The quick Q&A: How to support children with selective mutism

An anxiety disorder that prevents children from speaking fluently is not as rare as you might think, finds Jay Birch, who offers advice on how to support children with selective mutism
26th February 2018, 3:05pm

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The quick Q&A: How to support children with selective mutism

https://www.tes.com/magazine/archive/quick-qa-how-support-children-selective-mutism
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I am a primary school teacher and I have a pupil who can speak but remains totally silent in the classroom. Are they just shy?

Possibly, or the child could be experiencing symptoms of selective mutism (SM).

What is that?

The Selective Mutism Information and Research Association (SMIRA) describes the condition as an anxiety disorder that usually begins in early childhood - typically between the ages of 2 and 4, but it can occur later and is often noticed when a child starts school.

How rare is this condition?

Not very rare at all. According to iSpeak, a support group run by people who have experience with the condition, SM affects about 1 in 150 young children.

OK, so what signs should I be looking out for?

Children with SM are able to speak fluently in some social situations but not in others. This contrast is the key sign to look out for. Does the child “freeze” when they’re expected to talk in class (eg, answering the register) or to someone they are unfamiliar with?

Got it. But when should I be concerned?

Following a period of transition, such as starting school or moving to a new class with a new teacher, children can initially be reluctant to speak. Monitor this behaviour and if, after a month, the child is still not talking, speak to your school’s Sendco and the child’s parents about the situation. Avoid “diagonising” the child yourself - there might be another explanation.

The Sendco and the child’s parents have noticed similar behaviour and agree it could be selective mutism. So, how can I get this child talking in class?

It is important to remember that a child with SM does not choose not to talk; they are unable to. Teachers should avoid putting pressure on a child to speak or responding negatively to the child for not speaking, as this can reinforce their anxiety. You should also ensure that other members of staff are aware of this.

What should I be doing to support this child instead, then?

Clinicians at Great Ormond Street Hospital (GOSH) recommend that you find alternative ways to allow the child to communicate in the classroom. This could include non-verbal communication, gestures, writing and visual aids and prompts. For example, you might introduce a sign to help the child show that they need the toilet or help with their learning.

And I should avoid addressing this child during whole-class discussion, right?

No, GOSH suggest that teachers should avoid assuming that the child will not communicate and reducing opportunities to interact. Remember to engage with the child, but not to expect a verbal response. Maybe, they could nod (if they are comfortable) to show that they understand or agree with an idea, or write their own thoughts on a Post-it note to share with the class. Be creative, but be inclusive.

Are there any other professionals who should be involved?

Keep communicating with the child’s parents and your Sendco to implement and review provision and support. Children with SM can often have other difficulties - such as with speech and language or their mental health, or have coexisting neurodevelopmental concerns, such as autistic spectrum disorder - so a referral to a speech and language therapist, Camhs or a local paediatrician may be made by your Sendco.  

Jay Birch is a primary school teacher and freelance writer

This Q&A was developed from responses provided by Kathryn Stevenson, senior clinical psychologist at the Social Communication Disorders Clinic, and Abigail Mance, speech and language therapist in the Wolfson Neurodisability Service. Both departments are based within Great Ormond Street Hospital

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