My child has stopped speaking in class
Amy didn’t say hello when she first greeted her counsellor in the waiting room. She was sitting in a chair with her head down. Her face could not be seen because she had allowed her hair to fall across her eyes. She came through into the counselling room, and despite very gentle encouragement, only made small noises in a childlike voice, if she responded at all. The counsellor sat for a moment in silence and then asked her how she could help. Very, very quietly she whispered "I need to be invisible".
Amy had recently moved house and changed area, so subsequently was also at a new school. She would not speak to anyone except one other friend. In the previous assessment carried out in the counselling service, her mother disclosed that the family doctor had been consulted, but could not find anything wrong. She had seen a speech therapist, had been checked by the audiology unit at the local hospital and her parents had privately consulted a child psychologist who had given the parents some cognitive behavioural therapy (CBT) exercises to use with their daughter. The family had been on the waiting list with Child and Adolescent Mental Health Services (CAMHS) for many months.
Recently, Amy had contracted a urinary tract infection (UTI), because she could not bear to be seen to ask or use the toilet at school. Since she had started senior school, she had gradually withdrawn more and more into herself until finally she began to isolate herself from her peers. Attempts by the school to remove the one friend she spoke with in the hope Amy would speak to others in her class had not helped. It had now been discovered that she was not eating her lunch, and would hide behind her friend when confronted in the lunch break, because of a fear of being 'an embarrassment', which was the word she gave to her counsellor. She had very little self-esteem, to the point where she had not put her name forward for a school trip because she did not feel as if she deserved to go. Furthermore, Amy had started to refuse to go to school.
Selective mutism isn’t attention seeking for the hell of it, but a way of taking control when all other means seem to have gone. It doesn’t feel like a choice for those affected by this form of anxiety, but as if words won’t come out, and that if they do, it will only be to cause strong feelings of anxiety, and activate a rabbit in headlights mechanism of freezing. Suggesting the child ‘to snap out of it’ and any other negative comment, will reinforce the behaviour. Any form of rescuing by well-meaning carers and teachers may help the child and adult in the short term because it lowers anxiety for both, but is not the long term answer. Untreated, the behaviour becomes ingrained and harder to treat so the earlier the condition is spotted, the better, and with an awareness of what is happening for the child, strategies can be put in place to help.
This anxiety affects around 1% of the population and is more common with girls than boys.
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