Association of Chief Psychologists with Ontario School Boards

 

 

LEARNING CHALLENGES:
selective mutism: suggestions for teachers

*Note: this article has been translated into French and can be downloaded here.

Typical Characteristics of Selective Mutes

These children do not speak in many social settings, particularly at school, even though they may use normal speech and language at home. They may be withdrawn and exceptionally shy at school and generally do not speak to teachers or classmates. Selectively mute children may or may not actively participate in non-verbal classroom activities, and may appear anxious or nervous in various situations. They are often accepted and well-liked by their peers, who may speak for them. Selective mutism is most common in the first two years of school, and is rare beyond that.

Approaches to Treatment

There are several reasons why children may not speak, and it is therefore important to determine, where possible, the specific factors for each child. Consultations with community professionals and others who know the child well (for example, physicians, teachers, school support staff, etc.) are important sources of information for distinguishing among extreme shyness, cognitive disability, language impairment, emotional distress, and so on; the reasons for the lack of speaking will likely determine the nature of the intervention undertaken. It is important to intervene with selectively mute children for at least two reasons: failure to do so may have long term negative ramifications in later childhood, adolescence, and adulthood; and proper intervention is usually successful, resulting in better social and academic functioning for the child.

The treatment approaches outlined in this document are psychological in nature, and assume that the basis for the child's selective mutism is his or her anxiety. Other approaches might propose pharmacological intervention, or speech therapy (for serious articulation and stuttering problems), for example. Psychological intervention views these children not as stubborn or non-compIiant, but as having an anxiety disorder or an acquired fear, rather than an oppositional or defiant disorder. These children know that they are afraid, but usually can't explain why. Selectively mute children vary considerably in their personality, temperament, academic capability, and communication style; therefore, treatment approaches vary. Change is likely to occur slowly; appreciating this can reduce adults' frustration and impatience with the child.

General Guidelines:

Most selectively mute children want to talk, but their anxiety about doing so is debilitating. It is important to proceed slowly and gradually if progress is to be made. I suggest taking the child aside in a safe, private, and comfortable environment and do the following:

1. Explain that you understand that speaking at school can be a frightening thing for some children. Try to communicate your empathy about what it is like to be scared.
2. Ask the child if he/she would like to be able to speak at school sometime in the future.
3. When the child indicates that this is the case, offer that you would like to help him/her accomplish that goal, that you know it might take some time, that it can be a difficult thing to do, that you will move slowly and gradually, that you won't force him/her to speak until he/she is ready, and will not allow anyone else to do so, and that you are confident that the child will be successful in achieving his/her goal.
4. Try to determine which settings and situations are the most difficult for the child, which are easier, and what would be helpful in their attempts to speak. For example, the student may feel less anxious when sitting in a bean bag chair in the resource centre, or if there is soft music playing, or if a particular adult is present. The most difficult might be in a noisy classroom in front of all his/her classmates. This "anxiety hierarchy" varies widely and you should never assume that one situation is more or less anxiety-producing or difficult. Have the child describe situations to a parent or another adult, who will provide you with the information. This is difficult for young children to do, and some careful questioning is needed.
   You need to establish a "safe" environment for the child; your expressions of warmth, support, and encouragement will go a long way towards providing this. When the child "trusts" you, you can then begin the process of encouraging speaking at school.
   Work from the identified "anxiety hierarchy", beginning with those situations which are the least feared by the child, and very slowly, when spoken language is well-established in those situations, begin to expect and require it in the settings which were identified as most anxiety-inducing. For example, you might determine those settings in which the child will talk (e.g., to his/her teacher alone in the hall with no other children around). Then gradually increase your expectations for the child to talk in situations that resemble the "safe" situation, for example, in the hall but closer to the classroom door, rather than 20 meters away.

Specific Techniques:

Encourage non-verbal activities with adults; provide opportunities to talk but don't force it (e.g., puzzles, board games). Involve the child in all regular group activities.
Support all attempts at verbal participation, but initially accept non-verbal attempts at communication (gestures, pointing, nodding, written notes).
Gradually increase the expectations for verbal communication (mouthing the words; respond by saying "yes" or "no" only; whisper in teacher's ear; whisper to a classmate out in the hall; etc.); over time, you can start to ignore the non-verbal interactions, and respond positively only to attempts at verbalization. However, ignoring other than verbal responses should begin only when the child has spoken to you several times over a period of at least a week, to ensure that he/she feels safe using words with you, even if those situations are limited and restricted.
Gradually phase out your responding to non-verbal overtures; don't stop completely and suddenly, but be selective about those occasions when you will respond. Continue to allow the child to respond verbally to you in those "safe" situations (e.g., out in the hall). Permit the child to speak to you and others from behind a closed door or a screen initially. Do not insist on eye contact.
Be cautious about the exuberance of your praise for vocalization: you don't want to increase the child's anxiety by making a public spectacle of him or her when speaking does occur; praise privately but sincerely. What you want to project is the notion that speaking is normal and expected; you don't generally lavish public praise on other children who speak, so don't do it with selectively mute children.
The child may be willing to sing rather than talk (e.g., O Canada with the rest of the class; group songs involving gestures, movement; alphabet song, etc.).
Do not use punishment or bribery to try and get a selectively mute child to speak. This will usually increase the anxiety level, undermine the sense of security, and increase the reluctance to speak in the absence of the bribe. Incentives rarely work to get a non-speaking child to speak; however, if the child is already speaking in a particular setting, incentives can be used to increase the number of words spoken.
In settings where the child seems at ease, speaking should be encouraged through such tasks as reading or story-telling. Consider using an older student who pairs up with the selectively mute child as a "reading buddy".
Consider the use of hand puppets, particularly if the child can be out of sight of others. In this way, the puppet is talking, not the child.

