Extreme shyness in children could actually be a form of anxiety

October is Selective Mutism Awareness Month.  Selective Mutism is an anxiety disorder that causes children the inability to speak in social situations, most commonly observed in school. A child will have normal speaking and confidence at home, but once they get to school they are so overcome by anxiety that they simply cannot speak or even make eye contact to peers and teachers.

This is more than a child being labeled as “shy.” Most children who are shy will begin engaging socially after the first month of school. However, children with Selective Mutism do not outgrow or overcome their shyness and will need parent/teacher intervention to be able to function normally in social situations.  

Our daughter was diagnosed at 4 years old, even though she had been showing signs since she was 2. She did not speak to anyone her entire first year of preschool and it took until the second half of her second year to begin saying one-word responses to her teacher. She never spoke to her peers throughout her first two years of school.

We noticed other signs/symptoms that led us to understand that she had Selective Mutism. For example, she would not let anyone take her picture, she would not make eye contact or speak to any extended family except for one set of grandparents, she would get a “blank” look on her face when others tried to engage with her, she had a hard time sitting still and relaxing, she had issues with separation anxiety, and she was unable to understand and process different emotions, causing many tantrums.

After we learned about Selective Mutism, we got to work on treatment right away — early intervention is key in overcoming this disorder.  The biggest hurdle in treating Selective Mutism is treating the anxiety that goes along with it.

A combination of anti-anxiety medication and cognitive behavioral therapy is the best treatment for Selective Mutism.  Cognitive Behavioral Therapy involves understanding what is causing the anxiety and doing exercises to change patterns of thinking so that the child can feel comfortable in situations that used to cause anxiety. For example, our daughter was having difficulty making eye contact and handing things to others. We started going to our local gas station and leaving a penny in the “Leave a Penny/Take a Penny” tray. This forced her to hand over the penny and make eye contact with the cashier.

Over time, her anxiety decreased allowing her to perform this task without being overcome by the anxiety. We encourage her by rewarding her behavior with brave tickets which she can cash in for ice cream and staying up later than her normal bedtime.  By combining anti-anxiety medication and the Cognitive Behavioral Therapy, she is now speaking to about 10 of her classmates, her grandparents that she was unable to speak to before, and she smiles for pictures with confidence.

If you feel your child or a child you know has Selective Mutism, go to www.selectivemustism.org to find resources and to get more information about signs/symptoms as well as treatment options.

Kelly Melhorn

Nowthen, Minn.


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