Some kids are just shy. However, there are some on the extreme end of shyness, such that it impacts their quality of life. For these kids, talking to others is not just hard, it can also be anxiety-inducing1. When a child has anxiety talking with others, talks only to a few people and this persists over time, your child may demonstrate signs of selective mutism. The American Speech-Language-Hearing Association (ASHA) defines selective mutism as a child who “does not speak in certain situations, like at school, but speaks at other times, like at home or with friends.”2. Sometimes our kiddos with selective mutism also have speech delays, which can make it even harder for them to talk. So, what can you do if you have a child with selective mutism?
First, understand the signs of selective mutism. This involves differentiating between shyness and selective mutism. A team of a developmental pediatrician, psychologist and speech therapist will be able to help provide a differential diagnosis for your child. Here are some signs of selective mutism3:
- Frequent and marked attempts to avoid speech and talking with others across settings (e.g., using writing, pointing, or miming instead, or total avoidance).
- Persistent mutism even when a child seems to “warm up” to somebody new, or even when they appear more confident.
- Intense anxiety when prompted to talk, like a deer in the headlights look. Your child may even avoid eye contact, and stop attempting to communicate altogether.
Next, understand the consequences of selective mutism left untreated. The effects of anxiety are cyclical. And understanding that when we prompt or push a child with selective mutism to talk, we may be creating a negative persistent cycle for that child, making it even harder for them to talk later on. By waiting to address selective mutism, or expecting them to “grow out of it,” a child may, we may be placing our kids at risk of perpetuating the cycle of mutism. Here’s an example of a cycle4:
- A child is asked a question or prompted to respond.
- That child feels very anxious when prompted to talk.
- Then the child avoids talking or responding.
- An adult or peer rescues the communication breakdown.
- Everyone feels better, and everyone’s anxiety is lowered.
- Which then creates a negative reinforcement cycle, making it harder for the child to speak next time he or she is prompted to do so. And the cycle starts again.
So what should you do? First, assemble your support team. Your team may consist of your pediatrician, developmental pediatrician, school speech therapist, teacher, counselor, private speech therapist, friends and family or others in the community. You and your team are your child’s advocates. It takes time and work to engage a child with selective mutism outside of the home, and even then, there can be barriers. Be sure your team is aware of and on board with the strategies that work best for your child.
Next, consider therapeutic support, including speech therapy, occupational therapy, or counseling. Therapy sessions for selective mutism work towards increasing your child’s confidence and reducing their anxiety, without the expectation for them to talk. As therapists, we tap into what makes kids excited, what makes them glow, and what tickles their funny bones. By reducing the need to talk, and having them simply engage with us in a calm and fun environment, they are allowed to feel more comfortable using their voice, without the detriment of that endless anxiety cycle.
Therapists have ample tools and strategies for engaging kiddos with selective mutism. For example, we may ask if they want to blow bubbles. They may not be expected to say it, but we may come up with another communication system that works and slowly introduce the drive to talk, to converse, to shout! For kids with selective mutism, we want them to feel comfortable making sounds with their body by clapping, stomping, then by mouthing words or making silly sounds with their mouth, then by whispering short simple sounds and answers, and finally to answering questions and initiating conversations on their own. Our kiddos with selective mutism are unique individuals, and with therapy, we’ll help you help your child find their voice.
For a parent’s perspective on selective mutism, watch this TEDx video.
If you are struggling to figure out if your child is just shy or may have selective mutism, please refer to this great article by Michael Jones, MRCSLT, or reach out to your pediatrician for a referral. http://www.talk4meaning.co.uk/wp-content/uploads/2012/11/1791.pdf