Selective Mutism

What is Selective Mutism and How Can a Speech Pathologist Help?

Our children are all unique, complex beings, each with their own specific talents, strengths, challenges and fears. As dedicated parents we relish in the opportunity to celebrate our child’s progress and knowledge and support them through their challenges. Some difficulties are quite obvious and are, as a result, simple to solve. Some challenges, however, are more complex and difficult to navigate. Selective Mutism is one of those complex challenges.

Imagine your greatest fear – it might be snakes, spiders or heights. Now imagine how you look and feel when you are asked to face this biggest fear head on. For children with Selective Mutism, speaking to others can feel like facing your biggest fear – all the time. To help our children overcome such a fear, we need understanding, compassion and the right support. read on to find out more about Selective Mutism and how speech pathologists can help.

What is Selective Mutism?

Selective Mutism can be described as a child’s consistent difficulty to speak in social situations, such as school, church or within the community, despite speaking ‘normally’ in other situations in which they feel comfortable. This challenge to speak does not happen due to a lack of language or comfort in using the language. It can occur with or without the presence of an additional communication disorder. If left untreated, Selective Mutism can significantly interfere with education, occupational achievement, social skills and confidence.

What Does Selective Mutism Look Like?

Whilst the umbrella definition of Selective Mutism refers to a ‘consistent failure to speak in social situations’, this can look quite different within individual children. A child with Selective Mutism may present with any of the following characteristics:

  • Very talkative at home but does not speak to anyone throughout the school day
  • More comfortable speaking to adults than their peers
  • More comfortable talking to one or two friends but not their teacher
  • Whispering to everyone rather than using their regular voice
  • Does not speak to anyone, even immediate family
  • Appearing completely calm until expected to talk to others
  • Present as a ‘shy’ or ‘timid’ looking child
  • Difficulties in speaking for at least one month

How Common is Selective Mutism?

Selective Mutism occurs in up to approximately 2% of kindergarten children. A child will usually start to display signs of Selective Mutism at around 3 years of age and it often co-occurs with a child’s first introduction to structured care, such as Daycare or Preschool. Girls are also twice as likely to be affected compared to boys.

Research shows that over half of all children affected by Selective Mutism also have multiple diagnoses, such as social phobia, Autism Spectrum Disorder or a severe language impairment.

How Is Selective Mutism Diagnosed?

If you are concerned about your child’s speaking patterns, the first step is to book an appointment with a Psychologist. You will first need a referral from your GP. Your psychologist will discuss your child’s communication patterns, such as the places your child will speak, the people they currently speak to and how they communicate. You may be asked to complete parent/caregiver questionnaires and your Psychologist may observe your child during play. A full case history will help to determine co-existing conditions, such as speech difficulties and any previous strategies trialled. Discussions with the child’s main educator is also an important part of the process to gauge communication levels outside the home.

How Can a Speech Pathologist Help with Selective Mutism?

Whilst Selective Mutism is regarded as a anxiety disorder, it is also classed as a communication disorder. As a result, it is essential that a family’s Psychologist and Speech Pathologist work together when planning assessment and therapy support. Speech Pathologists can provide a comprehensive assessment of your child’s current speech and language abilities and rule out any underlying delays or difficulties. A Speech Pathologist may undertake the following assessments:

  • Talking with you about your child’s speech and language development
  • Having your child’s hearing screened
  • Receptive language (the language your child understands)
  • Speech sounds (if able)
  • Expressive language (your child’s use of language, including words and vocabulary)
  • Pragmatic language (use of social skills)
  • Examining you child’s mouth for underlying structural difficulties

How Does a Speech Pathologist Work with Children Experiencing Selective Mutism?

Whilst there is more research required in the area of Selective Mutism, three techniques have been highlighted as being most useful when working with children experiencing Selective Mutism. These include:

  • Shaping – for children who have difficulty communicating with everyone, this strategy is useful as it praises all forms of communication that the child uses. This could be blowing, whispering or producing sounds, working towards the goal of verbal communication.
  • Sliding In – For children who are comfortable speaking with one particular person (such as an immediate family member), Sliding In can be a way to gradually put the child the ease at including additional communication partners in the interaction. The session may start with the child and parent in the therapy room, with the speech pathologist outside. The speech pathologist will slowly move closer to the parent-child interaction, a process that may take minutes days or even weeks.
  • Self-Modelling – for children who can communicate verbally, this strategy involves recording the child at a time when they are speaking effectively, such as with an immediate family member at home, to increase self-confidence, with the plan of expanding this skill to other settings, such as school.

 

Because Selective Mutism is a highly specialised area, it is recommended that you seek a Speech Pathologist who has specific training and experience in the area. The Speech Pathologists at A Growing Understanding have undertaken advanced training in the area of Selective Mutism and have a strong understanding of how to tailor assessment and therapy options to suit your child’s needs.

Selective Mutism is a challenging disorder, often confusing and worrying for families. We encourage you to contact us if you have any concerns regarding your child’s communication skills, confidence or social skills. Click here for further information on Selective Mutism.

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