Speech and Language Therapy  

  Children with Selective Mutism   

 
Selective mutism affects about 1 in 140 children; that's two children in most 
mainstream primary schools.  
 
Are you worried that your child or a child you support may have selective mutism? 
 
Would you like to feel confident that you’re doing everything you can to help? 
 

What is Selective Mutism?  

Selective mutism is an anxiety disorder that prevents children from talking in certain situations, such as at school or in public, despite being able to talk freely in other situations, such as at home with close family.  
 
Selective mutism is often misunderstood as shyness or refusal to talk. Children with selective mutism want to talk but are physically unable to do so in certain situations, due to a phobia of talking. The expectation to talk triggers a freeze response that prevents the words from coming out. The anxiety that children experience in these situations can also affect their movements (e.g. pointing, handling objects, walking, running).  
 
It is not unusual for children with selective mutism to develop maladaptive coping mechanisms to deal with the anxiety. Some children act out in front of family and friends, at parties and at school. 
Mood swings, crying, anger, temper tantrums, avoidance, procrastination, inflexibility and difficulty with changes and transitions are common. 
 
There are two profiles of selective mutism: high profile selective mutism, where a child never talks in certain situations, and low profile selective mutism, where a child gives minimal responses and doesn’t initiate talking in certain situations. Selective mutism usually starts in early childhood when children first socialise beyond the family. If left untreated it can continue into adulthood. 
 
If a child has been talking minimally or not at all in certain situations for over a month (two months in a new setting), despite talking freely in other situations, they can be decribed as having selective mutism. The earlier selective mutism is identified, understood and managed in the right way, the easier it is to overcome. 

Selective Mutism Services  

Assessment, report and initial recommendations 
 
Training for parents and education staff in understanding selective mutism and how to help 
 
Planning meetings with parents and education staff (and separately with the child if required) 
 
Support to devise and update the child’s therapy plan and goals 
 
Advice and guidance by phone call or email between meetings 
 
Some children will require regular therapy sessions with parents and/or education staff under the guidance of the speech and language therapist (e.g. 15 minutes on three days a week), or directly with the therapist 
 
Some parents and education settings jointly fund these services 

What Parents and Schools Say 

“Our 3 year old daughter suffered with selective mutism. We decided to get in touch with a specialist to help us deal with the problem. Pre-school recommended Natalie and we are so glad they did. The issue, which we were really worried could affect our child for years to come, was sorted in a matter of months. Thanks to her extensive knowledge and experience of this disorder, Natalie was able to put in place a great plan of action tailored to our daughter's specific needs and individual personality. The staff at pre-school and ourselves at home followed all of Natalie's expert advice and as a result, my daughter who wasn't saying a single word at pre-school can now happily chat to all her little friends and all the members of staff. It's such a joy and a great relief. Thank you Natalie for all your precious help and constant support throughout this stressful time - we couldn't have wished for a better outcome!” 
Parents of a 3 year 11 month old girl 
“You will remember that I asked if we could use a child’s pupil premium funding to buy-in an independent speech and language therapist who works with children with selective mutism. The work was completed today. The success is phenomenal. The child now speaks in class and is looking forward to going to secondary school and making new friends. She now has a positive outlook on life. Her educational progress is equally astonishing - maths: 11 steps of progress; reading: 10 steps of progress; writing: 10 steps of progress. Congratulations to the child for wanting to change and being brave, and thanks to the teaching staff for doggedly sticking to the programme, dedicating and ring-fencing time for it to happen, and also to the child’s mum for totally supporting and engaging with it every step of the way. Thanks of course to Natalie too who enthusiastically supported everyone along the way.” 
Email from a primary school SENCo to the Head Teacher 
“Our family have benefitted hugely from Natalie’s involvement. Our daughter at the time had selective mutism in school settings. With Natalie’s support and suggestions she is now attending school and able to communicate her basic wants and needs and get these met. Natalie’s support and experience in advocating for us with other professionals, particularly school-based staff, has been particularly helpful. Natalie has been instrumental in supporting our daughter to feel more confident in attending school. She was too anxious to attend a few months ago, but with Natalie’s support and advice she is now almost back on a full time basis. Thank you so much Natalie.” 
Parents of a 7 year old girl 

Feedback 

If you have used one of my services I would love to hear from you. Your feedback is invaluable and helps me to shape the way I provide future services. You can let me know your feedback by completing this form. 
Contact Natalie today to arrange a no obligation initial phone consultation. 
 
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