> There may also be concerns around autism. > There is no evidence to suggest that children with SM are more likely to have experienced abuse, neglect or trauma than any other child.While it is important to be aware of possible safeguarding concerns for all children, the view that children may be mute because they have suffered trauma can hinder families from accessing support. When mutism happens in the context of post-traumatic stress, it follows a different pattern to SM i.e. the child will stop talking suddenly in environments where they were previously confident to speak. It is more common in girls than boys and affects more children who are learning a second language. However, it is thought that SM affects around 1 in 140 children and young people. > SM usually starts in childhood, between the ages of 2 and 4 years (for example, when the child starts nursery or school). > be described by others as being “stubborn”, “rude”, “controlling” or “manipulative”. However, non-verbal communication (gestures/writing) can be difficult for many children with SM. > use gestures to support their communication for example, nodding for “yes”, shaking their head for “no” or using their hands to ‘describe’ an object or action. > speak with a whispered voice when communicating with peers/adults in the affected setting. As a result, they might go for hours without using the toilet/having a drink, and some may have accidents as a result. > struggle to ask to get a drink, use the toilet, or say they feel unwell at nursery or school. > find it difficult to ask for help or start conversations with others. > not be able to answer questions in class (even when they know the answers/how they should respond). > be quiet and reserved at nursery/school but become dysregulated (for example, having ‘temper tantrums’) when they get home. > struggle to separate from their parents/care givers. > stare, have a fixed facial expression, look physically ‘frozen’ or appear poorly-co-ordinated when there is an expectation to speak to someone outside of their comfort zone. > avoid eye contact and seem shy, nervous, socially awkward or be described as seeming uninterested or withdrawn. >be totally silent in specific settings (for example, school). > The difficulty will have lasted for a period of 1 month or more. > The child is able to speak freely and confidently in other situations, most often at home. This pattern is different for every child but is consistent and predictable. > An ongoing difficulty in a child or young person using their voice in a specific situation (for example, at nursery or school). > A marked change in a child’s ability to engage when they are expected to talk to someone who is outside their comfort zone. > The expectation to talk to certain people in certain situations results in feelings of panic, making it impossible for the child to speak at these times. When this happens repeatedly, the child learns to anticipate situations which trigger feelings of panic and anxiety, and then do all they can to avoid them. SM tends to be most notable in places like nursery, school or other public places but it may also happen around family members the child or young person does not see regularly. > A child with SM will speak happily and freely in some situations and environments, but will be unable to speak in specific situations. > Selective mutism (SM) is an anxiety It is best understood as a phobia of talking in certain situations.
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