The term selective mutism describes the behaviour of children who are able to speak but remain silent with certain people or in certain settings. It is a form of social anxiety.
Some children may choose to speak to specific friends, but not adults, others may only communicate in whispers when in certain settings like school, on the telephone, birthday parties.
Children with selective mutism are often misunderstood and may be wrongly punished for their inability to speak and communicate. Others are misdiagnosed with speech and language difficulties; autism, oppositional defiant disorder, or learning disabilities.
Children with selective mutism should not be forced to speak, as this leads to worsening of anxiety. Selectively mute children are not manipulative, nor are they developmentally delayed; they are simply too anxious to speak. It is most commonly noticed when a child joins a school.
There’s a variety of causes of selective mutism but as it is a phobia, most are associated with anxiety. Children literally become too distressed to speak.
Some children have trouble processing sensory information like loud noises and can shut down when overwhelmed. If a child has a speech and language disorder or hearing problem, it may also contribute to making speaking stressful.
There is no evidence that children with selective mutism are more likely to have been abused, neglected or suffered trauma than other children.
The diagnostic criteria for selective mutism are:
1 in 140 children are selectively mute and it occurs more in girls than boys, particularly girls who are learning a second language. Selective mutism starts in childhood, usually between the ages of 2 and 4 but may persist to adulthood. When it persists for a long time teachers and parents may experience high levels of frustration and even anger.
Children tend not to simply grow out of selective mutism, so when the condition persists a planned approach is usually helpful.
Approaches and interventions, which require patience, time and imagination, tend to work best when they occur in the places where the child does not speak. However, the involvement of the parents is critical. It is not helpful to insist a child speaks.
It is essential that all adults who come into contact with the child are aware of the difficulty. They must not react excessively when a child speaks in a social situation, even by praising it, as this will add to the child’s self-consciousness.
Teachers and support assistants can:
The speech and language therapist, educational psychologist or Child and Adolescent Mental Health Services (CAMHS) may be involved in planning an intervention programme for the child. Parents and others, with whom the child does speak, should be involved, but the targeted activities should be carried out at school. As more speech emerges, other people may be involved gradually.
This disability is usually overcome, but the best chance the child has is when the school works closely with parents and outside support services.
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