- “I understand that talking can feel really scary for you, it’s OK, you can join in, in other ways and still have fun!”
- “We know that you can talk happily at home, it may take a little while to talk in new places or to new people, but it will get easier!”
- “The most important thing is that you feel happy, no one is going to make you talk if you don’t want to.”
- “I know it’s very hard feeling scared to talk, but don’t worry, things will get easier, and we will help you until you feel ready to join in!”
Selective Mutism
What is Selective Mutism?
Do you have a phobia? Something you are really afraid of, like going to the dentist or flying or spiders…. What happens when you are in that situation? Do you experience feelings of panic and anxiety, sweating, dry mouth, not able to think clearly?
This is how someone with selective mutism (SM) feels when they are expected to talk to unfamiliar people or in an unfamiliar environment. SM is an anxiety disorder which presents as a phobia of talking and of others overhearing your voice.
The part of the brain that is responsible for stress responses is called the amygdala, and this kicks in when we perceive there is a threat to us, and this makes thinking rationally almost impossible.
Children with SM are not talking because they don’t want to. It is because they perceive talking to be a threat to their safety.
What happens when a child has Selective Mutism?
- They can talk happily to a few people (usually their families) and in familiar environments such as home.
- It is highly distressing for them to talk to unfamiliar people or in unfamiliar environments where they may be overheard.
- They WANT to talk but often physically can’t - some people report a feeling of their voice getting stuck in their throat.
- They will become increasingly frightened of situations where they may be expected to speak.
- They will avoid situations that may trigger the phobia response if expected or forced to speak in order to minimise stress.
- They will avoid drawing attention to themselves.
Other behaviours you might see
- A complete lack of vocalisation in some situations – not being able to laugh, cry or cough.
- ‘Freezing’ - a blank facial expression and more body tension if spoken to directly e.g if asked a question by someone unfamiliar or in an unfamiliar environment.
- Suddenly stopping talking when an unfamiliar person may be able to hear them.
- Becoming unable to talk at a certain place e.g at the school gate / door to their friend’s house.
- Struggling to take physical risks e.g in the playground.
Is Selective Mutism the same as being shy?
A child who is ‘shy’ will warm up in an unfamiliar situation or with unfamiliar people if they feel relaxed and have fun. A child with SM may not be able to speak in these circumstances, even if the adult with them is encouraging and sensitive.
What can you do to help?
As with any phobia e.g flying or visiting the dentist, you can;
- Talk openly about it with the child.
- Acknowledge their fear, help them to understand that the phobia response is not something they can control at the moment, but that it can be fixed. We can fix it by being exposed to the idea of talking in little, tiny steps.
- Tackle it at the first opportunity to prevent the phobia becoming entrenched.
- Reduce demands to speak where the child is struggling. Avoid direct questions from unfamiliar people e.g at school.
- Implement a programme, overseen by a speech & language therapist, where the person can face their fear in small steps, at their own pace.
- Encourage participation by using a communication method the person is comfortable with e.g writing things down, using pictures to say how they feel.
What to say to a child with Selective Mutism:
What to say to other people/other children who comment on the child not talking:
- “Sophie isn’t ready to use her voice just yet. You can play together, and she will talk to you when she is ready.”
- “Sophie finds it hard to talk to people she doesn’t know.”
What to say to people / peers who comment on the child not talking:
- “Sophie isn’t ready to use her voice at school yet. It can be hard for some children to talk in new places. You can play together and she will talk to you when she is ready.”
- “Sophie talks away happily at home with her family. When it feels right, she’ll talk in Pink Class too.”
What support will my child need from a Speech and Language Therapist?
A speech and language therapist can help set up a ‘sliding in’ program at school. This may involve a parent coming to the school several times a week to play with their child in their classroom until they are able to talk comfortably in that space. The class teacher or a TA can then be very gradually added to the activities at a pace that allows the child to continue talking.
TOP TIPS
Talk to friends and family who visit the home and school staff about SM and pass on these tips;
- Avoid direct questions!
- Practice using ‘commentary’ style talking (narrating what the child is doing).
- Gently introduce rhetorical questions that don’t need an answer e.g “Isn’t it cold today?”, “Now where did I put my pen?” during a shared activity. Leave plenty of pauses to allow the child to respond if they feel able.
- It is easier for a person with SM to feel safe if you appear relaxed, smiling and are happy to take on the talking. Think about activities that you can do sitting side by side e.g. craft / art activities where the focus is not on talking
- At school, create opportunities for the person with SM to talk comfortably to their family or friends in your presence as a first step towards talking to you.
Remember!
No amount of pressure to speak will help. This includes cajoling, persuading, bribing or punishing. These methods do not help and will result in the person feeling more afraid that they will be forced to speak. Create a safe environment for the child by educating those around them. If the child trusts the adults and feels safe in the environment, they are more likely to be able to use their voice.
You may hear some people refer to Selective Mutism as ‘elective mutism’, this is an outdated term that many people with SM dislike. Some who experience SM prefer the term ‘situational mutism’, they feel that the words ‘elective’ and ‘selective’ both imply that they are choosing not to speak.
What next?
To learn more about SM, you may find it useful to watch the documentary “My child doesn’t talk”, narrated by Maggie Johnson, who is one of the leading speech and language therapists in the field. She is also co-author of “The Selective Mutism Resource Manual”, which is written for parents, schools and professionals.
There are lots of books to read with children who have SM. You can find them online or order them from your local bookshop. Examples include: e.g;
You can also find more information and support online here:
- The Selective Mutism Information and Research Association (SMIRA), which is a charity providing support to parents as well as health and education professionals.
- The NHS Choices website also offers useful additional information.
Last updated19 Jul 2024