Anish was an incredibly cute baby boy when he was born. Weighing in at 6 pounds 13 ounces, he had a full head of black, curly hair and a dimple on his left cheek. His big brown eyes made him, according to his 3 year old brother Arjun, look like a cartoon character.
The family had immigrated to the US when Gauri was still pregnant with Anish, and they settled into a primarily Caucasian neighborhood where there were very few South Asians. Gauri and Ravi were very open to the boys having non-South Asian friends, as long as they maintained their South Asian culture at home. Both boys grew up bilingual, having picked up English quickly by watching TV and being around Caucasian and other American children in the neighborhood.
As a young baby, Anish was very shy. From the age of 7 months until 14 months, he was very wary of strangers. He did not like eye contact with them and was very anxious in their presence during this time. Although he learned to warm up slowly to them, he hated when people would try to touch him and would often pull back quickly as anyone other than his family would approach him. He very often hid behind Gauri or Ravi’s legs and rarely initiated contact with the unknown adult or child.
When strangers were not present, Anish was very comfortable. Because there were so many children of the same age in the neighborhood, Gauri and Ravi decided to keep the boys home until kindergarten, which worked fine for Anish as he got along with several neighborhood boys who were around his age.
Anish was, overall, a healthy boy in the 50-70th percentile for weight and height and seemed to reach all of his developmental milestones, such as crawling, walking, talking, etc. right on time. Ravi was slightly concerned about Anish’s shyness and was perplexed by how the two brothers could be so different from each other. Gauri insisted that once he began school, he would outgrow his shyness and become more outgoing like Arjun.
On the first day of kindergarten, Anish looked terrified. His big eyes got bigger as he watched 30 brand new, unknown children run around an unknown room. He gripped his mother’s hand tightly and had a very difficult time letting go. She sat next to him at his desk for a few minutes and when he was distracted by his teacher, Gauri slipped out of the classroom. Once he noticed she was gone, Anish cried the entire time he was in class.
Over the first couple of months, Anish slowly began accepting that his mother would drop him off and cried less and less every day. He would quietly color or sit in the circle during reading time. At recess, he often played in the sandbox next to other children.
“He’s such a joy to have in class!” gushed his teacher. “He’s quiet and diligent. He’s a little shy but I’m sure he will become more confident when he goes to first grade. He’s so well behaved!”
“I told you he would be fine,” Gauri teased Ravi.
It didn’t dawn on any of the adults in his life, that his quietness went beyond being well-behaved and “a little shy”. This became clear when he entered first grade.
Instantly, the work load and expectations increased on the children. No longer were they working primarily alone. Now the teacher expected group work and answering questions out loud. Anish’s teacher became concerned when he repeatedly responded to her questions with silence. One day, so she asked him to stay in during first recess.
“I wanted to talk to you Anish,” began the teacher. She saw he was hanging his head so she reassured him, “You’re not in trouble, ok? I just want to talk to you.” He still maintained no eye contact but raised his head slightly.
“I want to know why you’re so quiet. Is talking out loud scary for you?” asked the teacher.
Anish had a blank look on his face as he sat frozen in his chair.
“Do you know the answer when I call on you?” Again, her question was met with an emotionless face. “Are you worried you’ll make a mistake?”
“It was as if he was a statue,” the teacher told Gauri on the phone that night. “He didn’t say one word and did not indicate to me that he was understanding anything I was saying.” She paused and then asked carefully, “Does he understand English?”
Gauri became upset and said, “Of course! He and his brother speak both English and our home language!” Gauri quickly thanked the teacher for her concern, dismissed the teacher’s recommendation to see a speech pathologist and hung up. How dare she think Anish doesn’t understand English! thought Gauri, furious with the teacher.
Gauri and Ravi knew he had no speech impediment. At home, Anish spoke incessantly. He was a bubbly, lively boy who talked with his family and his friends in the neighborhood. They did not understand what the problem was. The teacher became busy with the rowdy kids in his class and did not follow up with her original concern. The parents assumed it was no longer an issue and did not pursue it either.
In second grade, however, he was unable to hide in silence any longer and his teacher became very concerned by his statue-like presence during in class activities.
“It’s not that he’s shy. It’s that he’s so shy that he can’t function in the classroom if he is required to do anything other than individual work,” his second grade teacher reported. “He seems smart but he’s not doing well because he doesn’t participate in group activities. He has no friends at school because he doesn’t speak. He plays along side children and shares toys during recess, but somehow he manages to get through the entire school day without saying one word to anybody. I’m worried about him.”
She pushed the parents hard to see a speech language pathologist and followed up with them consistently until they decided to do so, explaining that his life will become increasingly difficult as he gets older.
The speech pathologist found no speech problems. “He’s able to move his tongue properly and make all of the sounds necessary to produce language. And I tested his hearing, which is also fine. It seems his comprehension skills are also intact,” reported the pathologist.
“Yes! I know. He speaks fine at home. There are no problems,” insisted Gauri. The speech language pathologist referred the parents to a psychologist, who ruled out autism and other pervasive developmental disorders.
“He has selective mutism,” the psychologist explained. “It’s a childhood disorder characterized by a persistent lack of speech in at least one social situation, in this case school, even though he can speak everywhere else.”
“How did he get this?” asked a shocked Ravi.
“We don’t know what causes selective mutism, but it is associated with low self-esteem or high anxiety.” Ravi and Gauri looked back on Anish’s childhood and recognized the signs of anxiety since he was a baby that they assumed were normal for all children.
“The prognosis is excellent once we get him the right treatment. I recommend having him continue to work with me so I can help him learn better coping strategies for his anxiety. In addition, the speech-language pathologist can work with the three of you to help increase his verbalizations at school. I am confident he will overcome this.”
Selective Mutism exists more commonly than the research suggests, but it is often diagnosed far later than the symptoms begin to present themselves. Sometimes, selective mutism occurs in a child after witnessing or experiencing a trauma such as abuse. However, most of the time, it is often due to the child’s predisposition of being particularly anxious from a very young age. If you think your child might be exhibiting signs of selective mutism, please have them assessed by a mental health professional right away.
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