Rachel Biale, MSW, is a Berkeley-based parenting consultant who has been working with parents of very young children for more than 25 years. Send questions through her Facebook page: Parenting Counseling by Rachel Biale or via firstname.lastname@example.org.
My daughter started kindergarten at the beginning of September and seemed to adjust well. She goes to school without any fuss and looks happy when I pick her up. She tells me what she did at school and says she likes it.
But I just got a note from her teacher: She has not said one word in class since school started! She neither speaks up on her own initiative, nor answers the teachers’ direct questions. So it’s been 6 weeks and 0 words, but otherwise, she is cooperative and seems to follow what’s going on in class.
Should I be alarmed? At home she talks plenty — to me and my husband, to our dog and to her dolls. — L.P in Lafayette
Dear L.P.: It is rare that I tell a parent to worry more than they already do. Most parents have an overstock of “ready-to-worry” items in their psychic wardrobe. It’s a bit like the classic “Jewish telegram” (or tweet): “Start worrying. Details to follow.” But this time I do want to raise your anxiety. It’s in service of helping your daughter as early as possible on the chance that this is not a passing phase.
What you describe may be the telltale signs of selective mutism (SM), a childhood disorder affecting 1 to 2 percent of children across all cultures. It’s twice as common in girls as in boys. The frequency doubles in bilingual families and recent immigrants. Onset is typically at ages 21⁄2 to 31⁄2, most often in the first school setting.
SM is associated with other forms of anxiety (especially social anxiety) on either parent’s side. Treatment, when started early, is very effective: the sooner the better. But it does take time, a carefully crafted behavioral intervention and close collaboration among home, school and the treating team. The treatment team should include a behavioral specialist, speech and language therapist, and pediatric psychiatrist assessing and possibly prescribing anti-anxiety medication. It usually requires at least several months of treatment, if not most of her first school year. More limited interventions may be needed at the start of the next grade or when entering other group settings.
Now that I have alarmed you — hopefully into taking action rather than “freaking out” — let me offer reassurance and some insights and information:
• This could, indeed, be just a temporary adjustment phase. That said, please don’t wait much longer to see if it resolves on its own.
• Pressing your child to talk in school usually is counterproductive.
• It is essential to have a correct diagnosis. Some children presenting this way are suffering from a different condition, such as extreme shyness, hearing impairment, speech/language development problems, depression or social anxiety.
• Some kids with SM have extreme sensory sensitivity. All or some everyday sensory stimulation overwhelms them. What seems like ordinary street noise or physical contact to you is bombardment to them. For them, SM is a coping mechanism for shutting out the onslaught of stimulation.
• Some kids are extremely slow to warm up. What takes average children a few days or two weeks can take them months. This would be a pattern you see in multiple settings: adjusting to new people or places, changed daily routines, even new clothes or shoes.
There are excellent resources for information, referrals, state-supported diagnostic and treatment services and support. These two are gateways to everything you might need:
• The Diagnostic Center of Northern California: www.dcs-cde.ca.gov
• The Selective Mutism Group: www.selectivemutism.org (parents’ support network)
Start by gathering information. If by the time you feel well informed about SM the problem has gone away, that’s very fortunate. If not, you have a long road ahead of you. Don’t delay getting started.