Friday, August 5, 2011

Selective Mutism


            James is a boy who kept quiet in school.  It’s not that he cannot talk.  At home, he talks to his parents and siblings.  It’s just that he did not talk in school and in public places.  The first few years he attended school, his teachers tolerated his silence.  As he got a bit older, however, this became a bigger problem.  As his teachers graded students for recitation and other oral requirements, he remained quiet and consequently was not given a grade. 

            This is an example of a child who has Selective Mutism.  This is a condition where a child or adult remains silent even in situations that require them to speak.  For many children who have this condition, they typically do not speak in school but have regular speaking voices at home.  Oftentimes, these children are also quite shy and demonstrate behaviors related to fear and anxiety, such as, standing still and having a blank expression on their faces.  They have a hard time saying what they need to say. 

            Selective Mutism is currently understood as a form of anxiety disorder.  That means, children who cannot speak have anxious feelings that they cannot manage well enough, so their capacity to speak is hampered.  This seems to be related to a basically shy temperament that these children inherently possess.  Whereas science still does not fully understand the real cause of such behaviors, we do know that the children are not intentionally doing this as a form of resistance or rebellion, and that these behaviors do not appear to be linked to trauma or experience of abuse. 

            Some people wonder if these behaviors are self limiting, and would resolve on its own when the child gets older.  While there are instances when children who had Selective Mutism when they were younger eventually learned to speak in places and with people they did not speak before, there is no certainty that this will happen to all children with Selective Mutism.  In fact, there are times when Selective Mutism carries over until one’s adulthood, and the individual learns to cope with not speaking in many public situations. 

            The impact of Selective Mutism on the development of an individual is great, as children often learn to make friends as they start to go to school.  The socialization that happens in school provides important life experiences for children to learn how to interact with peers and other adults.  When children are too shy, even anxious, to speak and interact with others, they are also excluding themselves from opportunities to initiate and sustain friendships. 

            One of the first things that help these children is when parents recognize the situation early enough and seek professional help for it.  With at least one parent’s assistance and the family’s involvement, treatment can proceed using various techniques.  Many of these techniques often begin with helping the child become comfortable in the situation where he/she is not speaking.  In small, incremental steps that do not significantly heighten the child’s anxiety, the child is encouraged to make a sound, to whisper a word, to whisper some more, until such time that the child is comfortable enough to speak.  Sometimes, humor is used to get the child to feel comfortable.  They might be rewarded for doing these incremental steps, but never in a way that puts them in a spotlight, as that might further heighten anxiety.  They might also be taught techniques in helping themselves feel more relaxed.  Many times, this journey takes a long time, but it is often worth the time and effort. 

            As James received help from his family, school, and psychologist, he eventually started to whisper, and then to speak; at first, to one classmate, and then later to a few others.  He is now a teenager who enjoys sports and the company of his friends. 

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