Selective mutism is often frustrating for both the child and the parent. It might seem that your child is being defiant or manipulative, or trying to control the people around him. Instead, children with selective mutism are often just as frustrated and disappointed in themselves as you are in them. Practice acceptance and understanding while helping your child learn to overcome his difficulties.
Understanding Selective Mutism
Selective mutism occurs when a child who has no physical impediments to speech suddenly stops speaking in some situations. According to the American Speech-Language-Hearing Association, common scenarios involve selective mutism in school or public settings, while the child continues to talk to relatives or friends. SelectiveMutism.org notes that children with selective mutism often have a phobia of speaking, particularly to those they just met. The condition normally begins before age 5, although it might not be recognized until the child goes to school.
Play therapy can be the most effective treatment for very young children. In play therapy, the therapist enters the child’s world by engaging in play alongside her. Play therapists provide a wide variety of toys and games, allowing the child to become absorbed in whatever play most interests her. During the initial sessions, the child takes the lead, involving or not involving the therapist as she feels comfortable. Later, when the therapist gains trust, he takes a more active role in suggesting therapeutic play activities to the child.
Stimulus fading is a behavioral technique in which the child begins speaking with someone she trusts, such as a parent or close friend. This person then introduces someone else into the conversation, usually a "keyworker," perhaps a trusted staff member at the child's school. At first, the keyworker remains outside the room but within the child’s view. If the child keeps talking, the keyworker gradually moves closer, eventually joining in the dialogue. Over time, more people can join the conversation, but should not overwhelm the child.
Shaping is a behavioral technique that begins with nonverbal communication, which is acceptable at first. As the child grows comfortable with head shakes or nods, parents or counselors can ask him to point to responses on a card. When he is comfortable with that, he moves up to one-word answers, and then gradually meets expectations with longer sentences, conversation initiation, appropriate vocal tone, and inflection. Rewards at each step help the child.
Practice is the best reinforcement for any new behavior. Enlist your child’s teacher to work on shaping and stimulus fading in the classroom. In public settings, ask your child to participate in conversations at whatever level she is currently comfortable. For example, if she is able to point to response cards at school, ask her to point to menu items in a restaurant. Encourage her to use nonverbal or one-word responses to strangers, and reward her for her efforts.