Helping Your Child to Overcome Selective Mutism | Expert Says

 

Some children, although speaking normally in settings they are comfortable with, may face difficulty in verbalising when in specific social settings. This is selective mutism, a type of anxiety disorder (National University Health System, 2021). For instance, a child may be rowdy and chatty whenever they feel secure and comfortable eg in their own homes. However, the same child may be mild mannered or even silent in unfamiliar settings eg in school.

Selective mutism is a relatively rare condition that occurs during childhood. It affects approximately 1 in 140 children worldwide (National Health Service, 2019). If undetected or left untreated, selective mutism can persist into adulthood. Parents should, however, remain optimistic, as the condition can improve with appropriate help.

 

Why do some children develop selective mutism?

While it is unclear what causes selective mutism, it is unlikely to be just a single underlying factor. Recent research suggests that selective mutism seems to be associated with an underlying genetic predisposition to anxiety (Shipon-Blum, 2021). Simply put, these individuals have inherited a biological tendency to be more prone to experiencing anxiety. It is common for children to showcase signs of severe anxiety from as early as during infancy, in the form of separation anxiety, inflexibility, and so on.

Children who develop selective mutism tend to have an extremely shy and inhibited temperament (Janssen, 2020). In addition to that, research has successfully shown how children with such temperaments have a much lower threshold of excitability in their amygdala, an area in our brains that controls the “fight-or-flight” responses. When these children are placed in an unfamiliar social settings, such as the school or birthday parties, the amygdala receives signals of potential danger in the surroundings, setting off a chain of reactions that aims to protect the person. In such situations, feelings of fearfulness are elicited, which in turn triggers the “fight-or-flight” response, causing displays of selective mutism in the child (Child Mind Institute, n.d.).

 

Selective mutism and multi-lingualism

Interestingly, selective mutism seems to be more prominent among children who come from bilingual/multilingual families. However, this does not mean that bilingualism/multilingualism causes selective mutism. Instead, it could be due to the fact that children with inhibited temperament are faced with the added challenge and stress of having to learn a second language.

Elevated stress in addition to insecurity in their language skills can result in an increased level of anxiety, and subsequently selective mutism. As such, selective mutism is more commonly observed in children who are exposed to a second language during their linguistic developmental stages (Child Mind Institute, n.d.).

 

Signs & symptoms of selective mutism

Selective mutism usually begins during childhood around age 2 to 4. Typically, one would first notice it when the child starts interacting with non-family members, such as teachers and friends.

When unfamiliar people approach, a child with selective mutism may present the following behaviours:

• Avoidance of eye contact, freeze and stare blankly
• Refusal to follow the directions
• Nervousness, uneasiness, and appearing socially awkward
• Rude, moody, disengaged
• Clingy to parents/people they are comfortable with
• Shy and reserved
• Stubborn and aggressive

In mild cases of selective mutism, the child may still be able to communicate using hand gestures, speak a few selected words, or even whisper. They may even be able to effectively communicate with one or two selected friends or teachers. Nevertheless, children with more severe symptoms may stand motionless in fear, or appear expressionless and quiet in an unfamiliar surrounding (Shipon-Blum, 2021).

How selective mutism can affect your child

Behaviours that accompany selective mutism can significantly impact a child’s academic performance, especially when the child is cautious about drawing attention to themselves. They fear that by doing so, others will comment or try to get them to speak. Furthermore, the fear of making mistakes may hinder a child from raising concerns or asking questions in class, which in turn hurts their learning (Child Mind Institute, n.d.).

Selective mutism may also put a strain on social relationships, especially with non-family members. Refusing to talk or appear reluctant to engage in any reciprocal social interactions in unfamiliar settings may come off as rude, stubborn or even ignorant. As a result, these children experience difficulty in forming meaningful connections.

 

Tips for parents on overcoming selective mutism

It can be emotionally and physically draining to manage children with selective mutism. However, there is relatively good prognosis for selective mutism. In addition to seeking professional help, here are some ways which parents can adopt to aid your child in overcoming their fears and ease their levels of anxiety.

