By Marie Tsilimos
What is Selective Mutism?
Selective Mutism (SM) is a relatively rare anxiety disorder that causes children to experience difficulties when communicating in certain social situations such as at school, with relatives or friends. Children with Selective Mutism typically speak in situations where they are comfortable, such as at home with family members and siblings or with select people. Selective Mutism is usually diagnosed between the ages of 3 and 6 years, however children can often be misdiagnosed or go through school undiagnosed.
Common Characteristics
- Consistent refusal or fear to speak in certain social situations.
- Physical symptoms of Anxiety.
- Excessive shyness or self-isolation from social situations.
- Oppositional Behaviour.
- Difficulties with the development of speech and language skills.
- Non-verbal communication such as gesture is used in situations where they have difficulty speaking.
The Do’s and Don’ts for Parents, Teachers, and Professionals
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Functional Impacts of Selective Mutism
- Difficulties attempting or completing classroom tasks such as answering questions, reading aloud, or participating in group work.
- Inability to express needs and wants to their teacher e.g. asking to go to the bathroom, letting the teacher know when they feel sick or have hurt themselves.
- Difficulty initiating and maintaining conversation or play with their peers.
- Difficulty forming and maintaining peer relationships.
- Difficulties with learning and developing literacy skills required for reading and writing.
What can Speech Pathologists do?
- Speech Pathologists can conduct an in-depth assessment of the child’s communication skills including receptive language (understanding of words and language), expressive language (use of words and language), pronunciation, play and social communication, attention and listening skills.
- Speech Pathologists can work with families to help them obtain a language sample through storytelling or ask the parents to send through videos of the child in order to assess the child if they do not speak to the clinician.
- Speech Pathologists can provide the child, families, and teachers with non-verbal forms of communication such as pictures or gestures to encourage communication as the child works toward verbally communicating.
- Speech Pathologists can facilitate structured activities either with the family or at school where the child is provided with opportunities to communicate in small groups where they may feel more comfortable.
- Speech Pathologists can help to create a behavioural intervention program for the child as well as assist with targeting any underlying speech and language difficulties.
- Speech Pathologists can liaise with school staff and families to provide strategies such as offering choices, tips to develop the child’s confidence and other ideas to encourage engagement and communication in all environments, to ensure the success of intervention.
References
Catchpole, R., Young, A., Baer, S., & Salih, T. (2019). Examining a novel, parent child interaction therapy-informed, behavioral treatment of selective mutism. Journal of anxiety disorders, 66, 102112. doi: https://doi.org/10.1016/j.janxdis.2019.102112
Cleator, H., & Hand, L. (2001). Selective mutism: How a successful speech and language assessment really is possible. International journal of language & communication disorders, 36(S1), 126-131. doi: https://doi.org/10.3109/13682820109177871
Jemmett, M., Lanes, D., Jones, K., Bramble, D., Firth, C., Sage, R., … & Katz-Bernstein, N. (2014). Tackling selective mutism: A guide for professionals and parents. Jessica Kingsley Publishers.
Kovac, L. M., & Furr, J. M. (2019). What teachers should know about selective mutism in early childhood. Early Childhood Education Journal, 47(1), 107-114. doi: https://doi.org/10.1007/s10643-018-0905-y
Rozenek, E. B., Orlof, W., Nowicka, Z. M., Wilczyńska, K., & Waszkiewicz, N. (2020). Selective mutism-an overview of the condition and etiology: is the absence of speech just the tip of the iceberg?. Psychiatria Polska, 54(2), 333-349.