This term is widely considered to be offensive This term is generally agreed to be offensive toward a person or group of people. We strongly recommend you do not use this term and instead use a term not usually thought to be offensive. While it is possible that some people will not be offended by this term, just as some people will be offended by other terms when no harm is intended, it is best to avoid.
Remember that what is considered offensive can also change over time, by scenario, and by relationship. We provide this library of terms for informational purposes and we welcome feedback to help us get it right. The National Association of the Deaf provides this clarification in the context of the term "deaf-mute": This label is technically inaccurate, since deaf and hard of hearing people generally have functioning vocal chords.
For example, a child may not do their best in class after seeing other children being asked to read out good work, or they may be afraid to change their routine in case this provokes comments or questions. Many have a general fear of making mistakes. Accidents and urinary infections may result from being unable to ask to use the toilet and holding on for hours at a time.
School-aged children may avoid eating and drinking throughout the day so they do not need to excuse themselves. Children may have difficulty with homework assignments or certain topics because they're unable to ask questions in class. Teenagers may not develop independence because they're afraid to leave the house unaccompanied.
And adults may lack qualifications because they're unable to participate in college life or subsequent interviews. With appropriate handling and treatment, most children are able to overcome selective mutism. But the older they are when the condition is diagnosed, the longer it will take. Treatment does not focus on the speaking itself, but reducing the anxiety associated with speaking. This starts by removing pressure on the person to speak.
They should then gradually progress from relaxing in their school, nursery or social setting, to saying single words and sentences to one person, before eventually being able to speak freely to all people in all settings.
The need for individual treatment can be avoided if family and staff in early years settings work together to reduce the child's anxiety by creating a positive environment for them.
As well as these environmental changes, older children may need individual support to overcome their anxiety. The most effective types of treatment are cognitive behavioural therapy CBT and behavioural therapy. Cognitive behavioural therapy CBT helps a person focus on how they think about themselves, the world and other people, and how their perception of these things affects their thoughts and feelings.
CBT also challenges fears and preconceptions through graded exposure. CBT is led by mental health professionals and is more appropriate for older children, adolescents — particularly those experiencing social anxiety disorder — and adults who've grown up with selective mutism.
Younger children can also benefit from CBT-based approaches designed to support their general wellbeing. For example, this may include talking about anxiety and understanding how it affects their body and behaviour and learning a range of anxiety management techniques or coping strategies.
Behavioural therapy is designed to work towards and reinforce desired behaviours while replacing bad habits with good ones. Rather than examining a person's past or their thoughts, it concentrates on helping combat current difficulties using a gradual step-by-step approach to help conquer fears.
There are several techniques based on CBT and behavioural therapy that are useful in treating selective mutism. These can be used at the same time by individuals, family members and school or college staff, possibly under the guidance of a speech and language therapist or psychologist.
In graded exposure, situations causing the least anxiety are tackled first. With realistic targets and repeated exposure, the anxiety associated with these situations decreases to a manageable level. Older children and adults are encouraged to work out how much anxiety different situations cause, such as answering the phone or asking a stranger the time. In stimulus fading, the person with selective mutism communicates at ease with someone, such as their parent, when nobody else is present.
Another person is introduced into the situation and, once they're included in talking, the parent withdraws. The new person can introduce more people in the same way. Shaping involves using any technique that enables the person to gradually produce a response that's closer to the desired behaviour. For example, starting with reading aloud, then taking it in turns to read, followed by interactive reading games, structured talking activities and, finally, 2-way conversation.
Positive and negative reinforcement involves responding favourably to all forms of communication and not inadvertently encouraging avoidance and silence. If the child is under pressure to talk, they'll experience great relief when the moment passes, which will strengthen their belief that talking is a negative experience. Desensitisation is a technique that involves reducing the person's sensitivity to other people hearing their voice by sharing voice or video recordings.
For example, email or instant messaging could progress to an exchange of voice recordings or voicemail messages, then more direct communication, such as telephone or Skype conversations. Medicine is only really appropriate for older children, teenagers and adults whose anxiety has led to depression and other problems. Medicine should never be prescribed as an alternative to environmental changes and behavioural approaches. Though some health professionals recommend using a combination of medicine and behavioural therapies in adults with selective mutism.
However, antidepressants may be used alongside a treatment programme to decrease anxiety levels, particularly if previous attempts to engage the individual in treatment have failed. But what we do know is that treating it becomes much harder the older a child is, so it is extremely important not to put off treatment. Even when a child is in treatment, it can sometimes be hard to get her to talk in front of a teacher she has a history of not talking around. The more she is used to not talking in a particular setting, the more ingrained it will be.
If you do decide to switch classes or schools, it is best to have strategies and techniques in place before she makes the change. Ideally a new teacher would also be trained in what selective mutism is and how to help kids who have it. Kids with selective mutism are often unable to speak around some extended family members, which can be stressful for everyone involved, particularly if the SM is mistaken for stubbornness or oppositional or manipulative behavior.
Explaining to relatives what selective mutism is and sharing how they can help is important. Some clinicians meet with grandparents and other important members of the extended family to coach them in how to help the child.
We have over 60 guides and articles available to help you in Spanish too! Subscribe and get a curated selection weekly. Complete Guide to Selective Mutism. Get this as a PDF. Enter email to download and get news and resources in your inbox. Share this on social. Family Resource Center Guides. Guide Complete Guide to Selective Mutism. What's In This Guide? Treatment That Moves into the Real World.
Waiting five seconds without repeating the question or letting anyone answer for a child is a good rule of thumb. It also helps kids learn to tolerate their anxiety. Rephrase your question: Instead of asking questions that can be answered with a yes or no — or, more often, nodding or shaking her head — ask a question that is more likely to prompt a verbal response. Practice echoing: Repeat or paraphrase what the child is saying. For kids who speak very quietly, repeating what they say also helps them participate in bigger groups.
Can kids grow out of SM? Would switching classes at school help? What should I tell my family? Selective Mutism Group A national organization that can help you find a treatment provider in your area.
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