Selective Mutism - Alifia Bharmal Blog
Sep 04

Selective Mutism

She won’t speak to anyone”!!

Neha is a 6 year old who can dance and sing front of her family. She might even be the next idol!!

But in the music class she is paralyzed by fear and can’t say a single word.

Zaid is an 8 year old boy who plays cricket with his brothers and talks excitedly about his favorite world cup team. Yet, at recess time he stands alone watching the other kids play cricket and doesn’t speak when other kids ask him if he wants to play. The other kids think he is a snob and ignore him.

Tarun is a 4 year old boy who always speaks to his brothers, sisters and parents at home but never talks to anyone outside home.

Everyone feels shy from time to time. In fact, having just enough shyness can be helpful because it can protect us from doing things that maybe embarrassing or awkward. But when shyness keeps a child or teen from speaking then it maybe a condition called selective mutism.

Selective mutism normally develops during early childhood, when children enter new social environments – such as nursery – away from immediate family. There is no single cause although emotional, psychological, genetic and social factors are believed to influence its development. It’s more common in girls and multi-lingual children.

While lots of children are quiet or shy, selective mutism is a more serious problem when a child does not speak at all in certain social situations. A child with selective mutism might be chatty at home with their parents and other family members, but completely silent outside the home or at school.

Selective mutism is best understood as an extreme form of social anxiety. Rather than choosing not to speak, the child might become frozen with anxiety in a class or they might develop a phobia of speaking in public. Once selective mutism becomes a habit, it can be harder for the child to break it and can lead to long-term problems such as being disengaged in school and missing out on social opportunities.

How do I know if my child has Selective Mutism?

Most children with selective mutism look and act like any other child, when they are in a comfortable situation. But when they are in other situations, like school or other social settings, they feel very anxious.

Before or during social interactions, a child with selective mutism may:

Withdraw or ‘shut down’ when in the situation that makes them so anxious
Refuse to follow adult’s directions, and seem disobedient or defiant (for example, refusing to go somewhere that makes them feel anxious)
Avoid the stressful situation or activity
Complain of stomach aches or headaches
Stare into space, avoid eye contact or not smile
Have trouble saying simple things like ‘hello’, ‘goodbye’ or ‘thank you’
Children with Selective Mutism may also have:

Social Anxiety Disorder (9 out of 10 children with Selective Mutism have this)
Difficulty being away from parents (Separation Anxiety)
Some form of speech or language problems
Daytime wetting or bed wetting (enuresis)

What helps children with Selective Mutism?

Be very understanding and patient with your child. When you have a child with selective mutism it is easy to get frustrated with them when they don’t speak – because you know they can – and to end up constantly asking or pressurising them to speak. However, this can be counterproductive.
Be relaxed, patient and encouraging. As your child can’t speak due to anxiety, pressurising them or drawing attention to the fact they are not speaking will only increase their anxiety and self-consciousness and even make them feel bad for having the problem.
Create a safe space for expressing feelings. You can acknowledge your child in advance that “talking can feel scary sometimes”, and then be reassuring “don’t worry, once you start it feels easier and you are being brave trying”.
If possible, educate people in advance of meeting your child so they don’t make a fuss of him/her not speaking. Model good conversation yourself and include your child normally as you might with any child their age without drawing too much attention to them. Certainly, don’t make a big deal if he/she does communicate a little more as this will put him/her off and increase his/her anxiety. Instead, just repeat what he/she has said and ask him/her a further question.
Use a step-by-step gradual approach with your child. This usually works best in overcoming social anxiety. For example, if it is hard for your child to speak in public to strangers, then maybe you could start with him/her learning to speak to you when strangers are nearby.
Working with the school
Develop a program for your child in consultation with a speech therapist who has assessed the specifics of your child’s situation.

For example, In trying to increase your daughter’s speaking at school, the speech therapist might put together a program that consists of her spending 10 minutes daily with a teacher at school. They would work through a detailed program that starts with the smallest steps of speaking one-to-one in an empty room and builds towards your daughter speaking in the classroom.

For example, in the beginning, the program might consist of some of the elements below:

Communicating non-verbally with your child, perhaps via an imitation game to put her at ease.
Focusing on making and mimicking animal noises as a means to getting your daughter to make sounds.
3.Inviting some simple one-word communications between your child and the teacher, and progressing to sentences and conversation.

4.Gradually introducing other children to the room, so your child learns to speak in their company.

What doesn’t help your child with Selective Mutism?

Forcing your child to speak, this will only make the anxiety worse.
Ignoring the problem. Parents may hear that their child is just shy and will outgrow the Selective Mutism. But there are serious consequences for a child who can’t communicate or speak to others:
It can be hard to make friends. Not having friends or being isolated can put children at risk for teasing or bullying.
It can impact a child’s learning. Your child won’t be able to ask questions or ask for help. Teachers can find it hard to assess your child’s learning needs. Your child will not be able to take part in group work or learn important presentation skills. Over time, problems at school can affect your child’s self esteem, make anxiety or depression worse or make your child feel isolated. Children in these situations sometimes refuse to go to school.
Blaming your child for being manipulative. Remember, anxiety is at the root of this-your child is not trying to control things by not speaking. Your anger and frustration will only make things worse. All children do well if they can. When they can’t, it’s because they don’t have the skills they need.
Fortunately, there are effective treatments for Selective Mutism.

Managing anxiety and trying things that make you afraid takes courage. Take note of when your child takes a step forward and speaks in situations he finds difficult. But take care-enthusiastic praise can make your children’s anxiety worse, because it brings more attention to the problem. A warm smile, a wink, a touch or a calm, quiet word is all that is needed.

You might also acknowledge your child’s effort and success with a family treat like a special dinner or dessert, a family ‘toast’, or a family outing. Be sure to include your other children as well, for example “Let’s have a little celebration. Kiaan was able to ask his teacher a question today, and Sarah’s been doing a great job tidying up after school. Why don’t we all walk over to the store to get some ice cream after dinner tonight?”.

Remember-punishing a child for not speaking will not help. Punishment will only make the anxiety worse, making it even harder for your child to speak. If your child isn’t able to take an expected step forward, move down a step for a bit. Let your child get more comfortable at that step, and then try to move ahead again.

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