When children are silent: Understanding selective mutism

by Dr. Reiner Bahr

This site contains an English summary of a book, which has been published in German, 2002.

Reiner Bahr:

Wenn Kinder schweigen. Redehemmungen verstehen und behandeln. Ein Praxisbuch.

(When children are silent. A practical guide). 1^st ed. 2002. Duesseldorf, 160 pp., 14.90 €

Any English speaking publisher, who might be interested in this book, is kindly requested to get in contact with the author or the German publisher PATMOS VERLAG – http://www.patmos.de

mailto:Drbahr@aol.com

Short summary:

They keep persistently silent in strange environments, although, as normally developed children, they could speak and even do so when being familiar with the situation: children with selective mutism. In kindergarten, school, or at the doctor's, their behaviour causes irritation, uncertainty and misunderstanding. What causes this up to now merely understood, anxiety-based disturbance of communication? Why is it so extremely difficult being together with these children? This book explains competently and in understandable language the facets and causes of selective mutism. It shows, how parents and specialists may find a mindful and communicative access to these children and how they could give them emotional suppport, using numerous forms of play and working tasks.

Who might be interested?

This book has been written for parents and specialists:

§ Parents, whose children are not yet ready to talk outside the family, although they are able to speak, find explanations which help to better understand their own children. They find a lot of hints, how they could support their children at home in becoming more independent and how they could explain selective mutism to teachers, doctors and others.

§ Teachers, no matter in which school, speech-language-pathologists, social workers, psychologists, pediatricians, psychiatrists and students in these fields find explanations, which expand their knowledge about selective mutism. They can apply the numerous ideas concerning the educational support presented in this book and they may use the diagnostic questions when forced to write expert evidence.

Long summary:

Introduction: Silence is golden, isn't it?

In this chapter, the author explains, what it means to be persistently silent, although the ability to speak is not limited. The chapter refers to the resources of the book (theoretical investigations, personal practical experiences, hundreds of mails from parents, teachers and therapists) and points out its purpose for the different target groups (parents and professionals).

1. Selective mutism: What is this?

Symptoms and frequency

The chapter contains a definition of selective mutism, some statistical data and critical remarks concerning the hypothesis, that selective mutism is mainly a problem of girls.

Vulnerability and resilience

This chapter points out the individual and social risk factors, which might lead to selective mutism. A model of balance between vulnerability and resilience is outlined. Special attention is directed to the question, whether children with selective mutism might be already born with an inhibited temperament (with reference to Kagan's investigations) or not. The answer is: yes!

Distress and self-efficacy

This chapter explains coping strategies in situations of distress, including some neuropsychological circumstances. Children with selective mutism seem to have a lower self-efficacy and are highly stressed in certain situations, such as school or kindergarten, when feeling under observation. Some articles about fluoxetine medication (Prozac) for children with selective mutism are critically discussed.

Anxiety and shame

This chapter is about the deeper lying aspects of anxiety, already beginning with the trauma of birth. Moreover it points out the emotional memory (LeDoux) as a significant factor for the heritage of anxiety in here-and-now-situations. Shame is explained as a counterpart to autonomy in children's development (Erikson). Selectively mute children are limited in their autonomy.

Mother and child

This chapter refers to the fact, that a very strong attachment between mother and child is sometimes observed in cases of selective mutism. But there are no reproaches at all, instead, the text tries to develop understanding for mothers, while pointing out the significance of bonding in early childhood. Some questions try to motivate mothers (and fathers) to reflect their attitudes of clinging to the child.

Talking and being silent

This chapter refers to the difficulties which are caused by silence in communicative situations. It points out, that selective mutism is not a problem of speaking, but a problem of talking, which always is a form of disclosure.

2. Diagnosis: What do we have to concern?

Communities and differences

This chapter points out parallels and differences between selective mutism and autism, shyness and anxiety to speak in public situations. Purpose is to find criteria for a differential diagnosis.

