Situational mutism (often still referred to as selective mutism) is an anxiety disorder where a child is unable (not unwilling) to speak in certain social situations, such as at school or with unfamiliar people. They may speak fluently in some situations but remain consistently silent in others and may have a blank expression, or appear ‘frozen’ when expected to speak. It is crucial to realise that this isn't a choice or refusal to speak; rather, the child is physically unable to speak due to overwhelming anxiety.
Situational mutism typically affects young children, often starting between ages 2 and 4, although it can begin at any age. It is more common in girls and children who are recent immigrants to a country. It is estimated that in the UK about 1 in 140 young children are affected by this condition.
Exactly what causes situational mutism isn't always clear, but it is known to be closely linked to anxiety. Children who experience situational mutism often have a tendency to anxiety and may find it difficult to cope with everyday events. It can also be triggered by separation anxiety (from parents/carers), speech and language disorders, and/or sensory processing issues. In the latter case, sensory integration dysfunction can cause some children to "shut down" and be unable to speak when overwhelmed in a busy environment. This is very different to the situation where a child suddenly stops talking in response to a traumatic event, which is a sympton of post traumatic stress. It is important to remember that children who experience situational mutism are neither controlling nor manipulative and whilst some autistic children are also affected, there is no causative relationship between selective mutism and autism.
Supporting a child with situational mutism involves creating a low-stress environment and gradually encouraging verbal communication. Potential strategies might include:
Accepting nonverbal communication and allow the child to use gestures, nodding, or pointing to communicate;
Easing into verbal communication, beginning with one-sided communication and gradually introducing verbal responses;
Creating a supportive environment which ensures that the child feels safe and understood.
Diagnosing and treating situational mutism typically involves a team of professionals, including psychologists who conduct assessments and provide therapy to address anxiety; Speech and Language Therapists ("SALT") who help with any underlying speech or language issues; Educational Psychologists ("EP") who work with schools to develop support plans and pediatricians who can rule out any medical conditions that might contribute to the mutism. In England parents and carers can self-refer to a speech and language clinic directly.
To get a diagnosis of situational mutism the symptoms must:
Interfere with a child’s education and social and cognitive development;
Extend at least one month beyond the first month at school;
Not be due to a lack of knowledge of the language;
Not be better explained by something else, e.g., a communication disorder such as stuttering
Schools can play a crucial role in supporting children with situational mutism by implementing the strategies outlined above and also by:
Identifying a key adult, whether a teacher, teaching assistant, or counselor, to support the child and
Collaborating with parents to keep them informed and involved in their child's progress.
If your child or young person is or might be experiencing situational mutism and it is impacting their education, SEND Advocacy can provide advice and support. To have someone in your corner to help you secure the education your child deserves, contact us today.
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