Selective Mutism

WHAT IS SELECTIVE MUTISM?

Selective Mutism is an Anxiety Disorder, usually occurring in young children, which causes an inability to speak in specific, usually public, settings (i.e. school). Selective Mutism may also present as an inability to speak to particular individuals, such as certain close relatives.  

Selective Mutism is a condition that is more than simple shyness. It is accepted thatpeople with Selective Mutism have a genuine fear of speaking and social interaction. This puts it on the same spectrum as specific phobias.

Children with Selective Mutism are able to verbalise and understand language and often have no other identifiable problems, conversing freely at home or within other settings where they feel comfortable. They will usually be able to make age-appropriate progress at school in areas where speaking is not required.

People commonly associate an Anxiety Disorder with physical symptoms, such as trembling, sweating or shaking. Children with Selective Mutism are not usually unhappy or shy in activities not requiring speech. This can confuse some professionals as to the relationship between the condition and an Anxiety Disorder .

Once considered rare, Selective Mutism is now known to affect more than six in every 1000 children, which is about the same number as those affected by Autism. It is therefore important that awareness of Selective Mutism is promoted as few people (even professionals) have much knowledge or have had training of how to deal with it.

Although it is thought that Selective Mutism usually begins before the age of five, it may only be properly noticeable when the child starts to attend school. Accordingly, early diagnosis and intervention is important, as not speaking can become a habit that gets increasingly harder to break the longer it persists.

HOW IS SELECTIVE MUTISM DIAGNOSED?

Selective Mutism is not the result of a child wilfully refusing to speak due to shyness, bad behaviour, or attention seeking, and can only be formally diagnosed by a qualified child mental health professional following specific guidelines.

The diagnosis can only be made if the following factors are all present:

• The condition interferes with the child's educational, social and cognitive development;
• The duration of the disturbance is at least one month beyond the first month at school;
• The failure to speak is not due to a lack of knowledge of the language;
• The child can speak normally in alternate settings;
• The condition cannot be better explained by a communication disorder (e.g. stuttering ); or
• The condition is a result of another known abnormality.

HOW SHOULD SELECTIVE MUTISM BE TREATED?

Treatment for Selective Mutism focuses on both lowering anxiety and increasing confidence. The child should never be prompted or expected to talk and, at the same time, other children or adults should refrain from always talking for him/her. Opportunities for non-verbal communication should also be given.

The aim should always be to make the child feel more comfortable speaking in other surroundings and to other people. The child must be allowed to develop their confidence at their own pace.

Conversation in comfortable surroundings, such as at home, needs to be encouraged to develop verbal skills and confidence in self-expression. Humour and laughter can often teach a child that learning can be fun. The love, support and patience of friends and family can also have a massive impact on helping a child to overcome their condition.

If the inability to talk is related to a specific person, it is important that they are made fully aware of the issue and are able to co-operate. Conversing over the telephone may help until the child feels able to communicate in person.

Home visits by a teacher may help a child feel more comfortable at school and, with the teacher’s agreement, a ‘situational fading’ programme is sometimes employed. This approach involves gradually adjusting the situation in which a child will speak by changing the location and/or people present, until the child speaks confidently.

Professional help can also be sought, with Cognitive Behavioural Therapy, Play Therapy, and sometimes family therapy being useful.

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Although the information we have provided here is meant to be helpful to you, Douglas Silas Solicitors cannot be held responsible for any damage or loss caused by any inaccuracy or reliance placed upon it. If you have any concerns about your child, you should seek professional educational or healthcare advice as soon as possible.