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  • Toni Pakula

Reluctant Talker or Selective Mutism?

Updated: Sep 5, 2022

© 2022 Toni Pakula |voice for selective mutism.

Children, teens and adults struggling with Selective Mutism cannot physically talk and socially engage when they are in certain social situations due to anxiety and the freeze response. Yet despite new research and understanding regarding Selective Mutism, it is still possible to find literature written by ‘professionals’ referring to Selective Mutism as a reluctance to talk. There was a good reason why the name changed from Aphasia Voluntaria to Elective Mutism to Selective Mutism. The word selective was chosen to highlight how the mutism occurs in select situations, but sadly the title still infers choice. There are many people who are advocating for a name change, they would like to see Selective Mutism changed to Situational Mutism.


Recently, I fell upon a document on the internet which was using the term Reluctant Talker interchangeably with Selective Mutism, alongside aggression and stubbornness. I alerted a UK charity about the document considering it was published in the UK. A spokesperson for the charity, reached out to the publishers of the article who have now removed the guide and apologised. This spokesperson states, this is not the first time they have had to challenge written literature referring to Selective Mutism as a reluctance to speak.


After another internet search, I came across another document called “A Reluctant Speaking and Selective Mutism Resource Pack.” I contacted this spokesperson for a second time and asked him if he could contact the publishers as he had done previously. However, he responded by saying the term in this pack is being used to describe the stage before Selective Mutism. He said he will challenge the document if I insist, but he is reluctant to raise a concern, because he feels there is value in the pack that outweighs the risk of using the term ‘Reluctant Talker’. This spokesperson for the charity then explained they had overseen the document before its publication. After a few back and forth comments on the social media thread, he stated that he is not a fan of the term ‘Reluctant Talker’ and does recognise, the term can be abused when a therapist avoids diagnosing SM.


I find this spokesperson’s final response extremely troubling for a few reasons. Firstly, if the term “Reluctant Talker” places an obstacle in the way of a child or person receiving a diagnosis of Selective Mutism, this is a grave issue. Children cannot grow out of Selective Mutism, left untreated it continues into adolescence and adulthood. Children with Selective Mutism need to be recognised and diagnosed correctly to receive the right intervention and therapy so they have a chance to overcome this condition. Therefore, surely it is unethical to use a term that could hinder a child receiving a diagnosis. Secondly, there are many professionals, parents and teachers who look to this particular charity for support and guidance regarding Selective Mutism. If this charity is reluctant to change literature that uses the term “Reluctant Talkers,” what hope do we have to better ‘educate’ others? As research evolves it is critical that researchers, educators and advocates for mental health are able to review their work with a critical eye and change what may have passed its sale by date. They should not allow this type of information to circulate, especially if they have a conscious awareness of the risk it carries to those struggling with this condition.

This resource pack has been created to help educate teachers and caregivers on Selective Mutism. Despite the pack describing “Reluctant Talkers” as not children with Selective Mutism, it worryingly claims “a child who is reluctant to speak is at risk of developing Selective Mutism if they do not receive the right early intervention.” This statement is problematic because it states Selective Mutism can be caused. This article dismisses the idea that children who are quiet in the first month of school might have a predisposition of Selective Mutism and be on the lower end of the spectrum.


I understand that there is a difference between a child who is very quiet at school for the first month or so and who does not necessarily have Selective Mutism. However, is the term ‘Reluctant Speaker’ an accurate term to use for a quiet, shy and maybe reserved new entrant child? Are publications like this defining these children in a fair, kind, and accurate way? Rather than using the word reluctant, wouldn’t it be more accurate to use the term quiet or cautious?

Children are vulnerable, they seek support and reassurance from adults. It is natural for them to be cautious away from their primary caregivers, families etc., Why are we labelling these children as ‘Reluctant Talkers’? What is this really signifying? And why are we putting this phrase in the same paragraph as Selective Mutism, when professionals and charities have been working relentlessly for years to debunk the myth that Selective Mutism is a choice?


The exact cause of Selective Mutism remains unknown. However, the aetiology of Selective Mutism is agreed upon to be a combination of hereditary, environmental, and temperamental factors. The idea that ‘Reluctant Talkers’ are children at the stage before Selective Mutism is leading, because it implies the child can be pushed into Selective Mutism. Implying that you can cause a child to develop Selective Mutism is the same as claiming you can cause someone to develop Autism. For a person to develop Selective Mutism they would have to have a predisposition for this condition in the first place. If these quiet ‘Reluctant Talkers’ have a predisposition for Selective Mutism, then should we really be referring to them as Reluctant Talkers? Do you see the point I am trying to make here?


Selective Mutism like many conditions lays on a spectrum. Experience and research shows when pressure and force is used to push the person with Selective Mutism to talk, this not only further entrenches the condition but causes unnecessary suffering.

A child with Selective Mutism can be “low profile” but become “high profile” or worse develop Progressive Mutism, especially, if they are receiving the wrong approach. Progressive Mutism causes the child to be locked into the freeze response in all situations including at home.


