My 5 year old was recently diagnosed with selective mutism, a rare childhood anxiety disorder where children are unable to speak in certain situations. Looking back, we can see that Gabriella has suffered with this her entire life, and our whole family has learned how to accommodate, or more accurately put, enable, her selective mutism.
Once we had a name for Gabriella’s behavior, I went on a quest to find professional help. Selective mutism is rare and finding professionals who have heard of the disorder and treated it successfully is a challenge. In the state of Texas, I found only one therapist who had more than a superficial knowledge of selective mutism, and that wasn’t going to work for me.
Ultimately, we decided to visit the Child Mind Institute in New York City. There are a few places in the country specifically treating selective mutism and I chose CMI because they are the best- the gold standard in research snd treatment, not only in selective mutism, but in the many other mental health conditions, including social anxiety, that often accompany selective mutism.
Building Brave Muscles
We just got back from a week at CMI for intensive behavior therapy. We started with an evaluation and diagnosis, did three days of one-on-on treatment and Gabriella did a one-day camp with a dozen other kids with selective mutism. It was an incredible, amazing week where we learned how selective mutism works, how we can help Gabriella and hands-on experience practicing the skills in the real world.
During our week at CMI, Gabriella approached complete strangers to ask questions, ordered a cupcake at a bakery, ordered her own food at a restaurant, talked to a TSA agent at the airport, nodded her head in response to a passerby’s question, said goodbye to a peer, said “you’re welcome” spontaneously in response to a “thank you,” made eye contact with adults outside of our family and close friends…none of which she had ever done before!
Her progress in such a short time was incredible, but CMI does not offer a cure. They have given us the tools to continue working with Gabriella to increase the number of people, places and locations where she can verbalize, be responsive and carry on spontaneous conversations.
To be able to practice “brave talking,” we have to constantly work on building her “brave muscles.” That means we have to systematically place her in different situation at different places with different people so that she can learn to be more and more comfortable with being uncomfortable. The aim of treatment isn’t to diminish the anxiety, just to help her learn to manage it better.
How you can help
Treatment for selective mutism has to happen in the real world, which means I am going to have to call on family, friends, teachers and strangers to help my daughter build her brave muscles. There is so much that we have learned about selective mutism and I wanted to share a few ways that YOU can help Gabriella or any child with selective mutism:
1. Use one-way greetings
One of the biggest triggers of anxiety for selective mutism is situations where speaking is socially expected. Greetings as simple as “hi” or “good morning” can cause great anxiety because most of us instinctually reply without a second thought, but for a child with selective mutism, that puts on way too much pressure to speak. Hello and goodbye are some of the most difficult two words she will ever say.
A better option to greet a child would be something like “nice to see you” or “I’m so glad you’re here” or “I see you brought your toy with you!” Instead of “goodbye,” try “See you next time!” or “That was fun playing with you!”
2. Don’t ask questions right away
It is natural to jump right into asking questions when we see someone new, especially children. How are you? How old are you? What grade are you in? What’s your favorite color? All simple questions, but extremely anxiety provoking for a child with selective mutism.
Before you workout, you warm up your body to be able to bend, lift and stretch. Before we start working on building brave muscles, we have to warm up too. The warm up period varies, but give at least five minutes in a new place or with new people to acclimate. Playing a game or doing an activity is a great way to warm up. During this warm up period, you can help her by talking to her without asking questions by describing what she is doing or describing what you are doing.
3. Give options
Once she is warmed up and engaging, speaking freely still may not be possible depending on the people, place or activities going on. Open ended questions will be the most challenging to answer, so when possible, give options. Instead of asking “What’s your favorite color?” you might ask, “Is your favorite color pink, yellow or another color?”
4. Don’t be offended
I promise you, I have a sweet, caring little girl. Her inability to say hello, goodbye, thank you, make small talk or look you in the eyes shouldn’t reflect on my parenting or her character. She’s not being rude and she can’t control it.
We’re working our hardest to help her be able to speak and interact with the world, but until then, I’m here to help her. I may ask you to give her some space or more time, I may rephrase your questions to help her be able to answer and I may have to focus more of my attention on her than on you when we’re together.
Overcoming selective mutism is going to take a village. We need to practice brave talking with adults, children, family, friends and strangers in familiar places and new places doing familiar things and new things.
We have a lot of work to do and I’m so grateful for all of the support we have willing to put in effort alongside us.