A diagnosis of social anxiety with selective mutism (SM) can be hard to navigate.

Especially if you’re an extrovert or you just enjoy social interactions, it can be hard to put yourself in the shoes of a child that feels intense anxiety in those same circumstances. Or your child may not be able to articulate their feelings and tell you exactly what’s wrong when you go out in public.

This article will not only give you a better idea of how to spot this disorder but also the best methods for treating it.

Let’s dive into it.

Signs and Symptoms

So, how can you spot a child that may be struggling with social anxiety with selective mutism? The symptoms are quite similar to many anxiety disorders with the differentiator being that the anxiety is brought on or worsened by social situations.

The ‘selective’ in selective mutism means that it only happens in certain situations. The child is physically capable of speaking and forming words, but they feel such intense anxiety in certain situations that they are unable to speak.

This disorder can also involve intense fear even when just thinking about or anticipating social situations. So, parents may notice that their child stops speaking while at home when they know that they will be leaving soon for some social event.

This can seem confusing at first since their home also seems to be their safe place. Sometimes it is necessary to take a step back and examine the full situation to understand how a child may be feeling.

Other emotional symptoms of this disorder include:

Intense anxiety or panic in or about social situations
Refusal to participate in social situations
Temper tantrums
Fear of embarrassment or judgment
Expecting the worst possible consequences during social situations
Inability to interact with strangers
Lack of self-confidence
Difficulty concentrating in various settings

n addition to these emotional symptoms, a child may also experience various physical symptoms independently or as a result of their anxiety. These include:

Heart palpitations or a racing heart
Trembling
Difficulty breathing
Feelings of weakness
Excessive sweating
Fatigue
Headaches
Stomachaches
Difficulty sleeping

When any of these symptoms begin to interfere with a child’s ability to function normally, help from a professional is needed.

Causes and Risk Factors

The causes and risk actors of SM are similar to those of many other anxiety disorders. The three main risk factors are a predisposition, genetic influences, and a child’s environment.

Predisposition is the fact that some children, because of their personality or other factors, are more likely to develop SM and are less capable of handling stress in a healthy way. It may take less severe events to trigger the onset of anxiety episodes or the disorder as a whole.

Our genetic makeup also influences mental health. If a child’s parents or other people in their family tree have mental illnesses, specifically anxiety disorders, then a child is more likely to develop SM.

Certain environmental factors can also bring on a mental health crisis. These factors could include embarrassing social situations, overly controlling parents, others in their home having a mental illness, attending a new school, or being bullied. Any event that brings trauma can also bring on an anxiety disorder.

None of these factors mean that a child will for sure develop social anxiety with selective mutism, but they do make it more likely to happen.

Treatment Options

If your child is struggling with symptoms of social anxiety or has been diagnosed with social anxiety with selective mutism, there are multiple treatment options that you can consider.

Cognitive-Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is the most recommended and evidence-backed form of treatment for anxiety disorders. CBT helps children identify their thought patterns and recognize how those thoughts may be helping or hurting them.

CBT can guide a child to see how what’s happening inside their heads translates into their behavior. A mental health professional will help a child use relaxation techniques, role-playing, and positive self-talk to help them face and conquer their fears.

One of my upcoming children’s books addresses social anxiety with selective mutism in specific. Darcy Deer Is Afraid to Talk, Sometimes! follows Darcy Deer as he wants to perform in the school play but is very worried that he won’t be able to say his lines. Darcy uses a science-proven, stepladder approach to face his fears.

A stepladder approach, or Graded Exposure, slowly and systematically helps a child face their fears and learn to manage the symptoms of their anxiety. It involves gradually taking on tasks that cause increasingly more anxiety. Throughout the process, a child would use the coping skills that they learned in therapy.

A child that is receiving CBT for a diagnosis of social anxiety with selective mutism will relate to Darcy Deer. They will see the hard work that he is putting into managing his symptoms. This might help them feel less alone and more confident in their ability to overcome their own anxiety.

Darcy Deer Is Afraid to Talk, Sometimes! can also be a great resource for parents. Each book contains an About Anxiety page, a Coping Strategies page, and a Stepladder page. This information will you better understand your child and give you concrete ways to help them

Darcy Deer Is Afraid to Talk, Sometimes! will be available late 2023.

Anti-Anxiety Medication

In some cases, a child may not respond as well as hoped to CBT. If therapy options have been exhausted, your child may be prescribed anti-anxiety medication. Medication can be very helpful for some children, but the benefits and risks should be weighed carefully by the parents and a child psychiatrist before medication is given.

Social anxiety with selective anxiety can be tricky to navigate and understand. Oftentimes, figuring out exactly what’s wrong is the biggest obstacle. With the right support and therapy, almost all children are able to cope with this disorder and even push beyond it and thrive.

For more tips and insight on child mental health, be sure to subscribe to my newsletter or check out my podcast Genius Little Minds.

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