What are some signs or symptoms of selective mutism ?

Symptoms are as follows:

  • consistent failure to speak in specific social situations (in which there is an expectation for speaking, such as at school) despite speaking in other situations
  • not speaking when it interferes with school or work, or with social communication
  • when it lasts at least 1 month (not limited to the first month of school)
  • when failure to speak is not due to a lack of knowledge of, or comfort, with the spoken language required in the social situation
  • not due to a communication disorder (e.g., stuttering)
  • it does not occur exclusively during the course of a pervasive developmental disorder (PPD), schizophrenia, or other psychotic disorder

Children with selective mutism may also show:

  • anxiety disorder (e.g., social phobia)
  • excessive shyness
  • fear of social embarrassment
  • social isolation and withdrawal

A child with selective mutism should be seen by a speech-language pathologist (SLP), in addition to a paediatrician and a psychologist or psychiatrist. These professionals will work as a team with teachers, family, and your child.

What we do…

The assessment process is very important and includes:

  • gathering a complete background history
  • an educational history review
  • hearing screening
  • oral-motor examination
  • parent/caregiver interview
  • perform a speech and language evaluation

The educational history review seeks information on:

  • academic reports
  • parent/teacher comments
  • previous testing (e.g., psychological)
  • standardized testing

The hearing screening seeks information on:

  • hearing ability
  • possibility of middle ear infection

The oral-motor examination seeks information on:

  • coordination of muscles in lips, jaw,and tongue
  • strength of muscles in the lips, jaw, and tongue

The parent/caregiver interview seeks information on:

  • any suspected problems (e.g., schizophrenia, pervasive developmental disorder)
  • environmental factors (e.g., amount of language stimulation)
  • child's amount and location of verbal expression (e.g., how he acts on playground with other children and adults)
  • child's symptom history (e.g., onset and behaviour)
  • family history (e.g., psychiatric, personality, and/or physical problems)
  • speech and language development (e.g., how well does the child express himself and understand others)

The speech and language evaluation seeks information on:

  • expressive language ability (e.g., parents may have to help lead a structured story telling or bring home videotape with child talking if the child does not speak with the SLP)
  • language comprehension (e.g., standardised tests and informal observations)
  • verbal and non-verbal communication (e.g., look at pretend play, drawing)

Once assessment is complete our speech and language Pathologist will 
offer intervention.  This may be a combination of strategies including;

  • creating a behavioural treatment program
  • focusing on specific speech and language problems
  • working in the child's classroom with teachers

A behavioral treatment program may include the following:

  • Stimulus fading: involve the child in a relaxed situation with someone they talk to freely, and then very gradually introduce a new person into the room
  • Shaping: use a structured approach to reinforce all efforts by the child to communicate, (e.g., gestures, mouthing or whispering) until audible speech is achieved
  • Self-modeling technique: have child watch videotapes of himself or herself performing the desired behavior (e.g., communicating effectively at home) to facilitate self-confidence and carry over this behavior into the classroom or setting where mutism occurs

For specific speech and language problems our therapist can:

  • target problems that are making the mute behaviour worse
  • use role-play activities to help the child to gain confidence speaking to different listeners in a variety of settings
  • help those children who do not speak because they feel their voice "sounds funny"

Working with the child’s teachers includes:

  • encouraging communication and lessening anxiety about speaking
  • forming small, cooperative groups that are less intimidating for your child
  • helping your child communicate with peers in a group by first using non-verbal methods (e.g., signals or cards)
  • gradually adding goals that lead to speech