Fostering and inhibiting factors

This chapter tries to give help for finding the abilities, forces and preferences of the child as well as the inhibiting, non-supporting factors in the child's history and presence. The importance of understanding diagnosis as a long lasting process is pointed out.

Family and friends

This chapter points out, how systemic thinking might help to understand the silent child. Methods of circular asking, working with scales and with keywords etc. are outlined. The child's family and peer group are focused.

Experiences and needs

This chapter focuses the child's perspective, his or her personal point of view. Adults should try to understand the child's basic and situational needs. They should ask themselves, with which expectations they are meeting the child and should try to cope with their own feelings of helplessness, loss of power and offence.

Language and cultural background

Understanding a silent child also means understanding his or her cultural background. Selective mutism is seen from the immigrant point of view: children living between two languages and two cultures might tend to become silent as a special form of coping.

Silence and secrecy

Sexual abuse might lead to keeping a secret and not to talk about it. But this is not the same as being selectively mute. There is no empirical evidence up to now, that selective mutism is a means to keeping a family secret.

3. Overcoming the silence: How can we succeed?

Being mindful and creating an educational atmosphere

This chapter explains, what it means to be mindful, in short: persons working with silent children have to be very empathic, have to recognize their own feelings, have to stay concentrated, should try to be humorous, might create a fostering surrounding by referring to the effects of light, sound, forms, smells etc..

Giving emotional support

This chapter starts with ideas for organizing first meetings with a silent child. The work with a children's picture book about a non talking boy is presented (Strauss/Browne: The Night Shimmy). Other subjects are: working with fairy tales and with metaphorical stories.

Finding communicative access

This chapter makes a lot of proposals for working nonverbally with silent children, for mindfully shifting from a silent to a talkative dialogue and for integrating siblings and peers in the fostering process.

Using fostering forms of play

Games and forms of playing which make the child feeling secure (while creating a "safe place") are presented in this chapter, e. g. table games, motor playing to loosen body tenses, painting, tinkering, constructing, working with mandalas, making music, fantasy and role playing, using e-mail and SMS to get in touch with the child.

Teaching with respect to the child's abilities

This chapter shows, how teachers could integrate a silent child in their classroom by giving him or her special tasks, using stimulus fading strategies, building up friendships, using and respecting literacy as a means of communication.

Evaluating success and failure

This chapter tries to point out, that criteria for success are very individual. It offers helping words for being very patient with the child's progress.

4. Working on problems together: What has to be cleared up?

Investigating the individual background

This chapter points out questions, which might be referred to in counseling situations from parents and professionals, e. g. to clear up the biographical and the social background.

Changing conditions

This chapter emphasizes the timeline in which problems could be solved as well as general aspects of a possibility to solve the problems at all, e. g. when do we have to accept, that certain problems could not be solved? - What do we do with our energies?

Organizing help

This chapter encourages parents and professionals to look for help, especially self-help, which has become very realistic now through the internet. Moreover, it is shown, which professionals might be competent for selective mutism.

Respecting emotions

This chapter refers to the feelings parents and professionals might have in counseling situations (e. g. feelings of guilt, low self-esteem, aggressions, ambivalence). It is pointed out, that feelings are connected with expectations, which often result from educational experiences in childhood and adolescence.

Reframing problems

Reframing in this context means putting the question: Under which circumstances is a child's silence a good solution? The chapter contains encouraging aspects, which help to see selective mutism from a different point of view (e. g. how a person has managed it up to now handling every day life with the silent child).

Proving calmness

This chapter gives help to become more calm and confident concerning the child's abilities to develop him- or herself. Controlling one's own breath in situations of distress and special affirmations, which express respect and empathy regarding the selectively mute child are outlined.

Last but not least: A look back ahead

The final remarks of the book look back to the understanding of selective mutism (then: elective mutism) at the beginning of the 20^th century. The author tries to make a shift from understanding selective mutism as a form of sickness then to a special quality which might be compared to Buddha's meditative silence now. This leads to constructing a new reality of holistic understanding.

References / Index

Thank you for reading this site.

For getting in contact with the author go back to the top!

Posted: August, 2002