Selective Mutism

by Care Speech 
28 September 2022

What is Selective Mutism?

Some children are shy and don’t like to talk to people they don’t know. They start talking when they feel comfortable. When a child will talk in some places and not in others, and this starts to impact their ability to participate and socialise, this is selective mutism. It is very frustrating for the child and others around them, and it can be difficult to understand why this happens. This often starts when the child goes to school or day-care but can also occur in younger children.

What are the Signs of Selective Mutism?

It can sometimes be difficult to distinguish the reason that a child is not talking. Some of the indicators that it may be selective mutism are:

  • Your child does not speak at times when they should, like in school, and it happens all the time in that situation. Your child will talk at other times and in other places.
  • Not speaking gets in the way of school, work, or friendships.
  • The behaviour lasts for at least 1 month.
  • our child can use the language that they need in that situation.
  • Your child does not have a speech or language problem that provides another explanation for them to stop talking.

What are the Causes of Selective Mutism?

There is no one cause of selective mutism, however, the following things are thought to contribute to this condition:

  • excessive anxiety;
  • excessive shyness;
  • fear of embarrassing themselves; or
  • a feeling of wanting to be alone or isolate themselves from friends.

Assessment & Therapy for Selective Mutism

Assessment

Assessment is undertaken by a multidisciplinary team.

While the diagnosis of selective mutism is not the same as the diagnosis of Autism, the same collaborative approach is required for assessment and diagnosis. The multidisciplinary team that works together may consist of a paediatrician, psychologist or psychiatrist, speech pathologist, teacher, school social worker, and family. The parents play an important role in this team as they are the only ones who can provide a sample of the child talking.

The role of the speech pathologist

The speech pathologist plays an important role in assessing a child’s receptive and expressive language skills. This determines whether a language delay or disorder is contributing to the child’s difficulties with communication. The speech pathologist can involve parents by requesting a video recording of the child's communication at home and then compare that to communication in a clinical or school setting. Video recordings may also be used to analyse language later.

Therapy

Getting help early for children with selective mutism is important.

There are several therapy approaches used by Speech pathologists to help children with selective mutism:

  • Stimulus Fading: A new person is slowly introduced to an activity with someone your child is already comfortable with. This helps your child get comfortable with new situations.
  • Shaping: Praise or rewards are given for all attempts to communicate. Your child may first only point or use other gestures. Then, he may mouth a word, which means saying it silently or whisper it. This creates a positive association with communicating with the goal for your child to eventually speak in all situations.
  • Self-Modelling Technique: Children can watch videos of themselves talking in a comfortable situation. This may help them feel more confident about how they speak, leading them to feel more confident about attempting to speak.

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