Selective Mutism and Play Therapy
What is Selective Mutism?
Selective Mutism (SM) is often confusing or frustrating for parents or carers who want to understand their child. SM is a form of anxiety, a clear example of the 'freeze' stress response from a child's body to keep them safe. The stressor is often something out of the child’s control, it may be common in their everyday lives; the hardest part of SM is that the child cannot tell their brain when or when not to identify a piece of information as a threat.
It is common for children with SM to present in some environments, such as home, as confident, vocal and happy. However, once in a public setting like child care or school, they cannot speak. They may speak openly with friends and children their own age, then are unable to speak around adults or adolescents. This is where the mutism is defined as ‘selective’. Not to be confused with that the child is ‘selecting’ when to speak or not.
During the response, the child's brain is 'flooded' with signaling, and the vocal cords shut down in response to the stressor. Similar to a person's body going into 'shock' or 'freezing' following a traumatic event, like a motor vehicle accident. Often the child wants to or would speak if they could but their bodies won't allow them. This can be highly frustrating, shameful, and/or embarrassing for the child.
It is important to remember during these times that the child wants to communicate with you, however, their body is not allowing them to do so. Breathe, reassure yourself and your child that they are safe. Allow the child to communicate with you at their own pace to avoid further flooding and extended periods of mutism.
Give your child space if necessary, connect with them in their own time, with their needs, a hug, a smile, whispered reassurance that they can speak when they are ready, read their favourite story, or watch their favourite program together. The important thing here is the connection and reassurance of safety, not the activity.
Perhaps try different ways to communicate that don't put pressure on the child to speak. Drawing, making pictures with playdoh or emotion charts are all positive ways to support the child to communicate their needs without them returning to the 'freeze' response.
How Play Therapy helps children with Selective Mutism...
As you would have read in last month's newsletter, in Child-Centered Play Therapy (CCPT) we don't treat any diagnosis, presentation, or symptoms of a child differently. We accept the child as they are in the moment and provide a safe and secure space for them to express themselves. This works exceptionally well with children with SM.
By providing a safe and secure space, the child is able to slowly build a therapeutic relationship with the therapist which in turn creates more trust and security. The child may speak a few words in a session or none at all, there is no pressure put on the child, allowing them to remain in a regulated state and the higher-order processing 'safe zone' of their brain.
We find the positive self-esteem-building nature of CCPT allows the child to explore their world, practice their words, build confidence, we model tools for children to regulate their brain and body to keep them in the 'safe zone' and avoid 'flooding'. Positive outcomes for the child sometimes come out in a whisper of 1-2 words, and by the end of the Play Therapy treatment, the child is talking non-stop, sharing all the fantastic things in their world through their verbal communication. Other times, the child chooses not to speak in the playroom at all but is busy speaking non-stop at home and at school. Some children take a little longer, with positive signs of talking in some environments, and need another block of sessions to continue to build their skills and confidence. Every child is different and every child is accepted and safe in the playroom.