Selective Mutism in Children: Why My Child Won't Speak at School
What Is Selective Mutism?
My daughter, Catherine, did not speak at school for three years. She went from a happy, talkative toddler in preschool to a silent, anxious five-year-old in kindergarten. The school psychologist guessed that she was just shy and would outgrow the stage. Our doctor told me that she was very strong-willed and just needed more discipline. Neither was correct. It was not until three years later that I discovered she had selective mutism.
Selective mutism is a rare form of childhood anxiety disorder that prevents a child from speaking in certain social situations, such as school or church. It is not to be confused with a speech or language disorder, or with willful behavior. The anxiety the child experiences prevents them from speaking. To be diagnosed with selective mutism, the condition must have existed for at least a month.
At school, my daughter did not speak a word to any child or adult, with the exception of her main teacher. To her teacher, Catherine would whisper her basic needs like, "Can I use the restroom?" She also was unable to say the names of her classmates in any setting. Away from school, she had no problems speaking, and in fact, she spoke quite a bit.
How to Recognize Selective Mutism in a Child
- The child does not speak in specific social settings, such as school, church, or daycare.
- The child seems to freeze and appears anxious in these social settings.
- The child does not have these problems in other settings.
- The condition has persisted for more than one month.
Selective Mutism Story From Wales
What Is Obsessive-Compulsive Disorder (OCD)?
My daughter's selective mutism was directly related to her obsessive-compulsive disorder (OCD), an anxiety disorder that affects millions. A person with OCD engages in certain compulsions or rituals that help reduce their anxiety. The compulsions are often irrational and can interfere with daily life. You may have seen the movie As Good As It Gets, in which Jack Nicholson portrays a character with severe OCD. His compulsions are very obvious—checking multiple locks on his door, always ordering a very specific meal at the same table in a certain restaurant, and using his own sanitized utensils.
My daughter's compulsions were not as obvious. We were not even aware that she had OCD until she was diagnosed with selective mutism at age eight. Looking back, we noted the following odd behaviors when she was 3-5 years old:
- She only ate certain colors of food for a few weeks.
- She didn't eat solid food for three weeks after getting a popcorn kernel stuck in her teeth.
- She constantly asked if her food was poisoned.
- She never lay down flat on her bed at night for fear of choking.
- She lined up small toys in color order.
When we expressed our concerns to her pediatrician, he assured us that she was just strong-willed.
Signs of OCD in a Child
- Excessive worrying
- Fear of unlikely catastrophes, such as poisoning, germ contamination, or sudden death of a loved one
- Getting very upset when things don't go as expected
- Lining up or counting objects
- Washing hands a lot
- Picking skin or pulling hair out
- Scratching or biting oneself when upset
- Perfecting homework by spending too much time and erasing a lot
- Following long, exact routines, for example, at bedtime
- Collecting random objects to an extreme, for example, shampoo bottle caps
How Can Schools Help a Child With Selective Mutism?
Unfortunately, public schools did not help my daughter in her first three years, but I know now that they could have. My daughter's kindergarten teacher alienated her, and her classmates followed suit. The following year, we switched to a much smaller, magnet school that had a reputation for having a nurturing atmosphere. Catherine did well there, academically, and she seemed much happier too. Her teacher often embraced her, and her new classmates did as well. However, she still did not speak. She attended the magnet school for two years, and one day, miraculously, she began to whisper to a certain friend. At the same time, though, she stopped eating at school. It was at that point that we decided to try homeschooling.
Now, I know that Catherine could have received the help she needed if we had all been aware of the disorder and possible treatment plans. Under the guidance of a trained psychologist, a school would be able to gradually introduce speaking opportunities to the affected child. For example, a time would be arranged when the child is alone in the classroom talking with the teacher. Later, they would arrange the same setup with another child in the room, but not nearby. The next session, the other child would be closer, and so on.
Tips for Getting Help at School for Your Child's Selective Mutism
- Prepare a one-page information sheet describing what selective mutism is and pass it on to your child's teachers and principal.
- Ask the principal if a training session on selective mutism can be provided for all the teachers and staff at the school.
- Consider asking your school for a formal educational plan to meet your child's needs.
- If your school does not seem to be cooperating in helping your child, consider asking for assistance from a child advocacy group
How to Treat Selective Mutism
After the first year of not speaking at school, we privately sought professional help. Catherine participated in 18 months of play therapy and learned coping skills and how to verbalize her fears in general. The therapist never mentioned selective mutism or had any ideas on how to solve the problem of not speaking. She thought Catherine would simply outgrow the silence.
After we withdrew Catherine from school at age 8 to homeschool, I began to research childhood anxiety issues online. This was when I came across selective mutism, and the puzzle pieces started to come together. We sent Catherine to a neuro-psychologist who immediately diagnosed her with OCD and selective mutism. Catherine did have some OCD behaviors, and the selective mutism was tied directly to her OCD. Being silent was her compulsion that alleviated her anxiety of being at school.
Once she was diagnosed, Catherine was referred to a psychiatrist for medication management. It was a very tough decision to make, but we decided to give it a shot to see if it could reduce the tremendous amount of anxiety that plagued her. Unfortunately, even the smallest doses of any type of medication had adverse effects on her. In many other children, however, the right combination of therapy and medication management has been very successful in reducing anxiety and related behaviors.
Leaving the Silence Behind
Catherine was homeschooled for three years and did very well—academically and emotionally. For 5th grade, we decided she was ready to try a brick-and-mortar school again and enrolled her in a public Montessori school. She has flourished there beautifully. We had concerns that the selective mutism would come out of remission, but it did not. She absolutely loves going to school. She completes her schoolwork enthusiastically, eats her lunch, has a best friend, and most importantly, she speaks.
Becoming your child's advocate and sharing information with the school will be a huge part of overcoming selective mutism. I once asked a school speech therapist, who had 30 years experience, if she had ever worked with students who had selective mutism. She replied, "Oh, we have had a few of those. We don't do anything with them, though, because they choose not to speak." Unfortunately, this attitude still exists in many schools, so raising awareness will be a priority in battling selective mutism.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.