How to interact with a child suffering from Selective Mutism

Is your child so ‘shy’ that they do not talk at school? Or maybe they talk to children but not adults, or vice versa. It may be that they have Selective Mutism (SM).

SM is an anxiety disorder which affects approximately 1 in 150 children. It is essentially a phobia of talking – children with SM want to talk but they can’t. Children often report feeling like their voice is ‘stuck’ or that their throat feels tight and the words cannot come out. These children talk comfortably at home, often described as loud and confident at home but freeze when they go to school. SM is place and person dependent – children can speak in certain places but not others, and similarly they can talk to specific people but not others. SM is highly treatable through appropriate therapy. Interventions focus on reducing the child’s anxiety levels, helping them to feel at ease, while gradually exposing them to talking.

It is so important that everyone who regularly comes into contact with the child, in and outside school, is aware of how to interact with a child with SM, this will create a supportive environment for the child.

The following are the do’s and don’ts of how to interact with a child of SM.

  1. Do not tell the child to speak to you or draw attention to their lack of speech 
    Never say to a child with SM ‘are you going to talk to me today?’
    Children with SM want to talk but as discussed they cannot. Their level of anxiety is so high that words just cannot come out. Drawing attention to their lack of speech only increases their anxiety, making it harder for words to come out. Our aim is therefore to make the child feel as relaxed as possible and remove ALL pressure to speak. Ironically, this puts the child in a stronger position to verbalise.    
  2. Do not give the child over the top attention
    Children with SM are often very self-conscious and do not like being the centre of attention. Treat the child exactly the same as you treat the other children. It is tempting to give the child extra attention because they do not speak but this is often counter-productive as being the centre of attention adds to the child’s anxiety level.
  3. Do not tell the child off for not talking or act frustrated by their lack of speech
    The child does not deserve to be told off, they are not being defiant or stubborn, they want to talk but they cannot. 
  4. Do not ask the child direct questions
    School staff sometimes ask the child questions, hoping that finally the child will answer. If the child has never spoken to you, they will not answer your question. Asking a question draws attention to their lack of speech, which only increases their anxiety, making it harder for them to speak.   When interacting with the child, it is effective to take part in a running commentary without any requirement for the child to speak. Essentially the person should describe what they and the child are doing.
  5. Avoid direct eye contact with the child
    Direct eye contact increases the child’s anxiety levels and implies an expectation of a response and can thus make the situation a lot scarier for the child. Of course, looking at the child is fine however, avoid staring directly into their eyes.
  6. If the child talks to you, don’t act surprised or instantly praise them
    When the child speaks for the first time, this is often a very exciting moment, however it is important not to convey this to the child but to act completely normal when they speak. This way they will see that talking evokes a normal response and is not as scary as they may have been anticipating. Therefore, if the child speaks do not draw attention to the fact that they have spoken, but instead respond in a calm and friendly manner.

The above do’s and don’ts create a non-pressured environment – this is the starting point required to put a small steps intervention programme in place to gradually expose the child to their fear of talking. There needs to be a clear plan for both school and out of school situations. With the teacher and keyworker leading the school programme and the parents leading the out of school exposures. The key is that the child should start to face their fear of talking in a systematic way in small manageable steps.

With a warm and understanding teacher the child with Selective Mutism can start to show more of the happy and confident child they are at home, at school. 

Written by Lucy Nathanson www.confidentchildren.co.uk 

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