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Dr. Zelinger’s successful treatment of children with selective
mutism, has prompted her to share her information at professional
conferences and in a newly released book, School Based Play
Therapy: second edition, 2010. Chapter 17 (pages 359-377) has been
written by Dr. Zelinger and is entitled, “Understanding and
Generalizing communication Patterns in Children with Selective
Mutism," intended for individuals who treat youngsters with
selective mutism in the school setting. Brief excerpts from her
chapter are provided below:
Selective mutism is a disorder of contrast, characterized by use of
appropriate verbal and non-verbal communication in particular
situations, contrasted with a persistent reduction or absence of
language in other settings. It is influenced by specific conditions
that determine how a child will behave and whether or not he will be
able to speak. The term “selective” is not meant to indicate that an
individual makes voluntary choices about his conduct in certain
situations. Rather, the environment and the people in it become the
resolute factors in identifying the extent of the child’s capacity
to communicate. According to Ford, Sladeczek, Carlson, and
Kratochwill, (1998), “Situations that most affected how often a
person with SM talked were strangers (76.7%), school (72.7%), new
settings (67.3%), family gatherings (60.7%) and stress/anxiety
(53.3%). This concept of labile language is difficult for others to
understand, given the tendency to view selective mutism as willful
or oppositional based on its changing position upon a sliding
continuum. In truth, the determinants of the inability to
communicate are likely found in environmental triggers that induce
unmanageable levels of anxiety or tension which literally shut down
the psychological apparatus necessary for communication.
Selective mutism can
be one of the more intractable conditions of childhood, harboring
the potential to create significant negative effects in many aspects
of the child’s life. It is often responsible for causing reduced
social interaction, delayed acquisition of pragmatics and
speech/language skill development, restricted involvement in daily
school activities and interference with the building of friendships
and academic skills. It is conceivable that the inability to
communicate could present serious consequences for a child who may
require immediate assistance but is unable to alert someone to help.
Children with selective mutism withdraw from interactive
experiences, enveloping themselves in a metaphorical cocoon where
their insulation keeps them safe and separate from the demands of
the outside world. Understandably, it is then difficult to step
outside of this protective retreat and relinquish their silence,
since the silence is functionally adaptive. It successfully allows
the child to escape the discomfort and anxiety caused by
interpersonal contact and to avoid public opportunities for
exposure. The silence is further maintained by the child’s awareness
that if he started to speak, it would draw immediate and increased
attention from others.
Children with
selective mutism are often terrified of being the center of
attention, making mistakes and being teased or ridiculed in public.
They also avoid making decisions, for fear of being wrong. Rather
than taking that risk, it is safer for them to be non-verbal and
non-committal, allowing them to fly under the radar. When the
pattern persists, teachers and classmates learn not to expect a
response from the student, and the mutism becomes reinforced,
eliminating opportunities for the child to say or do anything that
could be criticized. A teacher might refrain from placing demands
upon the child or referring him for treatment, assuming that he
needs a period of adjustment. These students are only too happy when
teachers refocus their attention on disruptive students, allowing
them to unintentionally but successfully recede in the classroom.
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