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My first advice was to consider taking the child to speech therapy, till the mother showed me a video of the girl speaking. The girl was jabbering away all on her own with no prompting from anyone.

The teacher was totally shocked that it was the same child.

It became rather obvious, that the child had some anxiety issues regarding speaking in “unfamiliar” settings.

The school, which the child had been in for over a year now, was a safe and comfortable environment for all children. Yet it was difficult to understand why this child would refuse to speak at school.

The most immediate result of this refusal to verbalize in the class is a fall in academic performance and poor social interactions. When this continues, there is no doubt that the cumulative effect of this failure will lead to further frustration with school work and peer relationships.

SELECTIVE MUTISM

There is no diagnostic test for Selective Mutism, but a list of symptoms can point to the possibility of its occurrence in a child.

The main criteria for recognizing Selective Mutism (SM) are

1.       A child has to be able to speak in at least one setting and be mute in at least one other setting.

2.       The typical presentation is the 'timid’ child , who can speak and act socially appropriate with family members, close peers and very familiar relatives, yet is mute or barely whispers to a few others in school or perhaps when addressed in public settings such as restaurants or shops.

Selective Mutism is a “complex childhood anxiety disorder characterized by a child’s inability to speak and communicate in a socially appropriate manner in select social settings, such as school. These children are able to speak and communicate in settings where they are comfortable, secure and relaxed, such as at home”. ( selectivemutismcenter.org)

WHY SHE WON’T SPEAK

The first instinct of teachers is to point to some family problems; divorce, absentee parents, arrival of a sibling or even simple stubbornness on the part of the child. Yet there is no evidence that this is caused by negligence or abuse.

On the contrary, the majority of children with Selective Mutism have a “genetic predisposition to anxiety”. In other words, they have inherited a tendency to be anxious from one or more family members. Very often, these children show signs of severe anxiety, such as separation anxiety, frequent tantrums and crying, moodiness, inflexibility, sleep problems, and extreme shyness from infancy on.

Another very interesting point to consider for Sri Lanka is the fact that children who grow up speaking their mother tongue and are then suddenly exposed to speaking English in school may suffer anxiety caused by their lack of confidence to speak a foreign language. When an inherited disposition to be anxious is combined with the difficulties of speaking English at school, the result may be the child’s decision not to speak at all.

SO WHAT DO WE DO NOW?

Despite the lack of professionals in Sri Lanka who have invested their time and expertise to studying Selective Mutism, when it does occur, parents and teachers will have to act on it so that  the child  does not literarily continue to suffer in silence. “More than 90% of children with Selective Mutism also have social anxiety. This disorder is quite debilitating and painful to the child. Children and adolescents with Selective Mutism have an actual FEAR of speaking and of social interactions where there is an expectation to speak and communicate”.

The first reaction will be to pressure the child to talk, this is considered the most unhealthy reaction to SM. Imagine being stressed about something and then been placed under more pressure to perform. This only creates a more debilitating impediment.

Another common response is to hope that the child out grows it. Most SM is recognized between 3 to 6 years, at this stage it is important that the child is given the help they need when they are still young before they get older and develop the habit of not verbalizing their thoughts.

Dr. Elisa              Shipon-Blum of the Selective Mutism Anxiety Research and Treatment Center says that “because Selective Mutism is an anxiety disorder, if left untreated, it can have negative consequences throughout the child’s life and, unfortunately, pave the way for an array of academic, social and emotional repercussions such as:

• Worsening anxiety

• Depression and manifestations of other anxiety disorders

• Social isolation and withdrawal

• Poor self-esteem and self-confidence

• School refusal, poor academic performance, and the possibility of quitting school

• Underachievement academically and in the work place”

It is important we do not just see this as another excuse to slap a label on a child to create a stereotype.

On the contrary, realizing that the child has anxiety speaking means that teacher will know not to pressure the child, but still encourage them to speak in subtle ways that do not elevate pressure, but enables them to complete their class work. Class work will have to provide accommodations for children who do not speak. This is to ensure that they do not fall behind in class. Parents will do well to record their child speaking and then play it back for them so they can see themselves talking and be encouraged to speak more.

Selective Mutism is a very complex disorder that cannot be oversimplified, however it is my hope that an awareness of it would empower parents and teachers to seek help and do their own research on how to help their child.  Each child is different, and there may be more than one reason why the child refuses to speak at school. Regardless of the reason, applying pressure on the child or threatening is not a healthy approach.

Maryanne Kooda

Early Intervention Tutor


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