Thursday, August 23, 2012

what is Selective Mutism

Getting back to basics for some time I have been talking about how to treat Selective Mutism but it is important to visit again what Selective Mutism is and what it isn't. While watching a refreshing documentary "my child isn't perfect" a definition or a description of Selective Mutism was mentioned "selective mutism is a communication disorder in which a person most often a child who is normally capable of speech is unable to speak in given situations." What is most confusing to anyone who meets a child with selective mutism is the stark difference between home and the alternate personality that is most visable, it's like living with two children. This can be most confusing for visiting therapists as they don't get the opportunity to see the child outside of the home environment.

Under the banner of selective mutism there are a few sub types that help explain it better, the Louise Porter explained it well "first is transient mutism, in which children are reluctant to speak for the first few weeks (or perhaps months) after entering a new setting such as preschool or school, but whose difficulties abate spontaneously (Kolvin & Fundudis 1981). It is important to wait a few months before forming a diagnosis as some children naturally start talking on their own. But anyone who is working with this child or is a parent of this child needs to be very careful to bring in intervention the moment that the situation does not resolve.

Another type of mutism is "migrant children Many bilingual children merely lack confidence in speaking in English, which abates as their English communication skills improve." As with transient mutism it is vital to monitor the situation and provide support so that the child has the best opportunity to feel comfortable. Some children also have a sense of resentment about moving countries as well which can complicate any therapy.

The third group is children whose mutism is  secondary to other conditions, such as developmental delays, speech and language disorders or Asperger syndrome. These children’s speech avoidance reflects their awareness that they have communication difficulties." This group of children present a considerable risk because of the issue of other conditions forming barriers for progress. Also the other consideration is that the other conditions can actually mask their Selective Mutism and it goes undiagnosed, which would be most unfortunate.

The last type of mutism is "persistent mutism, whose symptoms typically last for three or more years.  Compared to those whose mutism is transient, these children are likely to be more anxious overall (rather than simply in social settings) and also to  have difficulties separating from their parents. Most nevertheless do well academically, although their teachers tend  to underestimate their skills (Cunningham et al. 2004; Ford et al. 1998). "

What isn't selective mutism, now for the parents and teachers or relatives who may be having a silent heart attack thinking that their child may have this condition. This is how I understand it works. First of all shy in the dictionary means bashful, easily frightened away, suspicious, distrustful, reluctant and wary. A shy child is able to function, I heard this described in a interview on Selective Mutism. If a child has Selective Mutism he/she will not have the ability to function, they will freeze, shut down, their face expressions change in the anxious situation. A child with selective mutism can be bullied, hurt themselves, be sick and simply not be able to ask for help.

People also wrongly attribute what I call and is known as traumatic mutism as selective mutism. The difference with traumatic mutism is that the mutism is triggered by a event, it may include every person or specific people. It is still a reaction to anxiety but the treatment of it is completely different. If you don't treat the cause of the trauma with counselling or support then a progression out of mutism won't be possible. We need to be very clear selective mutism is never because of abuse or overprotection of the parents. This I believe leads to pointing of the fingers which is never beneficial for the child who is needing the support.

No comments:

Post a Comment