selecive mutism, anxiety in daughter

Hi there

My daughter who is 5 has always struggled socially with other children. She has been in school since age 3 but still does not talk to any of the other children. We expect she will soon be on the pathway to diagnosis as teachers agree she has ALN (autism and suspected ADHD - as well as selective mutism). In school she presents as very anxious and does not talk to other children, but does now talk to familiar adults (teaching assistants mostly). She has not even seemed to mind not being able to talk to other children, but is now occasionally saying she doesn't know what to say to them, and that she has no friends, which is upsetting.

She is taken to a few extra curricular activities outside school where she really enjoys herself, seems more at ease (with parent accompaying her) but still only talks to the adults and not with the children at all. 

I am really starting to worry about her as she seems to have low self esteem, she is also highly sensitive in that she feels rejection strongly. At home she is very controlling and needs constant one to one attention, which is difficult as she has a younger brother. I think she is showing signs of PDA also - she cannot abide being told 'no', and she must be right at all times and cannot be corrected without getting very frustrated.

Unfortunately we don't meet up with friends with children very much as we don't live close to them. I sometimes wonder if it might have been easier for her if we had friends that we meet up with frequently, but I find meeting up with friends difficult anyway as my daughter really resists any kind of socialising.

I am finding it hard to know how to help has as I am also autistic .I also recognise that I have also suffered with selective mutism myself which I have never had help with.

She doesn't have particularly strong interests but she does love sensory activities and being outdoors.

Not really sure what I'm looking for but any advice or experience particularly with girls with selective mutism, would be great. Has anyone got any experience of therapies with SM? What has helped?

Thank you X

  • What you're describing here IS the autistic difference. We tend to make friends with much older or younger individuals. When young, adults who appear dependable and stable are much more enjoyable to speak with. Due to not maturing with peers, we might simply observe until we can work out how to engage. 

    One's self esteem is developed over a long period of time. At her age, she's yet to learn to recognise her rich, wonderful and wild self, understand her human flaws, laugh at her control issues (we all have them), see the parts still in development, approve and respect her own nature and self-discipline with reason, her own growth so to better use agency to assert boundaries, understand what is human in another and make grounded choices which, in turn, reinforce a sense of being and contentment with the self. 

    At 5 we are still making sense of the world, but even sometimes still at 50 :) 

    If a child appears controlling on the surface, it means they are experience something which feels dangerous, could sweep them away, beyond their control and trying desperately to navigate. Or they might have a pre-envisioned plan which they are looking to resolve or fulfil and it's important to make room for this, even envision it with them, so you can feel a little more in control if need be. With young children, we need to always provide more time than we think for transitions, as they cannot handle smash-cut interruptions. Very few things are of consequence. 

    Children can never actually be controlling, rather looking to us for respect, protection and aid. Rather, old chaps in charge of banks are controlling. I rarely said no to my son on my grandmothers advice. So when I did, he took it seriously. 

    Her asserting a need for one to one is actually brilliant. It is part of her ability to focus and you'll want to reinforce and always affirm this. And then help her learn to steer / temper / direct it as she grows. For autistics, if we are vigilant about doing everything one-thing-at-a-time, we will find a better flow and avert harm. We function better like this. What you'll need to do is reinforce her worth while managing her expectations. So, if she needs to speak to you while you're on the phone, ask the individual you're speaking with for a minute. Focus on the child and tell them "I want to listen, you're important. And first I need to finish this. Give me (an exact amount of minutes) and then I can focus on you." Then make sure to follow through to the exact minute. This helps them learn to trust you. It teaches them how they will eventually act in a similar situation when older. 

    The term "Aut" in Autistic means Auto, autonomous. It was conceived by Grunya Sukhareva. 

