Selective mutism

Why is it that some children can speak, but they are completely silent in nursery or school? This condition is known as ‘selective mutism’. Not all children with selective mutism are the same, but experts agree that many of them are highly socially anxious. Some researchers suggest that it is helpful to think of selective mutism as an intense phobia of speaking. Just think about a phobia of spiders and how intense that can be! If you have a phobia yourself, you may understand just how powerful this can feel. A child with selective mutism may physically feel their throat close up. The thought of speaking can provoke such a strong anxiety reaction that the child then avoids speaking in this setting altogether. So how does a child with selective mutism feel about this condition? Children have used the following words to describe their feelings: “over-whelmed”, “isolated”, “anxious”, “upset”, “scared”, “worried” and “invisible”.

Before considering that a child may be selectively mute, it is important to rule out some other possible reasons for them not talking. A Speech and Language Therapist can help with this.

 

 

 

 

 

 

 

 

 

How to spot selective mutism 

• The child does not speak in one setting, but they do speak elsewhere
• The child may appear shy, withdrawn and socially isolated

 

How a Speech and Language Therapist can help

The Speech and Language Therapist’s role will include some of the following:

• Speaking to the child’s parents and teacher, to find out their views and concerns
• Communicating with the child, to find out their concerns
• Observing the child at home and at school
• Assessing the child for other speech and language difficulties
• Working together with the parents, child and educational staff to create a step by step therapy plan
• Working with the child using behavioural techniques
• Advising parents and educational staff on how they can help
• Onward referral to other professionals

 

 

 

 

 

 

 

 

More information

• The website Talk4Meaning aims to support speech, language and communication and has a section on selective mutism – http://www.talkformeaning.co.uk/selectivemutism.php
• The Selective Mutism Information and Research Association has an informative website – http://www.smira.org.uk/
• A book for parents and professionals: Johnson, M., & Wintgens, A. (2001). The selective mutism resource manual. Bicester: Speechmark.
• An online pdf document: Johnson, M., & Wintgens, A. (2010) Selective Mutism: Planning and Managing Intervention with Small-steps Programmes This is available from:  http://www.selectivemutism.org/resources/library/Treating%20Professionals%20Information/SM%20Intervention.pdf

 

Sources

Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) (2000). Selective Mutism, 125-127.

 

Cline, T. And Baldwin, S. (2004) Selective Mutism in Children, Second Edition. London: Whurr Publishers Ltd.

 

Johnson, M., & Wintgens, A. (2010) Selective Mutism: Planning and Managing Intervention with Small-steps Programmes  [Online]  Available from:  http://www.selectivemutism.org/resources/library/Treating%20Professionals%20Information/SM%20Intervention.pdf

 

Cleave, H. (2009) Too anxious to speak? The implications of current research into selective mutism for educational psychology practice. Educational Psychology in Practice 25, No.3, 233-246.

 

Omdal, H. And Galloway, D. (2008) Could selective mutism be re-conceptualised as a specific phobia of expressive speech? An exploratory post-hoc study. Child and Adolescent Mental Health 13, No.2, 74-81.

 

BBC1, (14 January 2010) My Child Won’t Speak.

 

RCSLT (2010) RCSLT RESOURCE MANUAL FOR COMMISSIONING AND PLANNING SERVICES FOR SLCN – Mental Health. [Online] Available from: http://www.rcslt.org/speech_and_language_therapy/commissioning/mental_health

 

American Speech and Hearing Association (2009) Selective Mutism [Online]  Available from: http://www.asha.org/public/speech/disorders/SelectiveMutism.htm

 

Johnson, M., & Wintgens, A. (2001). The selective mutism resource manual. Bicester: Speechmark.

 

Black, B. & Uhde, T. (1995) Psychiatric Characteristics of Selective Mutism: a

pilot study. American Academy of Child and Adolescent Psychiatry, 34, 847-

 

Cohan, S., Chavira, D. And Stein, M. (2006) Practitioner Review: Psychosocial interventions for children with selective mutism: a critical evaluation of the literature from 1990-2005. Journal of Child Psychology and Psychiatry. 47, Issue 11, 1085-1097.

 

Camposano, L. (2011) Silent Suffering: Children with Selective Mutism. The Professional Counselor. Vol. 1, Issue 1, 46-56.

 

Shipon-Blum, E. (2007). When the words just won’t come out: Understanding selective mutism. [Online] Available from: http://www.selectivemutism.org/resources/library/SM%20General%20Information/When%20the%20Words%20Just%20Wont%20Come%20Out.pdf

 

Roe, V. (2003) The Selectively Mute Child in School. [Online] Available from: http://www.selectivemutism.org/resources/library/School%20Issues/The%20SM%20Child%20in%20School.pdf

 

Jones, M. (2011) Talk4Meaning – Selective Mutism – [Online]  Available from:  http://www.talkformeaning.co.uk/selectivemutism.php