Information For Parents
How to Treat Selective Mutism: Information
for parents
In all probability you are
reading this because your child, or someone you care for, fails to talk in
select settings; You, as the child's parent, know your child the best! You
have the position of being the child's parent whose concern for his welfare is
paramount. It is most conducive to success when a respectful, open and
communicative relationship exists between parents, teacher and therapist, so
that each corner of this triumvirate can contribute his\her expertise, while
simultaneously gaining and adjusting his understanding by the insight of his
colleagues in this enterprise.
Your childs treatment program should be based on several principles. The
first is an ecosystems theory which tries to build bridges between the diverse
settings in which your child lives, enabling him to move more seamlessly between
contexts. In other words, to understand what allows him to speak at home,
and to try to incorporate those elements at school, so that he will feel more
comfortable there. At the same time, some factors at school may be
conducive to assertiveness and independence, which the parents may wish to
incorporate at some level, at home. This outlook is reflected in the location of
the therapy – at home and at school.
In addition, the treatment plan should incorporate what is widely accepted
today about treating selective mutism: that behavioral methods with cognitive
components are thought to be most effective for SM, that it is frequently
anxiety based, and that the family and school should be intimately involved in
any course of treatment.
How Selective Mutism can effect your Child and your
Family
While all children and every family is unique and responds to SM in their own
way, certain feelings and reactions are common. One thing is always the case
with a child who is not speaking (usually) in kindergarten or school: A child
with SM suffers! He cannot be himself, the more spontaneous, communicative
child he is in other contexts. He must expend effort to ensure that his radar
informing him of who is in his proximity is always on, and control himself so
that when his private space in encroached, or when he is in a setting in which
he does not speak, he stays quiet. High and constant energy expenditure is
required to maintain this awareness and control. This in itself is anxiety
producing, however effortless the SM child appears to make it.
The lack of verbal communication causes the child to miss out on social and
learning experiences which would further his development. A child who cannot
say what he wants, will frequently be included in activities he wishes to avoid,
and conversely, will be excluded from experiences he desperately wants to have.
This is a recipe for frustration. This frustration is often taken out on family
when he returns home, and can finally express himself. Sometimes the
frustration expresses itself in school, as the child makes his presence felt
with his hands, not his voice.
When a child with SM is unfortunate enough to be in a context in which he is
misunderstood, and considered to be unintelligent, unable to communicate, or
oppositional, he may be inappropriately labeled and consequently placed in an
unsuitable learning environment. This frequently exacerbates the child's
difficulties.
Parents confronted with a child who fails to speak in school, frequently go
through a period of heightened anxiety themselves. The parents' concern for
their child, and their grappling with schools and possible interventions, as
well as long term projections and postulations regarding future implications for
their beloved child, can be overwhelming. To make matters worse, the parents'
posturing to get appropriate intervention for their child can be misconstrued as
over protectiveness and indentified by the school as the cause, not the effect,
of the child's SM.
For all these (and many more) reasons early intervention is vital. What's
more, it usually works! Response to intervention using behavioral therapies for
children with SM has been found to be highly effective. In addition, our
treatment plan is generally experienced by the child as an enjoyable, satisfying
experience, and once children break the barriers and speak, they usually
experience a surge in self confidence.
How to talk to your child about Selective Mutism
Selective mutism is usually anxiety based and that must be borne in mind when
talking to your child: One of the aims in discussing speech
difficulties with your child, is to lower her anxiety levels.
However you choose to express it semantically, the message should be " we love
you exactly as you are, right now you can't speak in some situations or to some
people, but we know that soon you will overcome it and be able to speak" In
other words, you are telling your child three things:
Other family members, siblings, grandparents etc, should adopt a similar
stance. This fosters confidence in the child that she has the strength and
courage to speak, and your apparent lack of worry will do wonders for lowering
her anxiety level. Paradoxically, the more she is pressured to speak, and feels
your concern, the harder it will be for her to speak, as her anxiety levels will
rise. Lowering her anxiety level regarding speech is usually prerequisite for
enabling speech.
It follows from this that constant checking as to whether she spoke in
kindergarten or school, and to whom, transmits to her your anxiety, and
increases her anxiety. Similarly, prizes offered for speech, or punishments for
non speech, are contra indicated – they too will increase your child's anxiety
levels.
You do not need to try to increase your child's motivation to speak – as
explained in the previous section, SM causes suffering and frustration in
children, and every SM child I have encountered desperately wants to speak.
Another productive message to your child is to normalize the SM. She can be
told that many children find it hard to speak in school, are wonderful children,
and overcome their SM in time. This is often a relief for a child who may see
herself as different, or problematic. During therapy, it can be said to her that
many children have been helped by sessions such as she is having in school.
This should not be said at the beginning of therapy, rather, when it has got
underway, and it is clear to the child that its aim is social communication.
