A few years ago, I was asked to observe a child who never spoke to her preschool teachers, although she had no trouble talking at home with her parents. She actively participated in all the preschool activities, including art, science, reading, writing–even dancing during music time—but she never spoke or responded to her teachers. Her parents and teachers were confused. She was quite chatty at home, but completely quiet at school. Parents and teachers assumed that it was a power struggle, that she was being willfully defiant. In reality, the child was simply “stuck.” She had retreated into a pattern of silence in the classroom. Over the past few years, I’ve observed a handful of children who exhibit similar symptoms. If symptoms persist for more than a month, children might develop selective mutism.

Selective mutism is characterized by a child’s inability to speak in certain settings and with certain people. The child may have no problem talking at home or with close relatives or friends, but may not speak at all, or may only speak in whispers, in other social settings, such as school, public venues, or extended family gatherings. In most cases, selective mutism is diagnosed between the ages of 3 and 8. More than 90% of children with selective mutism also have social anxiety, which can cause severe distress in the child and prevent her from participating in school or making new friends. It can also inhibit the child from asking for help, even if she has a basic need, such as using the bathroom.

The inability to speak in a school setting should not be confused with acquisition of a new language or shyness. If a child speaks another language fluently at home, she may be reluctant to try out the new language at school. But eventually, bilingual children find friends and begin the socialization process—first non-verbally, then with a few key words in the new language. A slow-to-warm child also needs time to adjust to a new preschool setting. However, once the child understands the rules and structure of the school, she, too, finds friends and begins to integrate into the classroom routines. The child with selective mutism, however, always “freezes” when presented with a social interaction, even months after school has begun.

To support a child with selective mutism, it is important to remove all pressure to talk. If a child is severely inhibited and unable to speak in school, putting pressure on her to speak will negatively reinforce the behavior. With all social anxieties, it is critical to build social skills and communication strategies using small, manageable steps. Create non-verbal communication strategies, such as pointing or using picture cards. Increase a child’s self-esteem and self-confidence by making her a helper in the classroom. Any steps toward communication (verbal or non-verbal) should be reinforced and praised. Allow the child to share her artwork or help another child during play. Make sure she has plenty of opportunities to partner with one friend on a particular task or activity.

With patience and persistence, a child can be given every opportunity to participate fully in the preschool setting, even without verbal communication. Create a plan of small steps toward the goal of speaking to the teacher and allow the child time and space to reach that goal.