How To Help A Child With Selective Mutism

From definition to contributing factors, Dr. Paul Jenkins gets into the details of selective mutism in children. How do you help a child with selective mutism? It may take a lot of patience, but don't run out of hope. Here are a few tips:

1. Intervention component
2. Reduce the expectation
3. Get the practice reps in

Watch and Enjoy!
Dr. Paul Jenkins

HELP & RESOURCES:
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MUSIC
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Track: Kisma - We Are [NCS Release]
Music provided by NoCopyrightSounds.
Licensed under Creative Commons — Attribution 3.0

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Video by Nate Woodbury

[christynagonzalez]

I was a child with selective mutism and its true that everyone making such a big deal about when I spoke freaked me out so badly. There were many times I did want to say something but I wouldn't for that very reason. I would even cry when my family sang me happy birthday. Here I am today a 42-year-old woman who overcame it and now I have a 10-year-old son who struggles with selective mutism but he is getting over it too. It's 100% anxiety driven. Great video!

[lifeisasymphony]

Please be careful, Dr. Jenkins and others who interact with those with SM, with your definitions and descriptions. SM is an anxiety disorder that is largely genetic -- it is NOT developed by some "trauma trigger" and it is NOT a child willfully refusing to speak. My daughter is one of thousands who claims she wants so, so desperately to talk, but the anxiety literally shuts her down. It is a chemical reaction in the brain and not something she can control.

Of course I believe she has the power to choose to make small brave steps towards communication and eventually speech, but trying to force or bribe a child to speak in the way you've described can actually be harmful to their progress and even their emotional state.

You do offer some sound tips in saying we need to offer them opportunities to face their fears, we should tone down our reactions, etc. but the examples given here likely only work for those with mild SM. My daughter would literally starve to death before being able to order her own food. She would bleed to death before telling someone she's injured. Her anxiety is that severe! It is crazy. So no, I do not believe she sees this as "avoidance that paid off" or that she "knows this is working for (her)."

For those looking for reliable, research-based information on Selective Mutism, please start with selectivemutism.org, childmind.org, or selectivemutismcenter.org. I do appreciate what you are trying to do, Dr. Jenkins, but prefacing your video with an admission you "kind of accidentally fell into an area of expertise I didn't expect" and following it up with misinformation and misconceptions doesn't convince me you really know what you're dealing with here.

[laurettayoung-violin]

I would ask that parents who believe their child has selective mutism find a different video to watch. Describing selective mutism as a 'choice' is very misleading and unhelpful for both the person suffering from it and for those around them who wish to help and are struggling to understand it.
My personal belief is that selective mutism IS an anxiety response in the brain which prevents speech. What it absolutely ISN'T, is somebody refusing to speak out of shyness or rudeness. I have at times been desperate to speak but felt physically incapable of doing so.
To my knowledge, the science of the brain is still little understood however, progress is being made here all the time. I'm confident that in some years time there will be more understanding and awareness of this subject, what brain chemicals etc. create the problem and therefore how to remedy it.
In the meantime may I suggest that we celebrate the strengths that selective mutes offer to society. I would guess that selective mutes are probably better listeners than most and may be very sensitive of other peoples' awkwardness in social situations. They must also be among the most strong and resilient of people because dealing with this problem on a daily basis is surely tiring and esteem sapping.
Please note that I do not pretend to be an expert on the subject of selective mutism and can only speak of my own experience with it.

[kakigr]

I am in my 50's now but as a child I had some form of selective mutism.. although they didn't refer to it as that back in my school days. I always hated other classmates and teachers who attempted to "help" me speak. It just made my anxiety so much worse and made me feel just awful. I always hated when my quietness was noticed and announced in public. So many times I heard.. oh.. you are so quiet.. do you speak? My school years were really miserable because of it. Its good to see there are people who actually understand it now and help children to overcome it in a healthy way.. I sure wish I had that kind of help back then.

