Selective mutism is an anxiety disorder in which a person who is normally capable of speech cannot speak in specific situations or to specific people. Selective mutism usually co-exists with shyness or social anxiety.
Whilst we signpost parents and settings to advice about supporting children with selective mutism, we do not actively treat this.
Where there are also speech, language or communication difficulties at home, the role of the speech and language therapist is to assess for any other underlying communication disorder.
The resources/resources below might be helpful in supporting a child or young person with selective mutism
STRATEGIES THAT MAY BENEFIT YOUR CHILD IN SITUATIONS THAT CAUSE THEM ANXIETY
- Take note of non-verbal communication your child currently uses, such as:
- nodding or shaking head
- pointing to indicate an answer or make requests
- tapping or nudging adults or other children
- writing messages to communicate
- smiling and laughing silently to show enjoyment and share humour
- Maintain the child’s need to communicate by creating opportunities but not expectations for them to speak (eg. Answering if they’d like a drink). Do not place pressure on your child to speak, but create situations in which they can communicate in some way.
- Accept non-verbal responses (including pointing, nodding/shaking head, tapping, writing) but don’t encourage these all the time. You may need to adjust styles of questions asked to be more closed, so that the child is able to make a response. E.g. whilst reading a picture book you could ask a question based on the picture. However, instead of saying, “John, point to the answer”, ask “Is it A or B?”, whilst pointing to the two possible answers that are on the page. The child then has the option to answer verbally or with pointing.
- When talking with the child, make more comments than questions. This reduces the pressure on them to make a response and avoids a situation where someone is waiting for them to respond.
- Make less direct eye contact with the child. Look instead at a shared object or sit/stand beside them, which is a less threatening position.
- Encourage the child to take risks by trying new things, but in a safe way. Working alongside your child to help them communicate or complete something challenging is better than someone doing it for them.
- If the child does speak aloud, it is important to reward their talking with ongoing interaction, but do not make a big deal about it.
- Acknowledge the child’s fear of speaking. In a one-to-one situation, speak with the child about their difficulties using phrases such as, “you are not alone”, “I’m going to help you”, “I know that it must be difficult for you”, “You are going to get better” and “You don’t have to talk, but you can if you want to”. Be direct about the problem, but reassuring.
- SMIRA – Selective Mutism Information & Research Association. This is a UK Register Charity and their work includes providing information to health and education professionals people and also to support families with selectively mute children. Their website can be accessed via http://www.selectivemutism.org.uk/
- Speech and Language Therapy colleagues from Kent Community Health NHS Foundation Trust have developed some free training videos with downloadable handouts and resources. Their aim is the training will give parents / carers and / or professionals an understanding of what causes children and young people to withdraw from communication or become silent in certain situations (selective mutism) and to help them provide appropriate support. There is a table which recommends specific training videos depending on the child or young person’s stage of education. These can all be accessed via their website: https://www.kentcht.nhs.uk/childrens-therapies-the-pod/speech-and-language-therapy/selective-mutism/