Understanding Selective Mutism…

Fear is the guiding force behind Selective Mutism. When a person with SM is in a fearful situation (around unfamiliar people and/or in unfamiliar environments), their brain interprets this as fear and begins the physical symptoms:

• the heart pumps faster
• breathing becomes shallow and quicker
• palms perspire
• hands shake
• mouth and/or throat becomes dry
• the chest feels tight
• dizziness or feeling faint may occur
• the ears may ring
• they become foggy-headed

Imagine one or more of these symptoms occurring without understanding why. That is what a child with SM feels, oftentimes confused and afraid. These symptoms don’t feel good. They need to learn that these physical symptoms are caused by the anxiety. Deep calming breaths can help them regain control.

Here are a couple of treatment approaches/ideas that are commonly used in professional therapy:

Stimulus Fading:

1. Practice by having the child with Selective Mutism talking to a person they are comfortable with (usually a parent or sibling). Bring one unfamiliar person into the room (unfamiliar person just means someone they aren’t comfortable talking to), but don’t have them engage with the SM child. Instead, they may only listen at a distance. The SM child should still engage in conversation with their comfort person. After a couple of short sessions, bring the unfamiliar person closer to the two. As long as the SM child continues to talk to their comfort person, continue bringing the unfamiliar person closer.
2. In the next phase, you can have the unfamiliar person ask a question to the other comfort person (not the person with SM). After a short dialogue, the comfort person and SM person can reengage with their conversation.
3. Then begin to have the unfamiliar person say something to the SM child (they do not have to face the person). They should only comment on a subject, not ask a question. Then the comfort person and SM child may resume their conversation.
4. Work up to the unfamiliar person asking the SM child a question. If the SM child manages to answer consistently for a couple of sessions, then advance to adding a second unfamiliar person and repeating the process.
5. *Before beginning this treatment (or any), inform the child with Selective Mutism what to expect. Explain the procedure, be clear and ensure they understand the steps. They may be able to handle their fear if they know that the unfamiliar person will not be talking to them in the first few sessions.

Self Modeling:

1. A comfort person (someone the SM child speaks comfortably to) records the child while they are reading a book or just chatting.
2. The recording is replayed to the child while they are in a less comfortable situation (in a classroom, at a relative’s home, in a restaurant, etc).
3. Begin with another person nearby but not in earshot. Then progress to having the other person get closer. But they should be involved in something else and pretending not to listen to the video.
4. The object is to allow the child to hear their voice while someone else is around without that person making a big deal out of it. Obviously, the “other” person would need informed on how to act (or not act, in this case) when they hear the child’s voice.

If you are the person who is suffering from Selective Mutism, you may need a comfort person to help you arrange the scenarios explained above. Practicing encourages comfort. And comfort is the key to recovery.