I kind of accidentally fell into an area of expertise I didn't expect. How to help
a child with selective mutism?
Selective mutism. Probably definitions going to help first. If you found this
video, either you were looking for this or you're subscribe to our channel and
thanks for that. Selective means when I want to and mutism means I don't talk.
Okay, so that's going to help. This can be a
really frustrating situation. Selective mutism, typically our kids who
can talk, they have all of the language skill and ability that's necessary to
communicate. But they choose not to talk in certain settings. I use the word
choose very carefully because this is a complicated dynamic that has at least
three components to it that I will share with you here. But this is frustrating
for parents or for teachers to see that this kid can talk but doesn't talk in
certain settings. Now, what are the three components that add to this? I believe
strongly from my own experience and the kids that I've worked with that there is
an "anxiety" component that supports this particular diagnosis. What I mean by that
is... it develops almost like a phobia does. In a phobia, something
happens where we have an unpleasant experience with whatever the stimulus is.
Might be a spider, it might be something to do with heights or with social
interactions. Whatever it is, but it triggers a fear response. We basically
have two choices when we have a fear response to something. We can either face
that fear. Yeah, like that's likely. Or we can run away from it. More likely, right?
Because our mind tells us, "hey, that's dangerous. Get out of there."
When we avoid something that we fear, it actually increases our fear of that
thing, long-term. When we face it, it actually increases our fear short term
but in the long term helps to alleviate or reduce that fear. Phobias develop when
we avoid something and reinforce the fear because there's some fuzzy logic
going on. "Oh I feel so much better when I avoid that thing>" It must really be
dangerous. Do you see the fuzzy logic? It doesn't
mean that it's dangerous. It just means you feel better when you
avoid it, at first. But over time, it increases the fear. That's the problem
that we run into and I see this dynamic with selective mutism. Somehow, they have
an experience and we can't always even identify what that experience was. What
started this, what triggered it. Some of the parents who have worked with me can
say, "oh yeah, it was when this happened that my son
started to not speak anymore." But a lot of times, we can't even identify the
triggering source. It's just developed now into a pattern
where they never speak at school.They never speak outside of the home and
that avoidance has paid off for them because they feel better in the short
run. But in the long run it just kind of feeds on itself.
Now another dynamic that's happening here is a "relationship dynamic". This
one's a little tough for us as parents or teachers or counselors because we
actually train each other. We and our children, train each other how to
interact. So in this relationship dynamic as the child fears the social
interaction and refuses to speak, what does mom do? Well, she often will jump in
and speak for the child, okay? Or a teacher, what does teacher do? Uses sign
language or comes up with a different form of communication that works.
Teachers got 15 other kids that she's trying to deal
with. What am I going to do with this one? Well, I'm going to do what's efficient and
what's convenient and what's helpful. For that child to refused to speak causes an
inconvenience for the adult. That adult is going to solve the inconvenience in
the most efficient way that they can come up with. In the moment and usually
that dynamic then starts to train each other, how to handle certain situations.
So they might go to a restaurant for example and the child is completely
unwilling to verbalize what they want or to order what they want. So they whisper
it into mom's ear and mom orders if for them. And that tends to work for everyone.
But it perpetuates the dynamic too. So that relationship dynamic is the second
factor that I wanted to point out. Now the third one has to do simply with
"habit". Whatever we practice, we get really good at and if our kiddo has been
practicing not speaking for quite some time and it seems to be working for them,
they're going to get really good at it. Most of the kids that I've worked with who
have selective mutism, actually tend to be quite bright. They're thinkers and
they know at some level that this is working for them. Now, I'm not saying that
they enjoy it because most of the kids I've worked with also want to overcome
it. But they don't believe that they can. And the fear at this point has grown to
the the anxiety component has grown to a point that it's almost paralyzing
for them. So that's why it's frustrating and I wanted to share those dynamics
with you so that you get a sense of what it is that we're dealing with. Now based
on our understanding of it, what can we do about it?
Well, for each of these contributing factors, we can add an intervention
component. So let's go with the first one. Anxiety, knowing that this is an anxiety
based problem, what we want to do in terms of intervene
is to offer opportunities for that child to face his fears. Now, is he going to be all
excited about that? No! because everything in his mind is
telling him, he needs to avoid that. What it comes down to is an approach
avoidance conflict. We experienced this all the time as adults too. Where you
really want something, that's the approach draw. But there's all kinds of
costs or difficulties or hard things about that.
