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Supporting a child who has selective mutism

What is selective mutism?

A child who is consistently not able to talk freely within a school or nursery setting may have ‘selective mutism’. This is a fear (phobia) of talking in certain ‘settings’, usually nursery or school, or with certain people, causing an unconscious fear reaction. Usually, at home, they don’t have this fear reaction and they are able to speak freely and easily.

In the case of selective mutism, a child is not making a conscious choice to not talk – quite simply they want to talk but can’t.

How can adults help?

The most important thing is to make sure a child does not feel pressure to talk. By helping them feel comfortable in the setting, this takes away this constant feeling of fear about being asked, or expected, to talk. For these children, even the most well-meaning comment or question can provoke a fear response, so it is really important that all staff are aware of the strategies detailed below.

When a child is comfortable in the setting and given time, they can then take little steps towards communicating in different ways and then gradually begin to be able to talk in the setting. This must be at a pace that they can cope with.

For children who have been experiencing selective mutism for some time, these strategies remain even more crucial, but on their own may not be enough to allow a child to talk. In these cases, they may need a more structured programme of support to help them to take tiny steps towards talking.

Take the pressure off the child’s talking by doing these things

  • Make comments about what the child is doing without expecting an answer.
  • Warmly respond to any of the child’s communication attempts through gesture, pointing or by talking back in a natural way as if they have spoken.
  • Include the child in activities using alternatives such as pictures.
  • Make sure the child knows how to get help without having to talk (such as using a traffic light visual system, putting hand up and so on). However, so that the child isn’t singled out, make sure that whatever non-verbal system is used is introduced as an acceptable alternative for all children in the class.
  • Make sure they can access the toilet without having to talk (for example, show a picture, sign, get the toilet key). Again, a system that works for the whole class is best.
  • At registration (a high pressure moment to talk) give a non-verbal alternative (again to all of the class, not just the quiet child). For example “When I call out each of your names, you can either answer, ‘Good morning’ or ‘Hi’, or you can smile or put your hand up.” Or “When I call out each of your names, everyone can look round for your friend and answer ‘here’ together (in unison)”.
  • Praise independence and try to ensure success to build confidence.
  • Encourage being brave, trying new things, giving it a go, not being afraid to make mistakes.
  • Let the child know (privately) that telling a friend the answer to then tell the teacher is an option, if talking to an adult directly is too much.
  • If the child talks for the first time, carry on as if the child has always spoken (even though it is tempting to make a big deal and praise them!). Just respond positively and naturally to what they say, not the fact that they have spoken.
  • Please don’t be hurt or offended when a child remains silent.
  • Don’t make it your mission to get the child to talk! Don’t say “Are you going to speak to me today?!” or “Has the cat got your tongue?”
  • Please don’t ask that the child say “hello”, “please”, or “thank you”.
  • Please don’t ask direct questions which put the child on the spot.
  • Avoid looking directly at the child when you are hoping they might say something.
  • Don’t penalise the child for not talking or talking too quietly.
  • Don’t mistake a fixed stare on a child’s face as defiance or disinterest. It may be an expression of fear.

Talk to the child about feeling worried about talking

Parents or carers and those staff members with whom the child has a good relationship can talk to the child about their talking. This will give reassurance that the pressure is off them, and that their anxiety is understood:

Do
  • Reassure the child that adults are here to help the child feel less worried about talking.
  • Reassure that there is no pressure to talk and they will feel brave enough to do this when they are ready.
  • Reassure the child you won’t single them out to talk in class to answer a question, or to read aloud unless they let you know they want to be chosen, for example put up hand.
  • Say they can start talking as soon as they feel ready but until then to have a good time and have fun!
  • Explain that just because talking is hard right now, this will change as they get braver and feel less worried.
Don't
  • Ask the child why they find talking hard – they won’t know.

What to say when – useful phrases to have ready

When other children tell you the child can’t talk, you could say:

  • “They are really good at talking and if we are all patient they will be able to talk here too, isn’t that right?”
  • “Of course they can talk, but right now you would prefer to listen wouldn’t you?”

When other children ask why the child doesn’t talk, you could say:

  • “They haven’t found her voice in school yet, but when they do we will speak to them as if they have always spoken.”

If they put their hand up in class but then don’t talk, you could:

  • Smile and wait 5 seconds. If no answer comes, calmly move the conversation on, for example “Well done, I can see you know the answer! Who else wants to have a go?”

When they speak for the first time and other children comment on this, you could say:

  • “Great idea, that sounds like fun!”
  • “We always knew they would feel like talking one day, right what shall we do next?”

Additional resources and information

Additional resources and information

How to refer to Speech and Language Therapy

SMIRA – Selective Mutism Information and Resource Association

A training video for parents, carers and teaching staff on Selective Mutism – what is it and what helps?

Time: 38 minutes

3 YouTube videos by Lucy Nathanson (Confident Children)

My child doesn’t talk at school

Time: 3 minutes

What is Selective Mutism?

Time: 4 minutes

The Do’s and Don’ts when interacting with a child with Selective Mutism

Time: 8 minutes

3 recommended books

The Selective Mutism Resource Manual (2nd Edition) by Maggie Johnson and Alison Wintgens. ISBN 9781909301337.

Why doesn’t Alice talk at school?

Can I tell you about Selective Mutism? A guide for friends, family and professionals by Maggie Johnson and Alison Wintgens. ISBN: 9781849052894.

Contact us

For more information please email Katie Lea or contact the Speech and Language Therapy Service at Flockton House on 0114 226 2333.

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Disclaimer

Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

Resource number: SL83

Resource Type: Article

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