[earthangel]

Totally agree. My son has Selective Mutism. He’s in 2nd grade. I feel there’s a genetic component. My brother had it too. Many in our family struggle with either anxiety or depression. My brother slowly got over it. In jr high and high school he was fine. Never super talkative. He’s no 30 and totally functional. He just got out of the Army not long ago and is an electrical engineer. Hoping my son gets over it soon. Its been hard on him, me and his teacher. My son is quite bright and knows computers and technology and speaks very well everywhere else except school.

[laurettayoung-violin]

Sorry, me again. Having calmed down a little, I can acknowledge that there are many helpful things to try in this video. However, I still feel that the video comes at selective mutism from a 'spoilt/silly child' angle and lacks any kind of empathy or understanding of why selective mutes behave the way they do.
Like many mental/brain health issues selective mutism is treated so differently from any physical ailment. Of course, you don't clap, cheer and congratulate someone for overcoming their speech problems in the same way that you don't whoop and cheer when they go to a chemist and take antibiotics and overcome the flu - it would be patronising and implies that they're choosing to do 'better'. When you say that selective mutes are usually quite bright, I think you may be right and when you use bribery to get them to speak, it is seen through, and may have the opposite effect from that which you intend ie. anxiety breeds a need to experience control and a stubborn refusal to meet your expectations may set in as a result. I wonder whether, as a parent, just talking with your selective mute child about what you're going to do as a parent (ie. not get the ice cream unless they order it) and why might be better than what appears in the video to be an unsubtle manipulation that parents and doctors/therapists can giggle over!
Again, I acknowledge the practical ideas in the video as very useful and am just asking that the subject be treated with a less trivial delivery. In directing the video towards people who want to help selective mutes, I think more care should be given to the needs and feelings of the selective mute.
I applaud all wishes to help, but a more sensitive understanding of selective mutism needs to be demonstrated first.

[aprilthompson]

I nearly didn't watch this video, until watching my kids interact in public I realized that they both do this. Boy have I got my work cut out for me. Thank you so much for the practical (and sometimes difficult) advise.

[talkingdoc]

Kids with SM do NOT choose to not talk. It is an anxiety disorder on a continuum. It is largely genetic and present from infancy. It is NOT a traumatic response, from poor parenting or any other single reason that "triggers" the experience.

[jenniferzorrilla]

The most ridiculous video EVER... My child doesn't CHOOSE not to talk..

[SSSplayer]

Dr Paul, my 7 yr old daughter says that the only thought that goes on in her mind when someone approaches her wit a question is that, how wil the other person react/ respond to her...she tunes into the other person wondering what they are expecting from her, what they might be thinking, mosy importantly how surprised they might get to hear her answer them...so if shes answering a complete stranger the anxiety is lesser compared to a known person to whom she has not answered earlier...my daughter is otherwise v bold, positive and confident person...but, she just cant get over these thoughts which envelop her when she has to speak...anticipation of other persons reaction (expecting that the other person might get surprised) is the only thing that stops her from speaking... pleaaaase can you make a video which we can show to kids with selective mutism (something which involves role plays etc as you are so good at expressions and immitating others)..a video which my kid can relate to and watch and give her some tips to handle other persons reactions and continue the conversation despite the reaction ( as we cannot control the world/ others emotions, it is best if she learns what to do when she gets these thoughts)..

[annes]

Just found this looking for help with my teen daughter who's only just been diagnosed with SM.
I was a little disappointed with the definition of SM being a childs CHOICE to not speak.
My daughter is pained that she 'can't ' speak in certain situations.
She wants to desperately but just can't. It's not by choice at all, and no amount of persuasion or force will make it happen. If anything it would make it worse.

[paologreen]

As an anxiety disorder it is not willful. These children are stuck and would love nothing more than to be as “normal” as everyone else. Please look into revising your findings on this area prior to posting this kind of video by getting in touch with the Smart Center in Pennsylvania or NYU.