    My self-esteem has been grown in part as I take control - or rather - responsibility - for my own life, for my own research in understanding the physical and social world. In short, the library has aided my self-esteem. Good mentors and teachers have helped grown my self esteem, while peers around are busy trying to 'fit in' with a Neurotypical social/tribal and often Freudian "neurotic" mode of being, it is wisdom and sound guidance, building ethics and aesthetics that has crafted mine, along with learning to integrate my actions, words and deeper truths / intents of the self. And then there is the never ending immersion in creative and spiritual endeavours which grow contentment and ease of self. I have so much to learn and my being isn't fulfilled in the ways my non-autistic friends need. 

    Perhaps your daughter is perfect for you to invite over your single friends. The ones without kids. It sounds to me like she has a good sense of self. I don't know anyone who likes rejection, so her response is appropriate. The intensity of the response is autistic - we sense-perceive everything with a greater impact, internal and external. This is one defining feature and can work for us along side knowledge. The quicker our response, the better. As she grows she may begin to realise she doesn't actually want to be friends with just anyone. And that's a good place to be. 

  • Thanks for sharing the link to my other blog! I hope it resonates with others too!

    It is very relatable. Looking back I can see how it was made much worse for me in secondary school, due to a lack of understanding and numerous teachers who repeatedly tried to force me to speak. Whereas your experience was very different, as your teachers accepted you communicating in different ways. That is so good to hear but I suspect your experience is probably quite rare in mainstream schools even today.

    Glad it’s so relatable but also at the same time sorry that you were forced to speak and obviously not understood, that must have been quite distressing. I was quite lucky and privileged to some extent because I have more obvious physical needs (as explored in my other blog ‘The Intersectionality of Being Autistic and Physically Disabled’) teachers and other staff were naturally more supportive and accommodating. I understand that more generally it may be quite rare to benefit from such understanding and acceptance, however there is more awareness of alternative means of communication and thanks to the work of autistic advocates more information readily available about the cumulative effect of processing on our fellow neurokin (for example, the Coke Bottle effect).

    I think your experience of being forced to speak when experiencing mutism is sadly quite common for many people who are identified as having Situational Mutism/Processing Mutism as unfortunately it is seen as a problem to be fixed as opposed to be investigated for an underlying reason. 

    That’s one of the reasons why blogging about my autistic experiences is important as it provides an insight into the internal autistic experience.

    That NHS page is probably the first place a parent will look when they are first told or suspect that their child has 'selective' mutism. Like many NHS webpages it is poorly written and I don't think they use the term 'shut down' in the context of what we know as autistic shutdowns.

    Yes I agree, the NHS page is poorly written however that is partly because it is ingrained in the medical model.

    When the term shutdown is used, I think you are right it is not used in the context of us autistic people as the healthcare system generally does not know what a shutdown is (apart from a few specific trusts and settings) in that kind of situation I think a shutdown could easily be mistaken for a seizure (I completely understand why).

    At least there is some recognition that the condition can be related to sensory processing, rather than purely anxiety based. Despite this they still go on to recommend potentially damaging CBT and graded exposure 'therapies 

    Yes that is good, however like you mention such ‘therapies’ are not therapeutic and can actually lead to trauma, more specifically in this case sensory trauma.

    Just would like to mention that I am really enjoying this discussion!Slight smile

  • I hadn't read your other article. I've found it now and will link below for anyone else interested.

    https://autistic-village.com/2024/03/04/processing-mutism-vs-freeze-stress-response-shutdown/

    It is very relatable. Looking back I can see how it was made much worse for me in secondary school, due to a lack of understanding and numerous teachers who repeatedly tried to force me to speak. Whereas your experience was very different, as your teachers accepted you communicating in different ways. That is so good to hear but I suspect your experience is probably quite rare in mainstream schools even today.

    That NHS page is probably the first place a parent will look when they are first told or suspect that their child has 'selective' mutism. Like many NHS webpages it is poorly written and I don't think they use the term 'shut down' in the context of what we know as autistic shutdowns.

    At least there is some recognition that the condition can be related to sensory processing, rather than purely anxiety based. Despite this they still go on to recommend potentially damaging CBT and graded exposure 'therapies Slight frown

  • Thanks for linking to the article!

  • I remember your article and I related to it so much that I bookmarked it for future reference.

