What is Selective Mutism? Have you heard of it? I certainly had not until my son was diagnosed with it 2.5 years ago.
What is Selective Mutism?
“Selective Mutism is a complex childhood anxiety disorder characterized by a child’s inability to speak and communicate effectively in select social settings, such as school. These children are able to speak and communicate in settings where they are comfortable, secure, and relaxed.”
Over 90% of children with Selective Mutism also suffer with social anxiety. It goes way beyond being shy, a child with Selective Mutism simply cannot respond or make conversation with someone with whom they are not comfortable.
Not all children manifest their anxiety in the same way. Some are completely mute in a social setting. While others may be able to talk to one or two people in whisper. My son is able to talk to kids his own age, but he cannot talk to adults with whom he is not comfortable. With M, the more pressure he feels to talk the more anxiety he feels.
Selective Mutism usually develops in children with relatives with the disorder or that have extreme social anxiety. Approximately, 1% of children have Selective Mutism and it usually manifests around age 3 or 4.
Although, in some cases, like that of my son, kids are not diagnosed until much later.
M has always been different than my other kids
M has always been a quirky child. He was completely different than my 2 older kids. He always had trouble falling asleep, but loved to sleep late and never wanted to wear clothes. He was completely happy to spend all his time with his mommy. He never talked to people outside of the family but we thought he was just shy and needed more chances to practice.
At age 4 we enrolled him in preschool. It was a total disaster. That year we found out how deep his “shyness” ran. It was a fight to get him out the door every single day. He did not speak to his teacher once. We knew that M was super stubborn, but this was more than that.
We took him to the doctor. According to her, M was just shy and he’d grow out of it.
At age 5, M started kindergarten. Nothing changed for him, except now I was forcing him to go to school every day instead of twice a week. His teachers said he was fine once he got to school, so once again we thought he was just been stubborn. He didn’t like getting up in the morning nor did he like wearing clothes, that must be why he didn’t want to go to school.
Grade 1 wasn’t any better. His teacher didn’t seem to notice that he wasn’t speaking in class. He seemed happy, he wasn’t causing any trouble, so he was basically overlooked.
When we moved things started to change
Due to other circumstances, we moved before he started grade 2 and we started homeschooling him through a DL that year. This is when I really noticed that something was not right with him. He never ever talked to anyone outside of the family, even when we tried forcing him (which was really the wrong move on our part!). He wasn’t able to do his work without me sitting beside him. He was terrified that he would get an answer wrong.
We finally were able to get him assessed at the end of grade 3. He was diagnosed with general anxiety and Selective Mutism. My first thought was what in the world is Selective Mutism?!?! For four years we tried to figure out what was wrong with our son and not once had we come across this term nor had anyone ever mentioned it.
M is now in grade 5 and has been in therapy for over a year and a half. He has come a long way since he was first diagnosed. He has been working with a fabulous Speech Therapist. Even though she had never worked with someone with SM before, she worked very hard to establish a rapport with M and to figure out how to help him.
The following is the plan we worked out to assist M in learning to talk to people again.
M, myself, and M’s SLP made a list of of activities that we all would like him to be able to take part, without anxiety. We used a fear ladder. The first time we used a fear ladder, we only wrote down one thing, TALK OUT LOUD AT SPEECH THERAPY. After we decided on the task we wanted M to work on, we set a number of steps he would take to accomplish his goal.
This is what M’s Selective Mutism Therapy looked like
- Make brief eye contact throughout the appointment.
- Wave hello and and goodbye.
- Whisper answers to mom with the SLP in the room.
- Nod or shake his head to answer SLP’s questions.
- Make affirmative and negative noises in the back of his throat to answer yes or no questions.
- Whisper one word at the appointment.
- Whisper loud enough that the SLP could hear.
- Start talking out loud.
With every step he passed he got rewarded. Sometimes a cookie from the bakery, sometimes a candy or a basket of berries, sometimes a lego figure. He enjoyed getting the rewards so he worked hard to pass each step. Sometimes he passed more than one during an appointment. He got such a sense of satisfaction from his accomplishments, which prompted him to want to keep going.
Now 6 months later, we’ve gone through several more fear ladders and M is learning to talk to people one step at a time. It’s not a quick fix, but it’s working.
Do you have a child with Selective Mutism or anxiety? What has helped your child? Do you have a therapist that has worked wonders with your child?