My 4 year old daughter was selectively mute and since October 2001 has stopped speaking even within the family. She is going to therapy 2 times a week. I have seen improvement as she is now making sound words (Beep, Yuck, etc.) If I mention the fact that the expectation is for her to speak again she gets very upset and throws a tantrum. My doctor has encouraged me to not mention the speaking to her. What is your view on this? I do not want my child to think that I do not expect her to talk at some point in the future. She has become very comfortable with her pointing and made-up sign language to get her needs met. Thank you.


Before I answer this question, I am going to ask you to think of something that really, really scares you. Is it heights, being in a closed elevator, medical issues (cancer)? My point is, whatever scares you try to focus on the ‘feelings’ you get when you get scared. Then, understand that is what your daughter feels with speaking. Selective Mutism is a TRUE anxiety disorder that is incapacitating. Why your daughter stopped speaking at home is unknown to me. My experience leads me to believe that something ‘scared’ her and made her anxiety worse. i.e., Did you go away on a trip and she was separated from you? New baby? Increase pressure about speaking. In other words, if you daughter is NOT speaking at home, her SM is very, very severe and she has severe anxiety. Your approach needs to be to relieve pressure to speak 100%. Do not ask her to speak, do not let her know you are upset if she does not answer a friend or relative when they say hello.

Focus of therapy needs to be on lowering anxiety, not on speaking. From what you have said, ‘I do not want my child to think that I do not expect her to talk at some point in the future,’ it is obvious to me that you are implying to your daughter that she HAS to speak and you are not going to tolerate any other way. I can tell you that this approach is completely, 100% wrong. You need to take the ‘I understand you are anxious,’ approach and ‘I want to help you in everyway’ approach. You also want to praise her for her EFFORTS of trying to speak. Trust me, if she could speak, she would. Please try the following for 6 weeks: No talk about her talking., If she is mute, then so be it. If she uses sign language, accept it and see how this goes

Dr. Elisa Shipon-Blum