Sep 10, 2012

Selective Mutism:A Guide for Teachers

Compiled by Dr. Michael Cheng[1]

Purpose of this Handout

This handout has basic information about selective mutism for patients and families living in Ottawa, Ontario, Canada.

What is Selective Mutism?

Selective mutism is a condition where a child is able to talk in some settings (e.g. home) but is so anxious, that they areunable to talk in other settings such as school. Selective mutism is an anxiety condition, and is not simply the result of poor parenting, defiance, stubbornness or bad behavior.

What can school personnel do about this?

Teachers and school personnel can play a key role in helping these children overcome their anxiety.

It is important to remember that the focus is on creating an environment where the child feels comfortable enough to speak (i.e. reducing anxiety) as opposed to making the child speak (which only causes excessive anxiety if the child is not ready).

School Strategies

  • Extra efforts at connecting with this student. All students want to feel connected to their teachers and peers, but with this student, anxiety and a fear of being embarrassed makes it hard.
  • Make extra efforts at greeting the student every day, as well as saying goodbye at the end of the day.
  • Every few days or as time permits, try to find a time where you have more time in order to just talk and connect with the student, e.g. asking student about his/her interests, and other topics. These times are meant for connecting and not for anything ‘work-related’, such as “Have you done your homework yet?”

Other school interventions that have been recommended (Shipon-Blum, 2005; Kervatt, 1999) include the following:

Strategies outside of the school:

  • If possible, ideally the teacher or school social worker can visit the child at home, prior to the start of the school year. This gives the child a comfortable, safe place where the child can become familiar with the school personnel, and feel more at ease. School staff could ask the child about his/her favorite books, artwork, CD’s, games, etc. Allow the child to lead, and direct the visit. It may take a few visits to the home before the child starts to open up. The goal is to help the child feel comfortable with the school staff, as opposed to getting the child to talk. Smiling, waving, sitting close to, and speaking gently to the child often help them feel more at ease. Conveying acceptance and not pressuring the child is the most helpful. When a selectively mute child feels as though an individual is unaccepting and disappointed, they will often pull away.
  • Meet the child at school, possibly before school starts in the morning. Ask parent(s) to bring the child as early as possible so the child does not feel so overwhelmed when a group of children is in the class at the same time. By being alone with the parent and the child, the teacher can talk with the parent(s) and allow the child to just watch. The teacher can direct the conversation to the child when the child seems more at ease. Do not expect the child to necessarily respond. Just let the child know they are part of the conversation and any kind of nonverbal communication is okay with you. (From

Strategies for the Classroom

  • Give the child a seat where will feel safer and not the focus of attention, e.g. perhaps to the side, or in the corner somewhere. Avoid placing the child front and center! Consider asking the child, and letting the child use non-verbal communication, e.g. “I want to make things comfortable for you – point where you’d feel the most comfortable sitting.”
  • At some point, let the child know that you will help him feel more confident, but that you will not force him/her to talk.
  • Try to sit the child near another child that he is already comfortable or familiar with. Encourage social contact between those two children, and let the parents know, so that they can further encourage social contact, e.g. sleepovers, or play dates.
  • Communicate to the child about ways the child might communicate with you; additional ‘hierarchies of difficulty’ are shown below.

Hierarchy of Difficulty, based on Different Ways of Communicating:

  • Non-verbal communication – EASIER
  • Gestures (nodding to indicate yes, shaking head to indicate no), or using written cards to indicate “yes” or “no”
  • Writing on paper, on typing on a computer screen
  • Using a pass to go to the bathroom
  • Verbal communication -- HARDER
  • Whispering  easiest to do
  • Making noises (e.g. animal sounds)
  • Using a normal voice
  • Being able to give Yes/no answers (in response to closed-ended questions, e.g. “Did you like the ice cream?”)
  • Being able to give longer, more complicated answers (in response to others asking open-ended questions, e.g. “What did you do today?”)  hardest to do

Hierarchy of Difficulty, based on types of People

  • At School
  • Talking to parent at the school– EASIER
  • When the child and parent are alone together, the child talks with the parent
  • Alternatively, the child whispers through a parent
  • Talking to fellow students through a parent
  • When the child and parent are together with peers, peers talk to the child, and the child answers through whispering or talking to parents, who then relay the message to fellow students
  • Talking to one fellow student, or one fellow teacher
  • Talking to several fellow students or several teachers
  • Talking to anyone – HARDER

What to Tell the Other Students

When the selectively mute child is not around, talk with other school staff or students to educate them.

For school staff, one might include a bit more diagnosis about diagnosis:

  • “I’d like to tell you about (NAME OF STUDENT), who has a diagnosis of selective mutism, which is a type of anxiety condition. The good news is that there are things that all of us can do to help her feel more confident and overcome her anxiety.”

For fellow students, one might be more vague about diagnosis:

  • “I’d like to tell you about (NAME OF STUDENT). (NAME OF STUDENT) really likes (list some interests). She is a sensitive, caring person. She talks more with people when she gets to know them better and gets to know them better. And the good news is that there are many things we can do to help her feel more comfortable.”

Things to do might include:

  • Treat him like a good friend
  • Be nice to him and
  • Include him in activities, by asking if he wants to play or join in.
  • Talk about things that you have in common, such as common interests

Things not to do:

  • Forcing him/her to talk isn’t helpful, because it would just make him/her more anxious.
  • Don’t try to make him talk
  • Don’t say to others, “he doesn’t talk”. Its okay to say, “s/he will talk more when s/he gets to know you better.”
  • Don’t make a big deal if he speaks, because that might make him more nervous. Just calmly acknowledge what he has said, pretend as if everything is normal and continue on.”

Key Things to Avoid Doing

  • Key things to avoid are to avoid ever making the child feel as though you are ‘waiting’ for him/her to speak. This expectation is anxiety provoking. Children do not want to feel as though they are letting the teacher down.
  • Don’t make a ‘big deal’ over any verbalization that does occur. Very often, the selectively mute child will speak to a peer before a teacher. In this case, do not make mention that you ‘hear’ their voice, since many selectively mute children will often pull away if this is done.

References

  • which is a great website with information about selective mutism

Resources in Ottawa

  • Visit to find out where to get help in Ottawa for anxiety disorders and selective mutism, as about how to find a psychologist or speech-language pathologist.

Where to Get this Handout

This handout is available from in the Mental Health Information section. Any comments and suggestions are welcome and will help ensure this handout is helpful.

Disclaimer

The content of this document is for general information and education only. The accuracy, completeness, adequacy, or currency of the content is not warranted or guaranteed. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should always seek the advice of physicians or other qualified health providers with any questions regarding a health condition. Any procedure or practice described here should be applied by a health professional under appropriate supervision in accordance with professional standards of care used with regard to the unique circumstances that apply in each practice situation. The authors disclaim any liability, loss, injury, or damage incurred as a consequence, directly or indirectly, or the use and application of any of the contents of this document.

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[1] Child Psychiatrist, Children’s Hospital of Eastern Ontario, McArthur Site, Suite 200, 311 McArthur Ave, Ottawa, Ontario, K1L 8M3, (613) 738-6990,