Selective Mutism in Children
Selective mutism is a condition where children have difficulty speaking in certain environments or with certain people. They might speak perfectly fine at home or in some settings, but not in others or with certain people. This can at times feel puzzling and frustrating for parents and carers when children are unable to speak in specific social situations, despite their ability to speak fluently in other contexts.
A key for understanding selective mutism, is that although it is described as ‘selective’ and it may look like a refusal to speak, it is important to realise it is not a choice to the child. The neuroscience of selective mutism highlights a multifaceted interaction between brain regions involved in fear processing, executive functions, and language processing. Studies using functional magnetic resonance imaging (fMRI) have revealed that individuals with selective mutism exhibit heightened activation in brain regions associated with fear, such as the amygdala. This suggests that their brains perceive social situations as threatening, triggering a fear response that inhibits speech.
In other words, when children with selective mutism, experience a deep fear and do not feel safe in social settings, this shuts down their ability to communicate. A protective pattern response activating the lower brain quadrants involving fear, can initiate a freeze response, causing parts in the higher brain quadrants involved with speech, to go offline.
In the field of somatic psychology, research shows these protective patterns may manifest from emotional and body-based life experiences that are needing to be integrated; including experiences inutero, birth and post birth. These are pre-cognitive times or events, which can imprint and shape children’s stress responses or behaviours later in life. One of the key concepts in somatic psychology is the idea of "somatic memory," which refers to the idea that the body has its own form of memory that is separate from cognitive or verbal memory. Somatic memory is thought to be stored in the nervous system and in the cells and tissues of the body.
What not to do:
Pressuring a child to speak only adds to their internal stress and activates the fear responses. Their silence is not a reflection of poor manners or a reflection on how well they have been brought up. For parents it can be helpful to remove any expectations, or reward-based systems for speaking, or forcing goodbyes and hellos, as this will not address the underlying anxiety or fear responses, and will add layers to them.
How to help:
1. Accept them as they are. Apply words to help validate and bring awareness to their feelings. Reflect to the child what you think they might be feeling, in an authentic way, with words such as “it looks like this feels really scary to talk in front of people” or “It might not feel safe to talk, and even though you might want to, you feel like you just can’t’
2. Help them locate body sensations, ‘It might feel a bit tense in your shoulders, or tight in your jaw, heavy in front of neck/throat maybe you have butterflies in your heart and chest or your stomach’. ‘Let’s take a breath together and move our fingers and toes, stretch up to the sky’
3. Use reflective listening and positive encouragement when they do speak such as “You just used a strong voice, and explained what you wanted so clearly.’
4. It is helpful to understand the varying stages of selective mutism that children may find themselves in. Ranging from no social interaction; no engagement, stiff and frozen like in the body; non-verbal communication with eye contact, nodding or gestures of pointing, using picture cards to communicate; verbal sounds, making grunts and vocal sounds, humming; whispering, non sensical or made-up talk, baby talk, progressing to speaking clearly.
How Dance Therapy can help:
Dance therapy is a child centered, modality for selective mutism. It is a creative and expressive form of body oriented psychotherapy that combines elements of dance, play, movement, music, and psychology to promote healing for children. It provides a nonverbal mode of communication, promotes social interaction, boosts self esteem, and facilitates emotional regulation. Dance therapy helps children overcome their communication difficulties and improve their overall wellbeing.
As a child connects safely to their inner world through creativity, movement, and play, and their internal sense of safety deepens, it enables a gradual opening into the relevant psychological and emotional material. This happens at the child’s own pace. The issues causing the internal overwhelm for the child are expressed through their primary languages of movement, play and creativity, and they can begin to make sense of them. As a child ‘melts the internal freeze’ and begins to explore and regulate their emotions, this leads a holistic integration of the issues into the child’s psyche, no longer manifesting as difficulties in communication.