Shaping Vocal Responses:

Accept successive approximations to the desired response. "Shape" the behaviour that you want by gradually raising your requirements. For example: to the teacher alone:

1. child mouths the word "book"
2. whispers the word "book"
3. whispers, "I need a spelling book"
4. whispers the whole sentence but says the word "book" aloud
5. says the whole sentence aloud

Then, in class in the presence of others: same sequence as above.
Once the child has demonstrated some willingness to speak in the classroom, gradually expand those settings in which speaking occurs (for example, the hall, the gym, the lunch room, the yard). That is, provide "windows of opportunity" to speak.
Consider sending the child on errands in the school (e.g., to the office) where there is an requirement for some speaking.

Taping:

Consider allowing the child to audio or video tape him/herself at home (for example, reading aloud or talking to family members); listen/view the tape and respond with appropriate praise, comments.
Do not play the tape for the rest of the class unless you have the child's and parent's permission to do so; sometimes playing the tape is an effective way of letting the other children in your class know that the selectively mute child can talk, is bright, is "normal", etc.
The child may be willing to make tape recordings at school, e.g., in a private room other than the classroom; allow him/her to do this completely by him/herself at first, and gradually secure the child's permission for the teacher or trusted adult to get closer as the taping is taking place (for example, waiting outside the closed door of the room; then waiting outside while the door is open a little bit; then later, waiting outside with the door open a lot; then with the adult in the same room but away from the child and not interacting with him/her while he/she reads, etc.; then sitting beside the child).

Planning for Next Year:

It is important that there be a liaison with next year's teacher. He/she should be brought "on board" as soon as possible, and ideally should be flexible and unlikely to view the child's behaviour as oppositional or a personal affront. The child should have the opportunity to become familiar with next year's teacher and classroom prior to the commencement of school in September. This can be accomplished by having the child and parent visit the classroom in late August. The teacher should meet the child outside the building, perhaps in the playground before the classroom visit occurs.

Support at Home:

While most selectively mute children speak at home, the parents should be careful not to increase the child's anxiety about not speaking at school by asking, "Did you talk at school today?". Don't make a big deal of it. When the child reports that he or she did in fact speak at school, parents should respond with pleasure and reassurance of their confidence in the child's ability to do so, but treat it as though it's an expected and normal event. Again, avoid punishment and bribery as techniques for encouraging speaking at school.

Some children will talk easily in the presence of parents and siblings, but not when strangers are present in the home. Therefore, parents can help by having familiar visitors at home to help the child speak with others in a non-threatening setting. One of these visitors could well be the child's teacher. Additionally, consider having the child's parent accompany him/her in the classroom, for example, as a volunteer, for a few weeks, gradually decreasing the amount of time spent in the room.
There is a support group for parents (The Selective Mutism Foundation). Information is available from Sue Newman Leszczyk, Box 450632, Sunrise, Florida 33345.

General Techniques to Help Reduce Anxiety:

1. teach deep breathing, muscle relaxation, stretching, mental imagery, problem solving skills, coping with peer pressure, positive self-talk
2. provide reassurance and encouragement
3. seek creative outlets (music, art, athletics)
4. increase student's level of physical activity
5. be an active and understanding listener
6. don't dwell on mistakes
7. avoid derogatory labels
8. encourage social interaction
9. acknowledge the anxiety and deal with it, rather than denying it
10. avoid negative self-talk ("l don't know this stuff", "I know my mind will go blank", "I'm going to fail", etc.)
11. anticipate the problem of feeling anxious in advance so student is not overwhelmed or frightened by it when it happens. Provide practice opportunities
12. practise interrupting negative thoughts and replacing them with positive statements
13. teach student how to self-instruct (talk themselves through a task)

Important:

In most cases, the consistent and proper use of the above techniques will resolve the problem of the selectively mute child's reluctance to speak. If the problem persists, it may be a more serious psychological condition requiring other intervention. Psychological Services Department staff should be consulted.

Further, it is important to investigate the possibility of a communication disorder. This can be confirmed or ruled out by a Speech/Language Pathologist. Consult with Speech/Language Services if no apparent progress is made using the above techniques.
Contributed by Dr. Ian Brown

Useful Resources:

The Selective Mutism Group--Children's Anxiety Network

The Quiet Room

Selective Mutism Support Group

The Selectively Silent Child

Book Recommendation: The Silence Within

and finally, a review of the above-named book:

"The Silence Within" is a single case study based on the experiences of an elementary school reading specialist working with a selectively mute primary school student. While not a scholarly work, it is nonetheless an interesting chronology of the trial and error approach the author used to assist the student in speaking aloud, using a hierarchy of feared situations.

The example is a U.S. one, and so some of the education terminology differs from that in Ontario. The emphasis on standardized academic achievement tests is pronounced. The author's "research" was based largely on Internet articles. She refers to selective mutism as a "speaking disability" rather than more correctly as an anxiety disorder, thereby suggesting a somewhat superficial understanding of the complexities of this condition. Her work clearly demonstrates that progress with selectively mute children is slow and gradual.

Most of the book is the set of daily goal sheets established for the child; unfortunately, the reader must extract the key elements contained in those goals. There are a number of useful resources at the end of the book, including recommended books, software, songs, board games, and internet sites.

Dr. Ian Brown, Co-ordinator of Psychological Services,
Durham Catholic District School Board

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