The month of September is difficult for many children- the fear of a new classroom, new classmates, and a routine of long school days and homework after the summer make many dread the month. In September, many students are shy with their new teachers. But what happens when this initial shyness does not dissipate at the end of the month? What happens when the child does not speak to the teacher or even to their peers in October, November, and then that behavior persists into the rest of the school months? If this is happening, it may be time to look for a professional that specializes in Selective Mutism (SM).
Selective Mutism is defined as a complex childhood anxiety disorder characterized by a child’s inability to speak and communicate effectively in select social settings, such as school. These children are able to speak and communicate in settings where they are comfortable, secure, and relaxed. Children and adolescents with Selective Mutism are fearful of speaking where there is an expectation to speak and communicate. Most children with Selective Mutism have a lot of difficulty responding or initiating communication.
In my experience as a professional who treats many children and adolescents with SM, I quickly learned that not all children manifest their fear of speaking in the same way. Some may be completely mute but able to communicate nonverbally, others may be able to speak to a select few or perhaps whisper, while others may freeze and be expressionless.
Whichever way their anxiety is manifested, seeking help from a professional who specializes in Selective Mutism as early as possible is important. Children do NOT grow out of this and findings have indicated that the earlier a child is treated, the faster their response is to treatment and the better the overall prognosis.
During the initial session with the parents, it is extremely important for the professional to get a thorough developmental history. Included in this history should be questions such as: Has the child ever spoken at school? If so, with whom have they spoken? Many parents are unsure if their child has ever spoken in school because the teachers are not always clear in their delivery of the pertinent information. Parents are also unsure what questions to ask the teacher. Therefore, as the professional, I believe that school visits, whenever possible, are an imperative part of the treatment. These observations allow me to not only see the child in the school setting, but also afford me the opportunity to speak with the classroom teacher. Having ongoing communication with the teacher is also important in order to educate the school on SM, develop and maintain a positive behavior plan in the classroom, and get updates on the child’s progress. With the appropriate treatment, children and adolescents with SM often overcome it successfully.
Dr. Carly Orenstein is a clinical psychologist who practices cognitive-behavior therapy with children, adolescents and adults through individual, family and group therapy. Her specialties include (but are not limited to): Selective Mutism, Attention-Deficit/Hyperactivity Disorder (ADHD), anxiety disorders, and parenting issues.
Dr. Orenstein has had a great deal of experience treating children and adolescents with Selective Mutism (SM). She frequently provides family therapy to patients with SM, as well as educates schools (both Child Study Team members and teachers) about SM.