    I am so glad my article resonated with you so much, that’s a huge compliment! So glad, it’s so important to understand the distinction between PM (Processing Mutism) and Selective Mutism as they are very different experiences which ultimately require different support/understanding.

    I note that the NHS page on selective mutism does briefly refer to such difficulties. They call it sensory integration dysfunction:

    Yes however, that’s usually just in relation to the specific situations in which mutism occurs, whereas our sensory experiences are a result of our autistic neurotype and therefore occur in every setting. I have written another article about the difference between Processing Mutism and shutdown, have you read that one too? You may also find it relatable. 

  • I remember your article and I related to it so much that I bookmarked it for future reference.

    https://autistic-village.com/2024/02/07/my-autistic-experience-of-processing-mutism/

    I note that the NHS page on selective mutism does briefly refer to such difficulties. They call it sensory integration dysfunction:

    "Some children have trouble processing sensory information such as loud noise and jostling from crowds – a condition known as sensory integration dysfunction.

    This can make them "shut down" and be unable to speak when overwhelmed in a busy environment. "

    https://www.nhs.uk/mental-health/conditions/selective-mutism/

  • Great advice!

    A large part of it is due to auditory processing issues and also problems processing the sensory environment. Most social situations are in groups where there is a lot of noise and often multiple conversations happening at once. Trying to process all that is impossible, it is far too much all at once and my ability to speak will shut down.

    My experience at school was similar which is why I now refer to it as Processing Mutism. A couple of months ago I wrote about my experience for Autistic Village which you may be interested in reading. I have tried to copy and paste the link to the article but for some reason it won’t work.

  • I've had selective or situational mutism since a very early age but, like you, never had any help with it. I was very similar to your daughter at her age. I would not speak to any of the other children and had no interest in them but I would speak to selected adults. 

    Since my autism diagnosis I've begun to understand it more and realised it's not only down to anxiety. A large part of it is due to auditory processing issues and also problems processing the sensory environment. Most social situations are in groups where there is a lot of noise and often multiple conversations happening at once. Trying to process all that is impossible, it is far too much all at once and my ability to speak will shut down.

    One to one in a quiet place is easier, without all the sensory distractions, but there is still the difficulty of not knowing what to say. I've used scripting a lot throughout my life, to plan in advance what to say. That can help in some situations, but it is masking and not really a sustainable strategy. In the past I have done public speaking for work, where I was required to stand up and speak to a room full of people at a conference. I coped with that because it was quiet and I had my script. However with those same people at break time, where there was a lot of noise from multiple conversations I would be completely mute again.

    Reducing demands and expectations to speak can help reduce her anxiety over it. I know that at secondary school I would get extremely anxious attending lessons where I knew that the teacher as likely to randomly fire a question at me and expect me to speak. 

    What doesn't help is being forced into situations where speaking is required, being criticised for being too quiet or being praised for speaking. I hate having attention drawn to it when I do speak and having people praise me and make a huge deal out of it. Whenever that has happened it would increase my anxiety massively and make me much less likely to speak up again.

    Focus on the things she enjoys and being outdoors. If she prefers another form of communication then respect her preferences. 

    To me speaking is overrated and the vast majority of conversations I am subjected to or overhear are totally unnecessary.

  • Thank you very much Slight smile

  • Hello ,

    Thank you for sharing this with the community. I'm sorry to hear that your daughter has been struggling socially and has presented with some challenging behaviour at home. You may find it useful to have a look at our information on challenging behaviour, which includes information on 'Demand Avoidance':

    https://www.autism.org.uk/advice-and-guidance/topics/behaviour

    You may also like to have a look at the following information on social skills/making friends:

    https://www.autism.org.uk/advice-and-guidance/topics/family-life-and-relationships/making-friends/parents-and-carers

    Furthermore, you may find it useful to look at our information on communication strategies, which may help you to support your daughter:

    https://www.autism.org.uk/advice-and-guidance/topics/communication/understanding-and-developing-communication

    I hope this helps,

    ChloeMod