To date, there are no formal studies to prove or disprove that diet has an affect on Selective Mutism. In fact, there have been no formal studies to access the neurological effects within the peripheral and central nervous system. We can only assume for now.

Question: ” Dr. E, what percentage of children with SM get rapid heart rates, sweaty palms, feel dizzy, get stomach aches, feel nauseous, etc.?”

Answer: “From working with many children, teens, and adults it is obvious that individuals with SM suffer from anxiety; often from multiple sources. Most individuals with SM have social communication related anxiety when they sense an expectation for speech and communication. But some with SM have co-morbid anxiety, such as social anxiety, specific phobias, generalized anxiety disorder and OCD. Therefore anxiety, regardless of the cause, can manifest as ‘nervous’ upset stomachs, feeling scared, appearing shut down or avoidant and looking visibly uncomfortable. Others act out behaviorally and seem overly stubborn and inflexible. However, the exact percentages and the specific symptoms have not been formally studied. This would indeed be a wonderful study to do one day!”

However, some children, overtime, develop learned and conditioned ‘avoidant’ behaviors and no longer feel anxious or appear anxious. They only feel anxiety when they sense an expectation for speech and communication.  

If one were to examine the effects of diet on anxiety as a whole, perhaps we can apply some of the concepts to our loved ones who suffer in silence. For anxious individuals, the mere feeling of a rapid heart rate or sense of dizziness can cause the individual to enter into an anxious state. They sense anxiety, therefore the mind follows in acting out the part! I.e. If a child eats a lot of chocolate, gets wound up, heart rate goes up and the body senses anxiety, the mind therefore takes over and feelings of anxiety often prevail. We know this is fact for individuals with panic disorder, but this has not been studied with SM children and teens.

Below is a guide to a more stress-free way of life. The effects on SM are obviously not studied, but these recommendations can only help our anxious children, teens, and adults.

  • A diet high in complex carbohydrates has calming effects by increasing the amount of tryptophan the precursor to serotonin in the brain. Complex carbs, such as potatoes, whole wheat bread and pasta, take longer to digest than sugary simple carbs like white bread, so you stay fuller longer and your blood sugar is likely to stay steady, eliminating stress and anxiety. Eat carbs without fat or protein to feel instant contentment, but note that a balanced diet needs protein and fat as well.
  • Meats and high protein diets are somewhat taxing on the digestive system. They take a lot of ‘effort’ to digest, often causing an increase in secretion of the adrenal hormones, i.e. Cortisol. As a result, heart rates may increase giving a ‘sensation of anxiety.’
  • Milk and dairy products may cause digestive issues in some. For many individuals who get the ‘tummy aches’ having added dairy may exacerbate the ‘gas and bloating.
  • Limit or eliminate consumption of Simple Sugars that cause rapid rises in insulin and cause more rapid fluctuations in blood sugar. For some this causes mood swings and feelings of uneasiness/anxiety. For example: sugary chocolate (dark chocolate 70% cocoa can be okay in moderation), sugary sodas, processed cakes/cookies and candy products.
  • In regard to vitamins and herbs:
  • B –Vitamins, specifically B-6, which helps manufacture serotonin in the brain, have had positive effects on reducing anxiety.
  • Calcium, Zinc and Magnesium  (found in dairy and green vegetables) are also beneficial for anxiety and together with B vitamins can be taken together in a multi-vitamin format.
  • Herbal remedies, such as kava-kava, valerian, St. John’s Wort and chamomile are known to help adults with anxiety. However, because herbs are not FDA approved, studies have not proven their overall safety, ‘ability to work’ and effectiveness in children. Be sure to check with your doctor before using any of these, particularly on younger children.
  • Omega 3 fatty acids are known to reduce anxiety, specifically the EPA version. Research also indicates that Omega 3 fatty acids help with language development. Omega 3’s can be found in Fish, such as salmon or nuts, such as flax, hemp, chia and walnuts) or Omega 3’s can be taken as an over the counter supplements (

** Please consult with your local physician for exact dosages of vitamins and supplements above since recommendations differ based on age/weight and individual nutritional needs.

In addition to above, individuals should:

  • drink plenty of water to flush out toxins and to enable for adequate hydration. When dehydrated, individuals often develop fatigue, headaches, rapid heart rates and anxious feelings. 6-8 cups of water per day is recommended (using natural fruits, such as blueberries, lemons, strawberries and lime to flavor can help many children tolerate plain water!)
  • Be involved in regular physical exercise which reduces anxiety by relieving muscle tension, reducing blood pressure and produces endorphins and feelings of euphoria and calmness. At least 30 minutes/day is recommended.
  • Get plenty of rest and relaxation. Adequate sleep is known to boost immunity and lower internal stress levels. Most individuals need a minimum of 8 hours of sleep.

Obviously, the recommendations above can have an impact on a person’s well-being; however, to effectively overcome SM and all anxieties, the child, teen, or young adult needs to be involved in a treatment program, such as Social Communication Anxiety Treatment® (S-CAT®) Individualized Intensive Programs and/or CommuniCamp™ Intensive Group Treatment and Parent Training Program.

To effectively overcome Selective Mutism and all anxieties, an individual needs to be involved in a treatment program, such as those rooted in evidenced-based Social Communication Anxiety Treatment® (S-CAT®), like Individualized Intensives and CommuniCamp. Developed by Dr. Elisa Shipon-Blum, this holistic or “whole-person” treatment approach is designed to reduce anxiety, build self-esteem, increase social comfort and communication in all settings. 
As a physician, Dr. Elisa Shipon-Blum (“Dr. E”) views SM as a social communication anxiety where mutism is merely a symptom. The key to an effective treatment plan is understanding factors that contribute to the development and maintenance of SM as well as understanding a child’s baseline stage of social communication on the Social Communication Bridge©. Then, working as a team, the treatment professional, parents, and school staff members help the child build coping skills to combat anxious feelings and to progress across the Social Communication Bridge©.