After these two messages have been conveyed to your child, do not engage her
in ongoing discussion about SM unless she initiates it. Your frequent discussion
of SM may cause her to feel more pressure to speak, and paradoxically make it
harder for her to progress.
for parents
In all probability you are
reading this because your child, or someone you care for, fails to talk in
select settings; You, as the child's parent, know your child the best! You
have the position of being the child's parent whose concern for his welfare is
paramount. It is most conducive to success when a respectful, open and
communicative relationship exists between parents, teacher and therapist, so
that each corner of this triumvirate can contribute his\her expertise, while
simultaneously gaining and adjusting his understanding by the insight of his
colleagues in this enterprise.
Your childs treatment program should be based on several principles. The
first is an ecosystems theory which tries to build bridges between the diverse
settings in which your child lives, enabling him to move more seamlessly between
contexts. In other words, to understand what allows him to speak at home,
and to try to incorporate those elements at school, so that he will feel more
comfortable there. At the same time, some factors at school may be
conducive to assertiveness and independence, which the parents may wish to
incorporate at some level, at home. This outlook is reflected in the location of
the therapy – at home and at school.
In addition, the treatment plan should incorporate what is widely accepted
today about treating selective mutism: that behavioral methods with cognitive
components are thought to be most effective for SM, that it is frequently
anxiety based, and that the family and school should be intimately involved in
any course of treatment.
How Selective Mutism can effect your Child and your
Family
While all children and every family is unique and responds to SM in their own
way, certain feelings and reactions are common. One thing is always the case
with a child who is not speaking (usually) in kindergarten or school: A child
with SM suffers! He cannot be himself, the more spontaneous, communicative
child he is in other contexts. He must expend effort to ensure that his radar
informing him of who is in his proximity is always on, and control himself so
that when his private space in encroached, or when he is in a setting in which
he does not speak, he stays quiet. High and constant energy expenditure is
required to maintain this awareness and control. This in itself is anxiety
producing, however effortless the SM child appears to make it.
The lack of verbal communication causes the child to miss out on social and
learning experiences which would further his development. A child who cannot
say what he wants, will frequently be included in activities he wishes to avoid,
and conversely, will be excluded from experiences he desperately wants to have.
This is a recipe for frustration. This frustration is often taken out on family
when he returns home, and can finally express himself. Sometimes the
frustration expresses itself in school, as the child makes his presence felt
with his hands, not his voice.
When a child with SM is unfortunate enough to be in a context in which he is
misunderstood, and considered to be unintelligent, unable to communicate, or
oppositional, he may be inappropriately labeled and consequently placed in an
unsuitable learning environment. This frequently exacerbates the child's
difficulties.
Parents confronted with a child who fails to speak in school, frequently go
through a period of heightened anxiety themselves. The parents' concern for
their child, and their grappling with schools and possible interventions, as
well as long term projections and postulations regarding future implications for
their beloved child, can be overwhelming. To make matters worse, the parents'
posturing to get appropriate intervention for their child can be misconstrued as
over protectiveness and indentified by the school as the cause, not the effect,
of the child's SM.
For all these (and many more) reasons early intervention is vital. What's
more, it usually works! Response to intervention using behavioral therapies for
children with SM has been found to be highly effective. In addition, our
treatment plan is generally experienced by the child as an enjoyable, satisfying
experience, and once children break the barriers and speak, they usually
experience a surge in self confidence.
How to talk to your child about Selective Mutism
Selective mutism is usually anxiety based and that must be borne in mind when
talking to your child: One of the aims in discussing speech
difficulties with your child, is to lower her anxiety levels.
However you choose to express it semantically, the message should be " we love
you exactly as you are, right now you can't speak in some situations or to some
people, but we know that soon you will overcome it and be able to speak" In
other words, you are telling your child three things:
- 1. You are not anxious about her SM,
2. You accept her as she is,
3. You have total confidence that she will overcome her SM soon.
Other family members, siblings, grandparents etc, should adopt a similar
stance. This fosters confidence in the child that she has the strength and
courage to speak, and your apparent lack of worry will do wonders for lowering
her anxiety level. Paradoxically, the more she is pressured to speak, and feels
your concern, the harder it will be for her to speak, as her anxiety levels will
rise. Lowering her anxiety level regarding speech is usually prerequisite for
enabling speech.
It follows from this that constant checking as to whether she spoke in
kindergarten or school, and to whom, transmits to her your anxiety, and
increases her anxiety. Similarly, prizes offered for speech, or punishments for
non speech, are contra indicated – they too will increase your child's anxiety
levels.
You do not need to try to increase your child's motivation to speak – as
explained in the previous section, SM causes suffering and frustration in
children, and every SM child I have encountered desperately wants to speak.
Another productive message to your child is to normalize the SM. She can be
told that many children find it hard to speak in school, are wonderful children,
and overcome their SM in time. This is often a relief for a child who may see
herself as different, or problematic. During therapy, it can be said to her that
many children have been helped by sessions such as she is having in school.
This should not be said at the beginning of therapy, rather, when it has got
underway, and it is clear to the child that its aim is social communication.
After these two messages have been conveyed to your child, do not engage her
in ongoing discussion about SM unless she initiates it. Your frequent discussion
of SM may cause her to feel more pressure to speak, and paradoxically make it
harder for her to progress.