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A Unique Child: Selective Mutism - Silent types

How do you distinguish between children who are shy or 'just very quiet' or those who may have selective mutism? Maggie Johnson and Michael Jones offer advice for practitioners.

It is not uncommon for some young children to be confident talkers at home but to be very quiet or completely silent in nursery. The task for practitioners is to understand the possible causes for a child's reticence to speak and develop appropriate strategies for that particular child.

Young children are often very quiet when settling in to nursery. For some, this reluctance to speak may stem from a lack of confidence or experience in talking to unfamiliar adults and children, and these children benefit particularly from adult encouragement to join in group play.

Other children may have genuine communication difficulties and be reluctant to speak to people who may not understand them. However, this is often a temporary response, and with appropriate encouragement they emerge from their quietness and 'find their voice'.

Children who are described as 'shy' have a reserved temperament and a natural tendency to be wary of new situations and people. They gradually 'warm up' over time, and with familiarity. While they welcome and respond well to adult support, they remain uncertain in new situations, or with unfamiliar people. Often children are shy with adults and in large groups, but more confident when speaking with other children in small groups and individually with adults.

Many young children in the very early stages of learning a second language go through a 'silent phase'. They spend a lot of time listening and working out important aspects of their new language, such as when one word ends and another one begins. Children often emerge from this stage as chatty individuals who then learn their new language by talking a lot.

SELECTIVE MUTISM

Children with selective mutism speak freely with only a small number of people with whom they feel comfortable. Typically, the child is able to speak at home, with familiar family members, but experiences extreme anxiety about speaking outside their home. This anxiety is so strong that the child often describes experiencing an actual blockage in their throats, possibly caused by muscular tension.

Selective mutism may begin as extreme shyness in a child's pre-school years and develop into selective mutism by the time the child starts school. The condition was originally known as 'elective' mutism, as it was thought that the children were choosing to be silent in public. It is now generally accepted that the children do want to speak, but their anxiety prevents them from speaking in certain situations, and most typically in early years settings or school.

We can make a clear distinction between children who are shy and those with selective mutism by observing their reactions to adults. Shy children are generally unsure of themselves and usually welcome help with joining in, whereas children with selective mutism have a specific dread of speaking. They may suddenly shut down, back off or become almost frozen or rooted to the spot and unable to respond. They become wary of what they perceive to be a threat to make them talk. They may also be too 'frozen' to communicate non-verbally, including making eye contact, smiling, nodding or pointing.

SUPPORT AVAILABLE

The Selective Mutism Resource Manual (Speechmark Publishing) outlines many techniques for helping children to develop as confident speakers. Key to making progress is strong links between nursery staff and the child's family, so that everyone can have a shared understanding of the child's needs and adopt a consistent approach to support. In this way, the child's ability to speak confidently at home can gradually be developed into confident speaking in the setting.

The following suggestions can be used as part of a whole-setting approach to supporting children who are quiet, are shy or have a diagnosis of selective mutism:

  • Agree how you are going to talk about the children concerned. All staff need to practise using positive phrases, such as 'This is Lauren, she talks a lot at home, and we are helping her grow in confidence in pre-school.'
  • Share your concerns with parents, but be aware that how you talk about the child is important. Avoid referring to the child as having selective mutism unless there has been a professional diagnosis of this condition. Be positive with the parents, and tell them the types of strategies you are all using.
  • It is essential that staff, visitors, parents and other family members avoid pressuring the child to speak, through offers of rewards or regular questioning, such as 'Are you going to talk/did you talk in nursery today?'
  • If you feel that you are dealing with a child with selective mutism, seek advice and support from advisors, speech and language therapists, psychologists or the Selective Mutism Information and Research Association (see More Information).
  • Find out and discuss with the child the activities that they enjoy at home. If, for example, the family has a dog, share a book about dogs and play with toy dogs. Ask the family to help the child make an 'All about me' box - a decorated shoebox filled with the child's family photographs and favourite toys and objects to look at and share in nursery (individually and in pairs initially, and later in small groups).
  • Encourage the parents to spend time in the setting, helping their child to get to know others and to provide reassurance about joining in with activities. This may lead to children and their parents meeting each other outside the setting, so widening the range of people who are familiar to the child and helping build their confidence to speak.
  • At home, parents and children may find it helpful to play 'being at nursery' and sharing nursery activities such as singing familiar songs, using teddies or dolls.
  • If appropriate, visit the child at home, to help develop a familiar and positive relationship, and help the child relax in the setting.
  • Be positive and gently reassure the children that in time they will begin to feel more comfortable about being in the setting and about joining in. For example, say, 'We want you to enjoy yourself and be happy. We will help you to join in as much as you can. I know it's difficult for you at the moment, so we are going to help.' Or, 'Don't worry: once you have got used to playing in nursery, you will feel better about talking, there's no rush.'
  • Encourage the child to respond and join in by non-verbal means - for example, by pointing, nodding or shaking their heads, or using a puppet.
  • Encourage participation through natural conversation and by sharing books where you comment, laugh and pause rather than ask direct questions.
  • Within your setting, take steps to alleviate any pressures that may be affecting the child. For example, change from a registration system where children have to call their name to one where children 'self-register' with their parents, and arrange for a staff member to 'meet and greet' children and their parents as they arrive.
  • Encourage the child to take part in activities in pairs. Wary children can be reassured by another familiar child prepared to go first in trying something new.
  • Singing in a group can help children to 'find their voice' without anyone noticing or drawing attention to them.
  • Alert children to anything new that is going to happen, such as a visitor, a trip or a new activity. Allowing children to talk about events in advance will remove their uncertainty and reduce their anxiety.
  • Praise children for making small steps towards joining in and talking - for example, by saying quietly, 'You made a real effort to join in our group today. I bet that felt good.' If your setting gives stickers, you may find that quiet children prefer a chart to take home to show the family, as public praise and attention can sometimes be uncomfortable for them.

The most important thing that we can do for all 'quiet' children, regardless of the underlying cause, is to believe that they all want to talk, and that they will make progress if we are able to remain positive and have a consistent approach to helping them.

Maggie Johnson is a speech and language therapist specialising in supporting children with selective mutism. Michael Jones is an early years trainer and writer

MORE INFORMATION

  • The Selective Mutism Resource Manual by Maggie Johnson and Alison Wintgens (Speechmark Publishing)