My child has just being diagnosed with selective mutism and I am so confused. It was probably not the right thing to do but I looked on the internet and found a lot of scary information. I just want to know if it is my fault and what I can do to help while we wait for the speech and language therapy to start.
Selective Mutism (SM) is a complex childhood anxiety disorder that prevents children speaking in social situations, such as school. They are, however, able to speak in settings where they feel comfortable, secure and relaxed, usually at home. SM is very complex and is often a multifactorial condition, meaning that it is not likely to be due to one person or experience but can build up overtime making it hard to spot.
It is essential that an experienced Speech and Language Therapist (SLT) lead a programme of intervention focusing on reducing the anxiety that a child has built up for speaking. It is not something children grow out of and early intervention is crucial because the longer the SM is imbedded, the harder it can be to help the child.
What can cause selective mutism?
It is not always clear what causes selective mutism and there are several common misconceptions. There is no evidence to suggest that children with selective mutism have suffered abuse, neglect or trauma. Complete mutism can occur as a symptom of post-traumatic stress but this will generally manifest in children stopping talking in situations they previously felt able to. It is also not true that these children are being controlling or manipulative and although they do often co-occur there is no evidence to link it with autism.
- are likely to have family members who are shy, anxious or have difficulty in social situations which they have inherited
- may have a condition called ‘sensory integration dysfunction’ where they have trouble processing sensory information e.g. loud noises in a classroom
- often have other speech and language delay or disorders causing more stress in situations they are expected to speak
- can be in the early stages of learning a second language.
What can be done to help them?
How effective treatment is depends on how long the child has had selective mutism and whether they have additional difficulties such as, a learning disabilities, other anxieties or speech delay. A SLT will assess a child and create an intervention plan, using a small steps approach. The ultimate aim will be for the child to speak freely to people in a variety of settings. Therapy will not focus on speaking but will involve adapting the child’s environment and using several techniques to reduce a child’s anxiety. Some older children may need additional 1:1 therapy sessions, which may involve approaches such as cognitive behavioural therapy (CBT).
It is essential that families, early years settings and therapists work together to create a positive environment for the child. This includes the following:
- Understanding: everyone that is in the child’s life needs to understand and believe that they are not choosing to be silent but that they are physically unable to talk to certain people at certain times.
- Take away as much pressure as possible: do not to fire questions at them and try to use statements rather then direct questions: “I wonder if it is time for lunch?” This will allow them to be given an option and gives them a chance to make their own choices without being put on the spot.
- Build confidence and independence: do not avoid the situations they find difficult but make them easier to cope with. It is important to not to talk and make choices for them as this can take away their independence and reduce self-esteem further.
- Give praise and have fun: concentrate on having fun with your child and do not let them see you are anxious. Praise them for their efforts in joining in activities, for any vocalisations or non-verbal communication they use but do not show surprise or too much excitement if they speak.
Having a child who has selective mutism can be very difficult for parents because the condition is not well understated and can be difficult to diagnose. Often the child has no other identifiable problems as they talk freely at home, usually makes age-appropriate progress at school in areas where speaking is not required and when not required to speak can seem perfectly happy and carefree. A SLT can help to support both a child and family through the intervention process. Unfortunately, not also NHS services take on children with selective mutism and if they do there will likely be a long wait for your child to be seen this way. Alternatively, you can contact a SLT directly.
Integrated Treatment Services is a private Speech and Language Therapy service based in Leicestershire but offer therapy services across the East Midlands, Southern England, Northern England and Northern Ireland. Selective mutism is very complex and needs an experienced SLT to lead a programme of intervention; Integrated Treatment Services have highly experienced, specialised therapists to support you and your child. We have no waiting lists and a therapist in your local area can come and assess your child within a week of referral. We are also happy to offer therapy while you are waiting to be seen by an NHS therapist or can work along side any therapy your child may be receiving. You can contact us by calling: 0845 838 2921 or simply email:info@integratedtreatments.co.uk.