[CharlieX]

I feel there are a few good and bad points in this video...First, it isn't a choice. At all. You mentioned the Fight or Flight responses but didn't consider the third, Freeze. I believe Selective Mutism comes from the Freeze response. When the anxiety is so intense a persons body literally freezes. A child (or adult) with selective mutism, physically can't talk so please don't say it's a choice.

Secondly, your whole attitude about it...you came across as very patronising.

The whole ice cream thing doesn't sit well with me either...I'm sure it could work for some children but I fear it could have the opposite effect on others. I think my Selective Mutsim came from an intense fear of getting things wrong. If my mum had tried this out I would have felt an enormous sense of frustration at being unable to communicate what I wanted. But instead of working harder to overcome it, I likely would have withdrawn myself further, seeing it as a failure. Remember, Selective Mutism isn't a choice. The words I want to say are right there in my head but the anxiety is so intense they physically won't come out. You not letting a child choose their own ice cream because of this seems more like a punishment.

I feel a better way to tackle Selective mutsim is to reduce the anxiety and pressure to speak. Start small. Maybe encourage your child to talk to you in places they don't usually talk. Play word games and slowly bring in a friend.

I did see a couple of good points though. Especially the whole not making a big deal out of it part. This is very true. I remember getting very tense when I was able to talk and the people around me would act shocked and surprised. A little well done to reinforce that I did a good job was all it took for me to feel proud or my achievement.

Like you said, practice is very important too. Small steps and don't rush.

I think it's also true about it becoming a habit. It needs to be sorted out quickly because it can easily remain a problem growing up into an adult. I never had help as a child and I still struggle now as a 27 year old adult.

[jcomm]

Recent studies show many of these kids suffer from hyperacousia, as did mine who had super grades but suffered a lot at school. Accomodations may need to be made, ie. quiet time, earplugs in noisy spaces if desired and discussion with the teacher. These kids may be literally traumatised by their own voices since their brains can’t filter sound normally, and have much difficulty hearing conversation in noisy settings which can effect social development at school. These kids require understanding.

[meloyelokarma]

It's a faulty fight or flight response! I'm an adult with S.M.I suspect I have Autism which social anxiety disorder is very common in.

[TheHammer]

I had severe SM and beat it at age 13 on my own. Everything this guy describes about selective mutism is absolutely correct from my experience. The only critique I have is that some people with SM, including myself, were so stubborn that any amount of coercion would be in vain I think. I suppose I might have cracked if I was pressed regularly, particularly as a young child, the way the presenter describes. However, all the conversation and interventions I received did not sway me in the slightest. My SM definitely felt involuntary, but I did eventually beat it—so it can’t be 100% involuntary. It took a lot of courage and I went for very small goals at first and now I’m as recovered as a person can be I think.

[mangocookieforeverandever]

I have selective mutism and I choose to talk but I feel scared for some reason. I know they wouldn't hurt me. I used to be in a small school before when I was kinder, when I grew to grade 1 that's when it hit me. The new school was so big and i was so scared I won't know where my classroom is and I won't have friends. So I moved to a smaller school and nothing has seemed to change I made a story for my class because i wanted to be normal so i spent all weekend making it. When i had to read it in front of the class i just felt frozen and could not do anything. My body couldn't move I was so scared I ran away.

[megara]

as a server, I feel bad for the child. And I feel uncomfortable in that situation. It all depends on the energy of the parent in this process. When the parent is demanding, i see the kid become more anxious. Every child has different needs. People that experience selective mutism are very sensitive. I now understand why parents do this at restaurants now. Thank you for the new perspective. I experienced this myself and occasionally in adulthood in extremely stressful situations. I actually became a server to help myself get over this. I knew practice would help me in other situations and I am too much of a perfectionist to not try my best in my job.

As a person that experienced selective mutism and works with children this is an awesome video!

[tarawilliams]

If I wait for my kid to order she would starve. This video might work for some. However, this video doesn't work for all. I do however appreciate the attempt to provide information.

[professorpeaches]

I don’t like the way selective mutism is described. Selective implying I’m able to talk when I want to. The reality for me growing up was that I desperately wanted to talk but was literally unable to.