Selective mutism

Selective Mutism is a ‘consistent failure to speak in specific social situations, despite being able to speak in other, more familiar situations’. It is now  ‘seen as a manifestation of social anxiety or phobia, occurring in temperamentally predisposed children who are unable to take normal life events in their stride, particularly when the reactions of others reinforce silence rather than speech,’ (Maggie Johnson, 2012).

It doesn't sound too big a  problem does it? Might even be a nice change to have a quiet one in the class, be better if more had it to make life easier for the teachers?

But for the thousands of children and their families who suffer from Selective Mutism, it can be a terribly debilitating condition and one that encompasses all aspects of life.

With this in mind we reviewed and improved what Small Talk Speech and Language Therapy can offer and we are delighted to announce our new  services:

• We have done the diagnosis and management training and extension level training by Maggie Johnson and Alison Wintgens, who are the UK leading experts in SM.
• We will soon be able to use animal assisted therapy using Ralph our lovely therapy dog. This can just be having him the room to reduce stress/take the focus away from the child or he can be involved in a  small steps programme as he loves to do obedience work. We have had training in using him from Humanima which included the theory behind and helped us to prepare the necessary paperwork such as policies/procedures and risk assessments when doing any form of animal assisted activity
• As older chidren benefit from CBT, we are now trained in this so we don't have to refer on to a counsellor. It is a shame to see a child or teenager, build a rapport, diagnose and then pass on. We have a good relationship with an excellent counsellor so we can refer if they need anything else such as EFT.
• We also have excellent links with a clinical psychology team

The therapy for SM involves the people the child's own environment so more often that not we are 'explainers' and facilitators. This means it's straightforwards to see children and families who may live outside Staffordshire and who are prepared to travel for a diagnosis and/or help. If you are concerned about a child please get in touch to arrange an appointment.

Ralph the trainee therapy dog

Selective Mutism; a phobia of talking

I went to an excellent course on Friday by Maggie Johnson on Selective Mutism (SM). Thinking on this has changed so that it now needs to be considered as a phobia; a phobia of talking. Consequently, our approaches need to change. 

If we had a child who was scared of spiders we wouldn't expect then to confront their fears head-on immediately e.g. by sitting in a bath of spiders or putting their hand onto a box full. We wouldn't cajole, coax, bribe or order them to do it, yet we do all of those to children who are speech-phobic or selectively mute. If we had a child who had a phobia, we would use very small steps in any programme to help them overcome their fear. Similarly, we need to use very small steps with children who have SM.

Maggie recommended an excellent website www.selectivemutism.co.uk who produce advice sheets and resources. They also do videos. This is an interesting one, take a look:



If you are concerned that your child may have selective mutism, we can help: www.private-speech-therapy.co.uk

Selective Mutism

There will be some children who started school in September who aren't saying anything in school. Its always very difficult for a class teacher to know if its just shyness an underlying receptive language difficulty, an expressive language disorder or whether it could be selective mutism. 


Selective Mutism occurs when children who can speak and understand language perfectly normally at home are unable to speak elsewhere e.g. school or nursery. Unusually, there are many more girls who have selective mutism. It's also apparent that when boys display this condition they often have other social interaction or learning problems as well.


Selective Mutism used to be known as elective mutism, as people including professionals believed that children were choosing not to speak, and were therefore thought to be challenging and manipulative. The term Selective Mutism reflects current understanding that the children’s silence is not something they can control. It can be seen as a type of extreme social anxiety or phobia.


Michael Jones, specialist speech and language therapist has done a lot of work on this subject. This is an extract from his excellent article featured on his website.

How does selective mutism (SM) develop?

Michael says that 'SM can begin as shyness, but for various reasons children become progressively unable to speak in public, and especially at pre-school or in school. No single cause has been identified, though emotional, psychological and social factors may play a strong part. In some cases trauma can be an important factor, perhaps in school or hospital. Some children with SM are also anxious about new or unfamiliar situations and activities, and may be overly worried about taking risks.


Children may have other behaviours, such as limited eye contact and facial expression, physical rigidity, nervous fidgeting and withdrawal. SM often develops as children get older. It may not always improve spontaneously, and in some cases can become an intractable condition that severely limits young people’s life chances.

How can children be helped?

Early identification and appropriate support is of vital importance. If a child is not speaking at pre-school or school after a period of ‘settling in’ then a Speech and Language Therapist should be consulted. The most important form of help is to establish good links between home, school and any professionals who are involved. Maggie Johnson and Alison Wintgens, two Speech and Language Therapists, have produced a practical and comprehensive book about SM. ‘The Selective Mutism Resource Manual’ offers practical and effective strategies for helping children and young people with anxiety about talking in public. Their approach to developing confident speaking is a comprehensive guide to research and literature about SM, as well as offering effective advice to parents and professionals.


Maggie and Alison identify two very important ideas: that children with SM do want to talk, but need help to become confident speakers; children need a step-by-step approach that involves the family and school working closely together'. read more at http://talk4meaning.myhomepagemanager.com/selectivemutism.php


The Selective Mutism Information and Research Association (SMIRA) support families and schools by providing information and advice. Their DVD ‘Silent Children: Approaches to Selective Mutism’ is an excellent introduction to SM and to effective strategies.

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• Selective Mutism: Diagnosis of the Week (helpingpsychology.com)
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• Selective mutism - All Information (umm.edu)