Monday, December 11, 2023

Selective mutism: how to act at home and at school

We republish this article by María de la Villa Carpio Fernández, doctor in psychology and professor at the University of Jaén, published in The Conversation on October 16, 2023.

Selective mutism, according to the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, is classified as an anxiety disorder of the childhood stage characterized by the total absence of speech in specific situations. The boy or girl who suffers from it stops speaking in certain contexts, while in others they can express themselves without any problem.

The inability to speak in children with selective mutism cannot be attributed to lack of knowledge of the tongue nor comfort with language necessary spoken in the social situation, but to the inability to speak in specific situations.

There is no single cause

Selective mutism has a greater incidence in girls and is of etiology multifactorial, associated with genetic, temperamental, environmental and neurodevelopmental factors. It occurs mainly in multilingual minors and with family history of anxiety disorders or social phobia.

They are boys or girls who often present other anxiety disorders, especially social anxiety disorder, social isolation and withdrawal, negativism or communication problems.

It is a rare disorder, with a prevalence of around 0.72%, although in recent years there has been an increase in cases due to the ease of access to electronic devices.

The continuous use of screens at early ages could explain part of the increase in cases, since its use entails less social interaction with people around you since early childhood.

In what contexts does it occur?

The main symptom that a boy or girl with selective mutism manifests is the decrease and disappearance of the ability to speak in certain contexts or social situations such as at school, while in other contexts, such as the home, they have normal communication. . In contexts where they do not speak, they do use gestures, easy expressions and movements to communicate.

To be considered a disorder, it must persist for at least a month and substantially limit relationships with their peers, in addition to affecting social development and selfconcept.

Intervention in a case of selective mutism is complex because There are few good quality studies that demonstrate the effectiveness of the treatmentbut the majority agree that the main goal is to reduce the anxiety that speaking causes in the child and increase their social speech.

Although the interventions commonly used are multidisciplinary, the first steps in treatment are psychoeducation and behavioral management.

What to do at school?

The educational needs of students with selective mutism are related to two large areas: stimulate children’s speech and enhance their social skills, all in an emotional and safe environment. The guidelines that the educator must follow with these students are:

  1. Know your interests. Children feel safer and less inhibited when they work with things that interest them or when they can use their personal talents or abilities.
  2. Work in small groups or in pairs. If these boys or girls have particular friends or groups of friends, having them work cooperatively or collaboratively can decrease their inhibition and increase the likelihood that they will speak.
  3. Allow an adjustment period so that on the first days of school parents attend the classroom with them and can practice the language in that new setting.
  4. Support your non-verbal communication to show them that their participation is valued, thus promoting their safety.
  5. External support. Depending on the severity of the problem, it can be very helpful to have a trained person spend time in the classroom providing individualized support.

What to do at home?

From home, family members can help them by offering security, understanding and support in the face of all their fears and difficulties. For this it would be necessary:

  1. Don’t pressure them to talk and avoid scolding or punishing them for it.
  2. Do not talk to other people about this problem in the presence of these children.
  3. Do not overprotect them, do not speak on their behalf.
  4. Don’t label them nor tell them that they are shyto prevent the role from being consolidated.
  5. Don’t act effusive when they start talkingcontinue with the activity that was being carried out or reinforce them calmly.
  6. Promote their autonomy and sociability from an early age: it is necessary for children to interact and be able to create circles of friends.
  7. Help them develop empathy so that they understand how others may feel if we do not answer when they want to interact with us.
  8. Reinforce them when they are able to speak in situations or contexts that are new or complicated for them.

All these actions must be complemented with appropriate psychological intervention through exposure to feared situations in a gradual and careful manner, modeling and training in social skills, an intervention that is based on the use of strategies that overcome their fears and allow them to participate in different social environments, all in collaboration of family and school.

The Conversation


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