QUESTION…
I am the key person at a nursery and am worried about a child. She is three and a half years old and has been at nursery for three months. She is very quiet and does not talk to me or any of the adults.
I have seen her talk to other children, but if an adult approaches her, she stops talking. We have tried to encourage her to join in activities, but she often seems to freeze or avoids them.
Her mum tells me that she talks all the time at home but has noticed that she doesn’t talk if they are out and about. Mum thinks she is just very shy and might be a bit stubborn. I am wondering if she has selective mutism.
First, it is important to recognise that ‘selective mutism’ refers to a social communication anxiety disorder. So very quiet children, like this little girl, should be referred to as ‘reluctant talkers’ until assessed by a speech and language therapist or an educational psychologist and a diagnosis is given.
Children who are reluctant talkers are anxious about talking in certain social situations. For example, they may talk at home with their parents but may be reluctant to speak, or not speak, at nursery. Equally, they may talk to certain children and adults but show high levels of anxiety when with others.
To be diagnosed as having selective mutism, a child will persistently not speak in specific social situations, while they are able to talk in other, more familiar situations. Their behaviour will not be due to a language difficulty and will have lasted for more than a month.
Both children who are reluctant talkers and children with a diagnosis of selective mutism often have age-appropriate language skills. What is important to remember is that these children have a specific fear of talking and are not choosing whether or not to speak.
HOW TO IDENTIFY A RELUCTANT TALKER
It can be tricky to identify a child who is a reluctant talker. It is important to consider whether or not the child is just shy and needs more time to settle into nursery. Young children are often quiet when starting in a new early years setting and can be reluctant to talk to adults.
Children who are simply shy are likely to grow in confidence and usually accept and welcome adults’ attempts to help them join in. However, children who are reluctant talkers will continue, even after a month, to show signs of anxiety and reluctance to join in.
There are several signs to indicate that a child may be a reluctant talker. While a child may not show all of these signs, what will be common to all is a reluctance, or refusal, to speak in some social situations but not in others. It is worth looking out for:
- excessive shyness
- body language that indicates nervousness, such as a difficulty making eye contact and frozen facial expressions
- anxiety about joining in group activities even when encouraged
- avoiding situations that involve talking, even one-to-one
- not responding to others’ attempts to engage with them
- appearing to freeze when there is an expectation to talk
- not acknowledging anyone’s attempts at interaction
- talking to some adults and children but not others.
In addition, adults, including parents, may comment that they feel the child is being rude, stubborn or attention-seeking. This is not the case – reluctant talkers have a specific fear of talking.
WHEN TO BE CONCERNED – OR NOT
If a child has been in your setting for a month or more and is showing some of the signs of being a reluctant talker, you should talk to the child’s parents about contacting the local speech and language therapy team for a diagnosis. They will then provide interventions to support the child.
Learning an additional language
Children who are learning an additional language will go through a silent period when they may appear to be reluctant to talk. During this period, the child is tuning into the sounds and words of the new language, so there may be no cause for concern, though it is important to remain vigilant for signs of the child being a reluctant talker.
Typically during the silent period a child will remain keen to engage and interact with other children and adults.
HOW TO SUPPORT RELUCTANT TALKERS
To reduce a reluctant talker’s anxieties and help them relax, do the following:
Make sure the child has a good relationship with their key person and that the key person is available at every session. The key person should play side-by-side with the child and try copying what they are doing.
Talk to the child as you would to any other child, but don’t expect a response straight away.
Remove the pressure for the child to talk. For example, instead of asking open-ended questions such as ‘What is teddy going to do?’, make comments or statements such as, ‘Teddy is jumping. I wonder what he will do next?’
Ask closed questions that require only ‘yes’ or ‘no’ answers so the child can nod or shake their head in response.
Do not try to make the child speak or ask why they are not talking, as this can increase their anxiety.
Explain to the child that you understand that talking is difficult for them. Tell them that there is no pressure to speak and that they can talk when they are ready.
Adapt activities so that the child can join in without having to speak. It is important that the child feels included.
Continue to provide opportunities for the child to communicate even if they do not use their voice. For example, an adult might say, ‘I wonder where the fish is hiding’ and pause so that the child can communicate by pointing to the fish. If the child does not respond, carry on talking, although remember to keep leaving pauses.
If other children ask why the child isn’t talking, tell them that they talk at home and will talk at nursery when ready.
HOW TO RESPOND WHEN A CHILD TALKS
Finally, if the child does speak to you, don’t make it a big deal. It can be very exciting when a child who is a reluctant talker uses their voice, and our instinct is to praise this.
However, this can make the child feel embarrassed and can cause a setback. Instead, continue as you would with any other child, although after the interaction you should note it down and share it with the parents.
Part 2 of this series – about speech sounds – will appear in the 11 June issue of Nursery World
MORE INFORMATION
SMIRA – Selective Mutism Information & Research Association – has lots of useful information and leaflets on how to support children who are reluctant talkers or have selective mutism, www.selectivemutism.org.uk
Penny Tassoni is an author and early years consultant
Anne-Marie Tassoni is a specialist speech and language therapist, Kent Community Health NHS Foundation Trust
