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People with selective mutism are not "selecting" to be speechless, as if being oppositional.

Selective mutism is driven by anxiety in certain situations, thus, "situational" mutism may be more accurate.

Though the person is speechless, with some creativity, communication can still occur.

Over the years, in the juvenile court clinic, my colleagues and I have had several cases where a child referred for evaluation speaks only to select people. It is sometimes noted that the child has been diagnosed with selective mutism, though seems to interact with many people just fine. The referring source, usually a probation officer or attorney, might be wondering whether the child has become truly unable to speak, or if they are just being oppositional. It seems "selective" mutism may be a confusing term.

Selective mutism, for those unfamiliar, is when someone becomes speechless around certain people or social situations despite having normal speaking ability. It tends to develop early on and historically was only applied to children. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, published in 2013 (DSM-5), it was noted that adults can also suffer from the affliction.

Oppositional or anxious?

The condition first appeared in the medical literature in 1877—aphrasia voluntaria or “voluntary absence of speech.” It was changed to elective mutism in the 1930s (Drieson and colleagues, 2020). It wasn’t until the DSM-3 (1980) that it became an official diagnosis. At that time, it was still referred to as elective mutism because of the continued belief that there was an elective, or voluntary, nature to the child becoming mute. This implied the failure to speak was oppositional and thus a “behavioral” issue.

Before the DSM-3, however, some clinicians in the 1960s, most notably Alice Sluckin, felt the condition was not a function of contrariness, but rather one of anxiety (Kocovska, 2020). This would indicate it is more a failure to speak due to anxiety around certain people or situations. Kocovska (2020) also noted that some practitioners at the time began applying the........

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