Selective mutism

Selective mutism, sometimes called situational mutism, is an anxiety-based mental health disorder which usually starts in early childhood. Those with selective mutism may speak fluently in some situations but remain silent in others. They may have a blank expression or appear ‘frozen’ when they are expected to speak.

The term selective mutism is used when the condition:

• has lasted at least a month
• is interfering with the child’s educational and social development
• is not due to the child not knowing the language
• is not due to another communication or other difficulty, such as stammering or autism.

Early intervention is always encouraged as it can lead to a good recovery. It is important to understand that those with selective mutism want to speak but find themselves physically unable to do so due to their anxiety.

What’s the best way to help?

In Derby and Derbyshire, a graduated response is used. This means that a range of education and health services along with parents and carers, form part of a ‘virtual team’, each with different roles and areas of expertise. This is delivered in a graduated or staged way to respond to each child or young person’s unique circumstances.

Universal support: What parents and teachers can do to help

• Accept your child and show understanding and patience. If the adult shows anxiety, this can increase the child’s anxiety.
• Don't refer to your child as ‘non-speaking’ or draw attention to the mutism in front of others as this can also increase anxiety. However, do privately explain the child’s needs to others, so that they understand why the child may not speak to them.
• Encourage and praise participation in social activities, whether the child speaks or not.
• Accept all forms of communication, including non-verbal, such as gestures, facial expressions, use of pictures, drawing, mimes and signing.
• Encourage conversation at home, for example, talking about school and feelings.
• Don't put any pressure on the child to talk and don't reward them for speaking or sanction them for not speaking.
• Record your child when they are talking at home and encourage them to watch and listen to themselves speaking – this can help them make sense of it. If the child agrees, you could also play the recording at school, so the child can take part in ‘show and tell’ or other public speaking.
• Treat your child the same as their siblings and friends, and give them the chance to communicate, whether by speaking or non-verbally. Try not to let others speak for the child.
• Children with selective mutism may feel more comfortable speaking to pets, or when role-playing in imaginative games.

Targeted support: What education settings do to help

Derby’s and Derbyshire’s Understanding Selective Mutism Guide‌ Pack is a free toolkit that gives detailed, step by step information about what schools can do to support children with selective mutism. This was devised by educational psychologists, in line with the current evidence around selective mutism and information from the Selective Mutism Information and Research Association (SMIRA).

Autistic children often experience social communication difficulties and may experience associated social anxiety. This can result in difficulties speaking which may look like selective mutism. The National Autistic Society is a national charity providing support, guidance and advice for all areas of autism. The Autism Education Trust also has resources for schools to support pupils.

Specialist support: Who else is able to help

Several different services may need to be involved later, depending on your child’s needs. Usually, the SENCo or GP will coordinate this:

• A school educational psychologist can identify the child’s psychological and emotional needs and support the school to manage these, including support using the selective mutism guidance pack for schools and settings.
• A speech and language therapist can identify and support any other communication difficulties the child may have, including stammering, speech disorder or social communication disorder.
• A paediatrician or clinical psychologist can identify any other developmental or medical needs the child may have, such as autism spectrum disorder or learning disabilities.
• Mental health services in Derby and Derbyshire - the school pastoral support or counselling services, school nursing, specialist community advisors, Compass Changing Lives and Child and Adolescent Mental Health Services (CAMHS), all are able to help support with anxiety and mental health needs.