Challenges and solutions for Selective Mutism (SM)
The following are some of the challenges for children with SM:
Anxious avoidance is a way to escape anxiety-provoking thoughts, feelings or experiences. Children with SM become adept at communicating nonverbally or removing themselves from any verbal interactions. This may look like frozen face or body, hiding behind an adult, running away, nodding or pointing. Adults may unconsciously support this behavior by allowing the child to hide, answering for the child or telling others the child does not speak.
Contamination is a learned experience of not talking to certain people, in public places or at certain activities. Repeat experiences become “contaminated.” Children with SM believe others within those experiences also think they cannot speak, furthering their anxiety and making it harder to speak.
The following are some of the solutions or techniques to engage children with SM in verbal experiences:
Reflections are repeating or paraphrasing what a child says, to ensure the child feels heard and to echo the child’s response to others nearby. It reinforces others are listening, while subtly changing a perception the child does not speak.
Forced-choice questions provide children with SM two or more verbal options that provoke verbal responses—”Is your favorite color blue, purple or something else?”—rather than allowing them to fall into patterns of nonverbal responses. Avoiding yes/no questions prevents a nonverbal nod or shake of the head in response.
Shaping is a thoughtful, nuanced process that reinforces more desired, complex behaviors to help children reach higher-level goals. It entails identifying and breaking down a larger goal to achievable smaller goals. To encourage the child with SM to answer a question in the classroom, smaller goals may include: practicing speaking outside school, in the main entrance, in the hallway and eventually in the classroom.
Fade-ins help incorporate new people in a verbal experience. These typically involve a child verbalizing with a person they are comfortable with before introducing a new person, a way of “passing the talking baton.” Eventually, the first person fades-out, so the child is speaking with the new person alone.