Selective mutism and anxiety: helping your child to cope

Selective mutism is an anxiety issue where someone is unable to verbalise in certain social situations but perfectly able to with more familiar acquaintances.

Refusing to talk in certain situations – selective mutism – is not quite the same as being shy. 

A child who refuses to talk when at school or with strangers may be perfectly happy to join in activities and try new things. Just not speak.

A shy child, on the other hand, will be reticent but perfectly able to speak, despite feeling nervous.

So a child with selective mutism (or SM) is not being awkward or making a bid for attention. It’s anxiety showing up in this particular way in a specific set of circumstances (that’s why it’s “selective”), preventing them opening their mouth to let words out. 

You could look at it as an "avoidance strategy" – and if it weren't worrying it would be admirable. That's because rather than becoming overwhelmed with anxiety and feeling unable to find the right words, the child decides they won't speak. Result? The anxiety diminshes and they feel better!

The problem here, of course, is obvious. It happens again and again. And ultimately affects socialisation.

So it's much better to find a strategy to enable your child to push through their anxiety and out the other side so they can talk confidently anywhere.

The key thing to help them learn, then, is that the situation isn't dangerous, just uncomfortable!

selective mutism2

Example

I once worked as one of the leaders in a family group setting – families coming together to work on a particular issue that they all had. One child was selectively mute. We decided not to pressurise them, not to draw attention to them, to treat them exactly the same as the other children in the group and to just engender trust by being relaxed and informal.

Before the series of sessions was over, it was wonderful to see that child taking their first steps to speaking to the leaders, albeit in a whisper and not publicly. Their family members were pleased. 

They realised that, as the child forged a way through the anxiety, the selective mutism would start to lose its grip. I’m convinced they’ll have gone on to totally solve their problems by now.

But what becomes obvious from this example is that applying pressure and focusing on the child’s refusal to speak is not the way to help them overcome their intense anxiety. 

Remember: selective mutism is a form of social anxiety. 

Not knowing what to say, worrying that you will say the wrong thing, and feeling frozen at the thought of speaking... It's like having a panic attack. Bodily symptoms can be the same too: palpitations, sweaty palms, feeling sick, that sort of thing. 

A small amount of anxiety is always good. It indicates the presence of danger. It keeps us safe. 

But if there isn’t much danger (like in a classroom and wanting to take part), then allowing that anxiety to stop us speaking isn’t helpful to our wellbeing. 

So how can you help your child speak out when they need to?

I’m not going to reinvent the wheel here. There’s an excellent website dealing with all aspects of selective mutism at SMiRA, where you can find as much help as you need.

But I will jot a trio of things down for you so you can get started.

1 If you’re not calm and self-soothed yourself, you won’t be able to soothe your child. 

Your child needs you to

  • stay calm,
  • accept the selective mutism without pressure,
  • liaise with school (see below) so the teachers are in on how to help your child best, and
  • go calmly with them to new places and on new visits so they have the soothing comfort of your presence while they adjust to the situation.

2 You can teach your child about how anxiety works, and how to control it, but with no pressure to magically be OK.

How does anxiety work? In a vicious circle.

The brain foresees a disaster, thinks negative thoughts, the body reacts accordingly, your child pulls out of the situation and immediately feels better – thus proving there was indeed something dangerous to avoid, which means the brain foresees disaster in that situation next time too!

How to deal with this?

Maybe say something like: “I know you can’t manage this yet at school, but let’s try something out at home.”

According to your child's age, you can learn and practise activities together like slow breathing, or blowing out “candles” on their fingers and thumbs. They then have a way to start self-calming in a situation where selective mutism is kicking in. 

You can encourage them to try the techniques without saying they must also try speaking!

These tools are super helpful in class when a child with SM is often anxiously watching to see if they’re going to be asked to say something or answer something.

If they can learn how to at least stabilise their breathing, they can get rid of some of the horrible symptoms of intense anxiety. Controlling their breathing rate actually brings their bodily systems back into balance or homeostasis.

3 Encourage other people to chat to your child without expecting a reply...

...and without drawing attention to the fact that they aren’t answering.

Your child will maybe point at something rather than answer verbally. Or will maybe have learnt to indicate understanding by nodding. They may not make eye contact – but do encourage visitors (privately!) not to feel snubbed by this.

Such “conversations” held with other people keep your child in the real world instead of being seen as (or thinking of themselves as) ill, weird or bad.

This will increase your child’s confidence that they can relax and work through the anxiety that's causing their selective mutism, (using the above breathing tools as a first strategy). 

It’s not that your child can’t speak – they clearly can if they talk loads at home! So others need to understand that your child is normal in every other way and give them lots of chances to join in when they feel ready – like the child in our meetings. 

Some research on help that worked for children

There's something called S-CAT – short for Social Communication Anxiety Treatment. It's been used in research with children and families with a selective mutism diagnosis. The treatment for SM was in fact an integration of S-CAT and some CBT elements and other factors.

Briefly (because you can read about it here), after 9 weeks of treatment, 40 children aged 5-12 showed significant gains in speaking frequency.

Interestingly, one of the contributing factors to successful outcomes was "family compliance" with the elements and games they were asked to pursue at home in between sessions.

As so often with anxiety problems, it's families to the rescue because you have so much opportunity to help and offer support for any treatment your child is taking part in.

How can you help the teacher help your child?

The Selective Mutism Association has a list of 9 tips you could share with a teacher if they seem to not understand how to help your child. Have a look and see if it offers you something to help the teacher help your child.

A book I recommend

Can I Tell You About Selective Mutism is written by Maggie Johnson and Alison Wintgens and published by Jessica Kingsley. It's excellent for reading with your child and has lots of advice (from a child's viewpoint) for teachers and others who deal with your child.

Perhaps I’d better mention again that I get no payment if you buy a book recommended on this site! But Jessica Kingsley does do a good line in the Can I Tell You series if you’re interested in other issues with a child.

cover of Can I tell you about selective mutism

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