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What is Selective Mutism and How Is It Treated?

Selective mutism is a condition in which a child can speak well in situations in which they are comfortable such as at home with parents but stop speaking in certain situations like at school or kindergarten. Selective mutism can also affect adults. The pattern of speaking will vary from child to child but most have a very limited range of people they will speak to. The condition is usually first noticed when the child starts school or kindergarten. Some children are described as overly shy or slow to warm up at first. However, over time it becomes clear that the child refuses to speak to teachers and some or all students. A thorough assessment by a child psychologist and sometimes also a speech pathologist is needed to rule out other conditions that might better explain the lack of speech. The good news is that children with Selective Mutism are often good learners and are well liked by their peers because they are less distracted in class and tend to be kind, gentle children. That's not to say that they don't make up for it with tantrums at home when they frustrations of the day can be let out.

Since Selective Mutism can vary an individualised approach to treatment is needed. Behavioural interventions that promote and reward increasing attempts at communication are the most promising. Sometimes medication is suggested by a paediatrician or psychiatrist if the child is older and has suffered from Selective Mutism for a long time or has other anxiety. Behavioural approaches should generally be co-ordinated with the child's support team so that everyone is working towards the same goals. This team can include the child's psychologist, parents, teacher, teacher aide, guidance counsellor, principal or deputy principal paediatrician or psychiatrist. However, not all parties need to be involved on a regular basis. Only those working directly with the child to intervene and help the child communicate. Earlier intervention is best for children with Selective Mutism before strong patterns can be established.

One of the most important things to do with a child with Selective Mutism is not to panic and force them to talk. I always say to parents, you can't force a child to eat or talk. It just doesn't work. Instead take the approach that it is okay that they aren't talking right now and that one day they will feel like talking and we are here to help. Let the child know that lots of other children feel the same way about talking and have learned to talk more and more over time.

Reference: McHolm, A. E., Vanier, M. K., Cunningham, C. E. (2005). Helping Your Child with Selective Mutism. New Harbinger Publications, California.

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