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3 Important Things I Tell Parents and Carers of Children With Selective Mutism

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In my job as an educational psychologist, I’m pretty used to delivering presentations on many topics to varied groups. For me, usually it goes like this:

1. Prepare: power point, timing, interesting facts and amusing anecdotes. Learning is fun!

2. I am petrified and I know I can’t do it. My throat closes, my mouth is dry, my hands won’t move, I think I won’t be able to talk. Learning is not fun!

3. I do it and surprisingly, as I get into the swing, I feel really relaxed and confident.

4. It is over. It went well. I haven’t publicly embarrassed myself. I feel the buzz.

Wow, I could do this every day!

And that was my usual pattern until I spoke at a local university to parents and carers of children with selective mutism.

1. I prepared well — check.

2. I felt petrified — check.

3. I presented confidently — check.

4. The audience cried… Oh no…

So what went wrong? To understand that, you need to understand selective mutism or SM.

SM is a clinically recognized (DSM-5 and ICD-10) chronic anxiety disorder in which children and adults can speak fluently and confidently when they are relaxed (usually at home), but are physically unable to speak when they are anxious (usually at school or in public). The inability to talk cannot otherwise be explained by an underlying cause such as a speech and language disorder or autism, and it persists for longer than a month (two months for a bilingual learner).

Selective mutism used to be called “elective mutism” and, in the past, it was thought that children who were literally “struck dumb” in certain settings were manipulative, over-indulged by their mothers (that old chestnut!), foreigners (that old racism!), had a learning disability (that old discrimination!) or they just chose not to speak out of  “Dumb Insolence” (that old slack parenting!).

It’s not ideal that this clinical disorder is now called “selective” because, like the term “elective,” it still suggests choice, but one day soon I guess the popular label “situational mutism” will be widely used to underline that it is the situation, combined with the anxiety, that robs the child of a voice.

So… what happened to my audience?

Firstly, let me backtrack to how presentations go for me and for many other people:

Stage 2: I anticipate all of the symptoms of stage fright. I get worried that the stress of the situation will alert my amygdala (two little almond-shaped bits of the brain responsible for emotional regulation) into triggering the hard-wired fight, flight, freeze response and I will respond with the “freezing” bit.

My heart will race, my muscles will tighten, my mouth will go dry, my hands will sweat and I will be unable to speak. I will look and feel silly in public.

We’re great at this response. In fact it’s the fastest thing we do. It’s kept us safe from predators for generations and people who didn’t rock at this just got eaten, so your ancestors were definitely good at it. And there’s no thinking it through. If a threat appears, we react in milliseconds — long before our neocortex at the front of our brains slowly ambles up and says, “Hey…chill…it’s a rope, not a snake…lol.”

Children with selective mutism are extra anxious and react to perceived threats much more quickly. Their capacity to talk shuts down as they freeze. They might not look anxious, though they often have a “mask” face or a nervous smirk. They might seem stubborn but they’re not — they’re desperate to talk. And while they’ll improve with the right help, they often get worse if pressured to talk. Remember the, “Don’t Mention the War!” comedy sketch? Well it’s a case of “Don’t Mention the Talking!” The key to progress is taking all pressure off talking and go all out to gently increase their confidence in any other direction.

And that brings me to my audience…

Anxiety tends to run in families, so it’s no surprise these parents, grandparents, aunties and uncles I was addressing didn’t want to answer questions or debate the topic. They were desperate for help and information and heartbroken their bubbly, chatty child would wet herself in school because she couldn’t ask to go to the toilet or break her arm at Brownies and not cry. Without information, they firmly believed somehow, although they couldn’t think how, this condition was their fault. They were crying with relief.

Well after all these years in the job, I’m still learning. So, I now begin presentations with the important bullet points:

1. Your child has selective mutism which is a clinically recognized anxiety disorder.

2. It is not your fault.

3. With the right support, they will get better.

October was Selective Mutism Awareness Month. Please don’t pressure a child with SM to speak. Just look out for their other super powers.

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Getty image via djokovicdjordje

Originally published: January 26, 2018
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