1. Reward progress and avoid punishment

   Punishing a child who is already extremely anxious and fearful may have the unintended effect of making them even more reclusive. Children with selective mutism are more receptive to praise than harsh punishment. Hence, parents can practice labelled praising (giving more specific praises that address the action or behaviour), like “Great job in telling us you want to play with the cars!” This way, the child will know what he/she is being praised for and in return, they feel more encouraged and confident to keep up the good progress.

2. Practice echoing

   Echoing refers to the act of repeating or paraphrasing what the child said – a comforting act to show them that they are heard and understood. This positive reinforcement also builds confidence, especially for children who tend to speak very softly, steering them to feel more comfortable to interact in bigger crowds.

3. Rephrasing of questions

   It can also be helpful for parents to rephrase questions, especially when in public, to invite a verbal response. Rather than “yes/no” questions that can be answered with nodding or shaking of the head, this can be done by asking your child more open-ended questions such as, “What would you like to eat for lunch?”

4. Notice your own reaction to your child’s silence

   As a parent who is witnessing a child struggling to verbalise an answer to a question, it may be instinctive for parents to speak up. However, a response like this may deter a child from overcoming selective mutism. Instead, a helpful response would be to prompt the child to repeat after the parent.

 

 

Services at Thrive Psychology Clinic

Here at Thrive Psychology Clinic, we provide tailored treatment plans for both children and adults. You can find the necessary resources to help parents better understand selective mutism. It is possible to overcome selective mutism if it is recognised at an early age and managed appropriately.

Common forms of therapy to help children with selective mutism include cognitive behavioural therapy (CBT) and behavioural management programmes (BT). CBT is useful to understand individual triggers and levels of anxiety in different social settings, before outlining strategies to cope with the anxiety. Meanwhile, BT uses a reward system to encourage progressive exposure to situations that trigger their anxiety and fear. For optimal results, it is crucial for the therapist to work closely with parents and school to progressively expose the child to situations and settings that stimulate the child’s communication with others.

 

A Word from Thrive Psychology Clinic

At Thrive Psychology Clinic, we are committed to providing effective and efficient support for every adolescent, child or adult in their mental health. If you believe that your child may be struggling with mental health issues, feel free to contact us via email: info@thrivepsychology.com.sg or call: 6962 9753 and we will be happy to assist you.

 

References

1. Child Mind Institute . (n.d.). Parents Guide: How to Help a Child with Selective Mutism. Retrieved from Child Mind Institute : https://childmind.org/guide/parents-guide-to-sm/
2. Hurley, K. (2018, September 26). Selective Mutism in Kids. Retrieved from PSYCOM: https://www.psycom.net/selective-mutism-kids
3. Janssen, A. (2020, September 18). What Is Selective Mutism? Retrieved from Very Well Mind: https://www.verywellmind.com/what-is-selective-mutism-3024702
4. National Health Service . (2019, August 27). Selective mutism . Retrieved from National Health Service : https://www.nhs.uk/mental-health/conditions/selective-mutism/
5. National University Health System. (2021). Selective Mutism . Retrieved from National University Hospital (Singapore): https://www.nuh.com.sg/Health-Information/Diseases-Conditions/Pages/Selective-Mutism.aspx
6. Penner, E. (2015, November 3). Dos and Don’ts for Parents of Children with Selective Mutism . Retrieved from Good Therapy: https://www.goodtherapy.org/blog/dos-and-donts-for-parents-of-children-with-selective-mutism-1103155
7. Shipon-Blum, E. (2021). WHAT IS SELECTIVE MUTISM? Selective Mutism – A Comprehensive Overview. Retrieved from SMART Center: https://selectivemutismcenter.org/whatisselectivemutism/

 

 

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Tags

• behavioural management
• cognitive behavioural therapy
• developmental disorder
• happy childhood
• parenting tips
• selective mutism