11 May Selective Mutism and Play Therapy

Some children have a lot of trouble speaking. Other children are unable to speak only in certain places, like school or when they are away from home. This can be maddening for parents as the child will often speak freely in other settings, especially the home. If this occurs for your child, they may have selective mutism.

Although selective mutism is often talked about in terms of a child’s refusal to speak, it’s important to realise it does not feel like a choice to the child. The key with selective mutism, is that children with this disorder will speak where they feel the most safe, such as at home, among direct family members or with a close friend.

In other settings where they don’t feel as safe, like school or among adults they don’t know well, they will be unable to talk. Because the child ‘can’ speak in some settings, it can seem as though they are refusing or choosing not to speak at times and it can be easy to get frustrated and angry with them.

Children with selective mutism typically have an extreme fear of speaking in social situations and feel paralysed by this fear. As these children feel so unsafe in social situations, they use silence to gain a sense of control and safety.

How you Can Help

• Keep in mind that when your child doesn’t talk, it is not a choice for them, even though they can speak in some places and not others.

• Don’t pressure your child to speak, it will probably make them more silent.

• Reflect back to them what you think they may be feeling, e.g., “sometimes it’s scary to talk in front of people you don’t know” or “sometimes when you’re scared it makes you feel safer when you don’t speak”.

• Use reflective listening and encouragement when they do speak voluntarily e.g., “You explained how to play that game really clearly” or “you used a strong voice to ask for lunch”.

How Play Therapy Can Help

• Play therapy is a very gentle and caring modality for children with selective mutism. Carers often see play therapy as an obvious choice for their child as there is no requirement to speak. Even if the child does not want to play, the therapist will accept the child where they are at and start therapy from there.

• When children can’t speak, they do so because they do not feel safe. One of the chief goals of play therapy is to establish a relationship of complete safety with a child. This allows the child to feel in control and safe from the start.

• When children play with a therapist alongside, the therapist’s job is to help the child deepen their play and to aid their awareness of the psychological and emotional content that arises through their play. As this process takes place, the issues that are holding the child back are projected onto the toys, where the child can easily begin to make sense of them. This leads to eventual integration of the issues into the child’s psyche, so they no longer manifest in behavior, such as not speaking.

• Through play, children can experiment with being in control. Often, they begin to experiment with communication first, maybe through writing. This may lead to experimenting with voice -making verbal sounds, humming a tune, or playing a musical instrument. Finally, children often take the step to speaking, frequently first with non-nonsensical words, followed by real words then sentences.

• Play therapy is a lovely choice for a child with selective mutism, as there is no pressure to speak. They can work through their concerns and never utter a word!