Recently I had a tele-conference with 6 teachers, a guidance counselor, and school psychologist from a high school in Georgia . This conference was in regard to a 14 year old boy with selective mutism. The conference was facilitated by the boy’s mother who is learning how to advocate for her son. This 14 year old, while able to speak, only communicates via hand writing or non-verbal gestures. He does well academically. His only friend is his brother. He is well liked by his peers in school who have learned “to help him by talking for him”. This is a common form of ”enabling” the problem.

The school personnel came to the conference with what appeared to be an open and positive attitude. This is not always the case when working with schools. My objective in this first consult was to obtain a baseline perspective of the patient’s functioning so that an initial therapeutic strategy could be developed.

A very interesting process occurred. The teachers, one by one, were telling me that the patient was doing well. After some questioning and supportive words to the teachers that I was not criticizing anyone, I got the real story!

Each teacher was learning to accommodate the patient with their own style. Accommodate means investing in the belief and attitude that the child will not speak so why bother to treat him like a regular student.

By investing in a response that expected the student not to speak the well meaning teachers (I say this sincerely) were minimizing their own discomfort, but investing in the student’s disability vs. ability. They were enabling the disease!

Without the parent facilitated professional intervention it is a good bet that the current cycle of schooling would have made an already severe mental health problem even worse!

This is a common scenario. The complexity of selective mutism is not so complex when understood as a specific social anxiety; in essence “an addiction to the avoidance of speaking” based on over- dependence. When caregivers learn a productive strategy the problem is indeed resolvable. Of course there are different degrees of the problem, and the longer the problem remains the same the worse it gets over time as the anxiety insidiously works it’s way more and more into the personality.

Caregivers: be clear of the two biggest mistakes that are made regarding selective mutism/social anxiety:

1. The child will simply grow out of the problem.
2. Using medication before productive parenting strategies are in effect.