That's the avoidance part of the dynamic. The approach and avoidance conflict that
these kids are feeling, can be very intense. So, what we want to do is create
opportunities for them to face that and practice overcoming it. Here's an example
of one thing that I did with one of my young clients. We set it up. He really
loves ice cream. We set it up so mom was going to take him to
Baskin Robbins. 30 wonderful flavors. He gets to pick whatever flavor he wants and
what ever size he wants. As long as he orders it, mom buys it. If he doesn't
order it, mom doesn't buy it. Do you see the approach of avoidance conflict that
we're setting up? Now, normally when they would go to the ice cream store, he would
get really quiet. He'd back off mom, would ask him, "well, what do you want? Tell the
lady what you want." And he wouldn't say anything and he'd get this nervous look
on his face and he kind of looked down and look us up. He wouldn't say a word.
Mom would lean down to him and he would whisper into her ear what he wanted and
then she would order for him. That's how it typically went. Well, we changed that
dynamic right? What he orders he gets to eat, if he doesn't order anything, he
doesn't need anything. So mom ordered what she wanted. Gave him
an opportunity. Son, what would you like? He doesn't say
anything. He gets nervous, he looks to her to lean down to him. She's waiting
patiently. Would you like to order something? Still silent. Mom was great
how she handled this because can you feel that as a parent, how that's going to
pull on you a little bit and you're not sure you really want to do this. You have
to have the guts to actually follow through and she did it beautifully and
she did it in a kind way. Where she said, "well, I guess he's not going to order
anything. We'll just go with what I ordered."
Wow! Can you see that that's kind of tough? But the beautiful thing about this
is, after a few trials of this, the kid actually did order something and he had
a success there. We'll, come back to that when I get to the third tip. Tip number
two, adds on to what we've just talked about with creating opportunities for
them to face their fears and experience some success or failure. Be ready for
them to fail and be okay with that. In fact, step number two is this, "reduce
the expectation". This kid is bright. He knows that there's an expectation that
he changes this behavior and that he steps up and starts speaking. He knows
that. In fact, a lot of the kids that I've worked with are very sensitive socially.
And if, they make an effort to speak, everyone around them, mom, dad, therapist,
teacher start to celebrate. "Oh awesome! great job! And they're like, "ugh", it freaks
him out a little bit if we react too much. So we're going to reduce the
expectation and we're going to tone down our reactions. I think what we want to do
is take all of the drama out of this thing and make it very practical. You can
order ice cream or not, either ways fine with me. So the expectation comes down
and then the reaction comes down too. Kid orders the ice cream. I want a chocolate.
Single. Instead of saying, "oh nice job sweetie!" That probably works against us
in this case. Simply continue business as usual and allow the consequence to
happen. This is powerful based on what I know
about the psychology that's going on with these kids. So, we're not going to do
a whole lot of celebration. Reduce the expectation and the response to that.
Going right along with this is to remove the rescuing and not in a dramatic way.
"I'm not going to order for you anymore." No, it's simply, "you can order or not.
Either way is fine and you get to have whatever you order. Any questions? And I
love that little, "any questions?" because it's just like, "hey, I know what I'm doing
here, okay? And we we take the drama down. So, we're not going to rescue but we're
not going to do that in a dramatic way if that makes sense to you. Now, tip
number three has to do with the habit factor that I talked about. Whatever we
practice, we get really good at. They're not going to be good at speaking in these
uncomfortable situations until they've had a chance to practice it multiple
times. So when you get that first success that's awesome
remember don't celebrate too much because that freaks them out a little
bit on the social scale. Simply matter of fact, business as usual. Let the
consequence do the teaching. Maybe connecting with a little empathy helps
too. Well, you know after you leave the ice-cream shop, "well, son how did that
feel? I was nervous whatever. Well, I think you did a great job. Nice. We'll try it
again tomorrow." Or in a day or two or whatever it is but you need to repeat
the practice. Practice, practice, practice. That's tip number three. "Get the practice
reps in" because that's what's going to build the confidence. I'm so glad that
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