Breaking the silence
HEALTH | Selective mutism affects 1 in 140 kids, but many succeed in overcoming the disorder
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In a southeast Australian classroom, teenage girls sporting maroon uniform jackets chattered in front of computer screens on a school day. As their teacher, Tim Vanderstoep, supervised the girls in his digital technologies class while they programmed a robot to dance, he wasn’t worried that one of the students didn’t speak. It was a group project, and each class had its quiet kids, after all.
But when his pupils started working on individual projects, that student still wouldn’t talk.
“It felt almost disrespectful,” says Vanderstoep, who teaches at Clonard College, a Roman Catholic all-girls’ secondary school in Geelong. “With 20/20 hindsight,” he says, “I can see that’s not what it was.”
When the learning diversity team updated the student’s profile, Vanderstoep read about her history of communication problems and autism spectrum disorder. He realized she was dealing with selective mutism.
Also called situational mutism, selective mutism is a form of anxiety or communication disorder that affects about 1 in 140 young children, according to the UK’s National Health Service. Children who are selectively mute freeze up in some situations—when starting school or meeting strangers, for example—even though they can be chatty and animated in others.
Elizabeth Woodcock, a clinical psychologist and director of Sydney’s Selective Mutism Clinic, says kids learn the strategy of shutting down as a way to manage big uncomfortable feelings. It then becomes such a habit that speaking would attract unwanted positive attention. Selective mutism is one of the most severe anxiety disorders in kids, she says, but it’s also one of the most rewarding to work with, because the syndrome can be completely resolved.
Mary Lassiter of New Hope, Pa., says her son Ethan, 7, has experienced selective mutism since he began preschool at age 4. “He was completely silent. No laughing, no crying, not even when someone pushed him,” she says.
She found help in a cyber charter school. Less peer interaction in the online classes meant Ethan was no longer known as the boy who didn’t speak. It proved a good fit. “All I was looking for was teachers to have a simple relationship with my child, an extra 10 minutes after class to talk to him about the things that he loved, which was space, which was black hole theory, or doing a math problem,” Lassiter says.
When her second son, Aidan, started exhibiting similar symptoms, Lassiter enlisted the help of an au pair named Michéll Lourens. Lourens coordinates what Lassiter calls the “pit crew”—the 29 professionals Ethan and Aidan interact with each week, from teachers to speech therapists to staffers and students at Florida International University and La Salle University. La Salle is where Ethan saw the Richter-scale type graph of his attempts to speak without success. His mother says his anxiety doesn’t result in hiding or getting a deer-in-the-headlights look. “I call it the Little Mermaid syndrome. It’s all in his vocal cords.”
From Lourens’ perspective, play therapy has had positive effects. “If you sit and talk, the chances of them speaking back are zero,” she says. Instead, the family played thousands of games of Rock, Paper, Scissors, with the rock audibly crushing the scissors to help the boys learn to speak to their grandparents. Even though Ethan is fluent in English and French, he still hasn’t spoken to Lourens in English, and she doesn’t speak French. His brother Aiden now readily communicates with her.
Woodcock says she’s been seeing more cases of selective mutism. As anxiety becomes less stigmatized, more people may be willing to get help. But Woodcock also notices time-strapped parents who don’t interact enough with their kids. Their children keep more things to themselves and try to solve their own problems, leading to more anxious behaviors.
Julie Lowe, a faculty member at the Christian Counseling & Educational Foundation, says a childhood diagnosis of anxiety doesn’t have to become a child’s identity. Instead, it’s a part of his story of change. With selective mutism in particular, Lowe says, the therapy looks quite missional, with the counselor meeting the child at his level.
In a small study published in European Child & Adolescent Psychiatry in 2018, researchers found that out of 32 children with selective mutism who received treatment, a vast majority were in full or partial remission after five years, although many still found themselves anxious in certain social situations.
Vanderstoep began trying techniques suited to his student’s specific needs. When she said her first word in class, “Video,” to indicate how she’d like more instructions to build her digital 3D model of a skateboard, Vanderstoep gladly spent extra time over the weekend making it.
Toward the end of the semester, when she saw a student’s caricature of Albert Einstein on the board and said her second word, “Einstein,” he also got to see what makes her laugh. That gave Vanderstoep hope for her future.
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