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Selective Mutism - any advice?

Pageant

Hello everyone,

My eight year old daughter is soon to be assessed for ASD and I expect there will be a diagnosis of ASD/Aspergers.

One of the most significant problems she faces is selective mutism.  She is terrified of talking to people she doesn't know well (i.e. everyone except parents, brother and one friend she made at her old school).  Even Grandma/Grandad have trouble getting her to speak, although she speaks freely with her immediate family.  Everything I've read suggests it's an anxiety response and she is extremely self-conscious in general.  With us though, she's a different girl - happy, funny and giggly a lot of the time.  She'll occasionally be like this with others, but it's fleeting and never seems to last.

Anyone got any ideas for how to help?  I've read a lot about selective mutism unrelated to autism, but the strategies there suggest something more of a pure phobia about speaking.  With my daughter, I think it's different - it's anxiety about social communication (not surprisingly)...  I'm worried it could get worse, but don't know how to stem the tide of any regression (mercifully, she just recently started talking to her childminder again who she goes to once a week, but I've been worried there's been a general regressive trend lately, aside from this).

Any ideas would be very welcome.  Autism-related literature on the subject is thin on the ground - or I'm looking in the wrong places....

Parents

  • Hi Jane,

    I think it's possible it could be selective mutism - as you say, the key thing is the element of choice. I think it's hard to tell with ASD children because they're not always in tune with their own motivations. They may report something as a choice because they know it's physically possible to speak albeit fear prevents them speaking.  There's the bravado element with teens too - not wanting to admit they're crippled by fear, so claiming they choose not to instead.  

    So not necessarily a choice in the true sense.  You could probe the issue further - maybe ask what your son would do in a hypothetical situation where speaking to a teacher/club leader would bring a big reward of some sort if he gave a verbal answer to questions they ask.  If the motivation is rewarding enough, you might expect your son to say he would speak to gain the reward. If selectively mute, no amount of reward would cut it (and I wouldn't recommend offering rewards for speech - this is just to gauge your son's reaction to a hypothetical situation, if possible).

    Ideally, if you can afford it, you could seek a professional opinion from a private speech therapist with expertise in SM (and, ideally, ASD too). But they're few and far between. The NHS may have something to offer, but that certainly wasn't my experience.  CAMHS will likely show no interest if they think there's an element of choice because they'll see it as ASD related. But I haven't found our local CAMHS terribly clued up on SM at all, so I'd be wary of taking their advice at face value if you have your doubts.

    Amother key factor is how different your son is at home compared to other settings. If he's much more talkative at home than elsewhere, that may suggest SM is worth investigating. The trouble is that experts and professionals with a vested interest in doing as little as possible to help your son or provide resources will likely tell you everything is fine.  But if you're worried, I'd investigate further - maybe start with SMIRA which has a useful website and Facebook presence.

    Best of luck with it - my daughter continues to improve, but her ASD complicates progress with the SM, so a way to go yet...

Reply

  • Hi Jane,

    I think it's possible it could be selective mutism - as you say, the key thing is the element of choice. I think it's hard to tell with ASD children because they're not always in tune with their own motivations. They may report something as a choice because they know it's physically possible to speak albeit fear prevents them speaking.  There's the bravado element with teens too - not wanting to admit they're crippled by fear, so claiming they choose not to instead.  

    So not necessarily a choice in the true sense.  You could probe the issue further - maybe ask what your son would do in a hypothetical situation where speaking to a teacher/club leader would bring a big reward of some sort if he gave a verbal answer to questions they ask.  If the motivation is rewarding enough, you might expect your son to say he would speak to gain the reward. If selectively mute, no amount of reward would cut it (and I wouldn't recommend offering rewards for speech - this is just to gauge your son's reaction to a hypothetical situation, if possible).

    Ideally, if you can afford it, you could seek a professional opinion from a private speech therapist with expertise in SM (and, ideally, ASD too). But they're few and far between. The NHS may have something to offer, but that certainly wasn't my experience.  CAMHS will likely show no interest if they think there's an element of choice because they'll see it as ASD related. But I haven't found our local CAMHS terribly clued up on SM at all, so I'd be wary of taking their advice at face value if you have your doubts.

    Amother key factor is how different your son is at home compared to other settings. If he's much more talkative at home than elsewhere, that may suggest SM is worth investigating. The trouble is that experts and professionals with a vested interest in doing as little as possible to help your son or provide resources will likely tell you everything is fine.  But if you're worried, I'd investigate further - maybe start with SMIRA which has a useful website and Facebook presence.

    Best of luck with it - my daughter continues to improve, but her ASD complicates progress with the SM, so a way to go yet...

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