Selective Mutism

Selective mutism is an anxiety disorder where a person is unable to

speak in certain social situations, such as with classmates at school or to
relatives they do not see very often.

A child or adult with selective mutism does not refuse or choose not to
speak at certain times, they're literally unable to speak.

The expectation to talk to certain people triggers a freeze response with

feelings of anxiety and panic, and talking is impossible.

Signs of selective mutism

Selective mutism can start at any age, but most often starts in early
childhood, between age 2 and 4. It's often first noticed when the child
starts to interact with people outside their family, such as when they
begin nursery or school.

The main warning sign is the marked contrast in the child's ability to
engage with different people, characterized by a sudden stillness and
frozen facial expression when they're expected to talk to someone who's
outside their comfort zone.

They may avoid eye contact and appear:

● nervous, uneasy or socially awkward

● rude, disinterested or sulky
● clingy
● shy and withdrawn
● stiff, tense or poorly coordinated
 ● stubborn or aggressive, having temper tantrums when they get
home from school, or getting angry when questioned by parents

More confident children with selective mutism can use gestures to

communicate – for example, they may nod for "yes" or shake their head
for "no".

But more severely affected children tend to avoid any form of

communication – spoken, written or gestured.

Some children may manage to respond with a few words, or they may
speak in an altered voice, such as a whisper.

Diagnosis in children

A child can successfully overcome selective mutism if it's diagnosed at

an early age and appropriately managed.

It's important for selective mutism to be recognised early by families and

schools so they can work together to reduce a child's anxiety. Staff in
early years settings and schools may receive training so they're able to
provide appropriate support.

Do’s and Don'ts for interacting with those with Selective Mutism:
When interacting with a child with Selective Mutism, DO:
● Allow for warm-up time.
● Monitor the child’s body language.
● Talk “around” the child at first with focus on parents or
siblings.
● Get down on the child’s level and focus on a prop.
● Ask choice and direct questions to the child with focus on the
prop.
● Allow for hesitation.
● Re-ask questions if needed.
● Accept nonverbal communication (e.g., pointing, nodding,
gesturing) without an expectation for speech.
● Accept the child’s level of communication as the first step to
securing comfort.
● Understand that strategies can be used to help the child
progress into speech, and that developing the child’s comfort,
engagement, and nonverbal communication is a vital step in
the process.

When interacting with a child with Selective Mutism, DO

NOT:
● Try to be “the one who gets this child to speak.” These efforts
did not work in the past, are not working now, and will never
work in the future!
● Disregard warm-up time.
● Approach the child without preparation.
● Look directly at the child without focusing on a prop.
● Ask open-ended questions, which require the child to think in
order to formulate an answer.
● Ask, bribe, or beg the child to talk to you.
● Appear upset if the child does not respond to you.

What activities can you do with selective mutism?

● ROLEPLAY
● NOISY GAMES/MUSICAL INSTRUMENTS
● PLAYING WITH PUPPETS
● READING STORIES TOGETHER
● SINGING, RHYMES AND COUNTING
● ENCOURAGE THEM TO PAINT AND DRAW
● TALK ABOUT EMOTIONS