very expressive, communicative and sometimes talks extremely much (need to catch up).

  • The child has difficulty initiating interactions on his own (eg, greetings, goodbyes, thanks, questions).

  • In school, the pronounced silence is often compensated with good written performance.

  • The child seems to observe and perceive the surrounding world more carefully compared to peers, but often has difficulty expressing their own feelings.

What can parents do?

If the silence persists for more than four weeks, a speech therapy examination of the child should be arranged. This requires a prescription for speech therapy issued by a pediatrician or otolaryngologist. Selective mutism falls under speech developmental delays; this must be indicated on the prescription.

Therapy is paid for by health insurance companies and is provided by speech therapists (speech therapists, speech impediment educators, or respiratory, speech, and voice teachers). Close cooperation between parents, educators/teachers and possibly psychotherapists is recommended.

What should parents of mutists be aware of?

  • Do not take the silence personally!
  • Recognize the non-speaking as an active action that – at some point – has served its purpose for the child/adolescent.
  • The silence can not be consciously refrained from by those affected, because it has been developed and maintained over the years.
  • Do not constantly ask or even urge to speak. Each request to speak increases the pressure on the child and the fear of the next speech occasion.
  • Do not put the child in the center, treat them normally.
  • Do not exclude the child.
  • The final decision on whether and when to abandon silence is made by the person concerned! The role of parents and the environment is to accompany, promote skills, exercise patience and learn to understand.