Stressed Out! Helping the Child With Selective Mutism Cope With Anxiety

Symptoms of anxiety can range from physical symptoms such as a stomach ache to hoarding items and objects to moodiness and sleep disturbances.  For the child with Selective Mutism, anxiety manifests in different ways and in varying degrees, but the hallmark symptom is an inability to talk in certain social situations, usually at school and in other public places.  In my previous article, I provided an up-close glimpse into this social anxiety disorder that often times presents with a social phobia.  Parents and teachers of these children who suffer in silence are often at a loss as to how to help the Selective Mute combat their anxiety.  As with many anxiety disorders, including Selective Mutism, effective treatment must address the causes of the anxious thoughts and behaviors and healthy ways to address them. 

Before I go any further, I must emphasize that I am not a physician nor am I a mental health care professional.  However, I am a parent of two children, one an adult, one a small child, who have and are still struggling with anxiety disorders.  Moreover, I am also a teacher who has worked with children of all ages with differing anxiety-related disabilities, disorders, and syndromes.

When working with a child with anxiety, teachers and parents can help the child to change their ways of thinking, reacting, and behaving to feel less anxious.  This is often accomplished through conditioning or desensitizing.  Children need concrete coping mechanisms broken down into very small, manageable steps.  Along with a school counselor and the treating professional, students can unlearn debilitating behaviors, obsessions, and compulsions to combat anxiety.  For many children (and adults too), anxiety presents and is embodied as physical symptoms. This may include nausea, vomiting, headaches, a racing heart, butterflies, shooting pain and numbness in the arm and hand, diarrhea, mood swings, and insomnia. 

For the child with Selective Mutism, the anxiety is often described as feeling like they are being choked, as if they have rocks in their throat, and a fear that literally and physically paralyzes them.  In addition, these children may be prone to nightmares and have mild to extreme resistance to attending school and social events.  The key is to reduce the stress by having children learn ways to manage the anxious thoughts that invade their minds and to face their fears.

Tips for Helping Children Cope with Anxiety

•  Exposure therapy and desensitizing are often used to help students overcome their anxiety.  For example, with my son, we visit the school playground on weekends when students and teachers are not present.  By doing so, he is able to face his fear (talking at school) with me by his side and gain comfort and confidence.  The goal is for him to replace the negative thoughts he associates with the school to more positive ones.  Hopefully, this will transfer to the school day during recess and he will be able to whisper and then eventually talk out loud to a peer.  Teachers can assist in this process by possibly stopping by the playground one day when the child is playing, of course as arranged by the parents and/or the treating professional. If they can remember playing with a parent, friend, or sibling over the weekend, it can help them to reprogram their thinking during the school day.

• Many parents, me included, have an instinct to rescue their child from that which causes stress and uncomfortable feelings.  However, by doing so, we are not helping our children to face their fears, learn healthy ways to react and to control their feelings.  One such way to de-stress is to learn relaxation techniques.  This can include breathing exercises, Brain Gym exercises (specific movements to help with stress, with one’s memory, and with learning), listening to soft music, and visualizing.

• Many children with Selective Mutism and other anxiety disorders may be prone to temper tantrums, meltdowns, and emotional outbursts at home. One such reason for this may be because they have spent the entire day without talking or expressing their emotions. They lack the skills to settle and calm themselves down.One tip is to remove the child to a room by themselves and let them rant- get their emotions out- in a safe place and with a person with whom they feel comfortable.With the S.M. child, this will most likely occur at home.  Listening to your child, giving them a “bear-hug”, talking softly and gently can help the child to calm down.  The objective is to teach the child healthy self-soothing behaviors and to communicate to them that you may not be able to fix their problem (e.g., they have to go to school tomorrow), but you can help them deal with the emotions.

• Learning to identify different emotions is the first step in learning to control one’s negative feelings.  A new resource that I have recently used is the Kimochis, a soft, plush, cuddly toy that helps children to identify and manage their feelings through using puppet-like animals and play.  These toys can also help children to communicate to parents their feelings by selecting the toy that best illustrates their emotions.  For children that have a difficult time expressing exactly what it is that they are feeling, these toys are invaluable. 
• Keep a journal that chronicles the child’s behavior both the positive and negative.  In turn, have the child journal through writing or drawing (you can record their ideas if they are emergent writers) all the positive events of the day and the stressors that affected them that day, thus providing a release of the “bad” feelings and a celebration of the good feelings and events of the day.

In reality, it may not be feasible for the classroom teacher to implement all of these techniques.  However, as with many other treatment models, the teacher is part of a team that includes the parents, guidance counselor, physician, psychologist, and others.  By teaching anxious children different relaxation strategies and coping mechanisms for varying environments, they can learn to combat and overcome their fears, one step at a time!