My six year old son went under the radar at school because he was labelled a ‘Reluctant Talker.’ He could whisper ‘pass’ or ‘here’ on the mat at roll time, and he read books to his teacher in a quiet voice. Sadly, his quiet voice irritated his teacher who insisted he used his ‘loud speaking voice to read.’ After removing him from school and home schooling my son, I realised that he had low profile Selective Mutism. His sister had been diagnosed with high profile Selective Mutism, so it came as no surprise he was also predisposed to this condition. Had I not home schooled him and observed him in certain social situations like in the local park with the home schooling community, I would have never known he struggled with Selective Mutism. My son’s anxiety disorder was not picked up by his teacher, because she saw him as ‘reluctant and unwilling' to speak. My son whispered, because he was unable to speak louder due to frozen vocal cords, not because he was being defiant.


So, at first it might not seem a piece of literature written in the UK, using the term “Reluctant Talker” to describe quiet children in the first month of school, is a big deal. But it is a huge deal. The term “Reluctant Speaker” has managed to travel through the internet all the way to New Zealand, and influence the thinking of Teachers and several Resource Learning Teachers of Behaviour (RTLB) and Speech Language Therapists (SLTs) who are looking for guidance on Selective Mutism. Therefore, this literature is not only doing an injustice to those who live with Selective Mutism and their families, it is also setting up Teachers, RTLB and SLT’s and other professionals for a fall when they attempt to learn about this condition and adopt an approach they think will help.


Why is language important ?


Language is important because words carry certain connotations. When we use words like elective or reluctant to describe Selective Mutism or the step before Selective Mutism, this builds a distorted image in our minds and creates an inaccurate perception of the condition.

The Oxford Dictionary defines the word reluctance as an “unwillingness or disinclination to do something.” Labelling a child as a “Reluctant Talker” characterises them as being purposefully difficult. This label affects how others see children who struggle to find their voice or even feel comfortable in school. How we perceive conditions influences the treatment and support they receive. To support new entrant children into school we need to create a safe environment that they can explore and learn how to be independent. Holding a safe space for these children will lessen their anxiety and grow their confidence. If teachers view Selective Mutism or quiet children through the lens of reluctance, they are at risk of negatively judging their behaviour. This negative judgement can be projected in the teacher’s tone of voice and body language. Children with Selective Mutism need cues of safety to shift out of the ‘Freeze’ stress response, and young children need to feel safe to grow independent in new situations away from home.

When a child is told they are being wilful, stubborn, difficult, rude, and reluctant, this can damage their sense of self and can create a feeling of shame. Shame is an emotion we internalise and can cause internal pain, confusion and a fragile sense of self. Children with Selective Mutism long to talk, and they long to be seen and accepted for who they are. They do not know themselves why there are times they cannot speak. It is also important to note, not all children with Selective Mutism are shy. There are many children with Selective Mutism who are extroverted and extremely social, this is what makes the condition so debilitating. When a child shuts down in certain social situations it can leave them feeling out of control and afraid. Children with Selective Mutism need to know it is not their fault, they are not alone, and when they are in environments away from home such as school they will be supported.

Shy children, are children who need to warm up to their environment, and they are afraid of social judgement. They do not take the safety of an environment and people for granted. They observe the world around them and they reach out when they are ready to, when they feel safe and comfortable. Giving a child time and space to do this, does not enable bad behaviour, it teaches them that it can be a good thing to be cautious and it allows them to trust their own instincts.


Of course, there are some children who are introverted too. People who are introverted are our quiet leaders that we should embrace and support. Introverts should never be labelled as being wilful and problematic, because they are not extroverted enough. This world needs introverts, and when teachers and caregivers try to push introverted people into being extroverted leaders society risks losing our best thinkers. This world needs sensitive people who know how to scan their environment for safety, we need quiet thinkers who learn how to listen to others. As Susan Cain states, “The purpose of school should be to prepare kids for the rest of their lives, but too often what kids need to be prepared for is surviving the school day itself.” Susan continues to explain how encouraging children to “come out of their shell” [sic] can cause them to feel a certain shame and internal pain. By pushing children to become more extroverted, we fail to appreciate the gifts of introversion that this world is in desperate need of. So, next time you feel inclined to refer to a child or person as being a ‘Reluctant Talker’ and you begin to encourage them “out of their shell,” pause for a moment and consider what this label is actually doing.


Is this child being reluctant or are they learning to trust their environment? Change the narrative from reluctant to cautious. When you change your perception on how you see a child who appears shy or extra quiet, as a child who is cautious and who needs time. You can create safe spaces that help the child stretch their curiosity as they learn to trust the new environment and people within that environment. Not only will they learn to trust themselves, grow a positive sense of self, but they will also become fiercely independent.


Footnote:

A spokesperson from this charity has stated they are working on new documentation although they do not know when it will be published. Another spokesperson for this charity has stated “the charity does not support the use of the term 'Reluctant Talker' when referencing Selective Mutism”.


The purpose of this article is to discuss the term 'Reluctant Talkers' and to suggest the phrase be retired in the archive box where it belongs. This article has not been written to dismiss the good work this charity has and continues to do.


References:

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders; DSM-5-TR (Arlington, American Psychiatric Publishing, 2013).

Brown, Brené. The Power of Vulnerability: Teachings on Authenticity, Connection and. 2012.

Cain, Susan. Quiet Power: Growing Up as an Introvert in a World that Can't Stop Talking. Penguin UK, 2016.

Dr Lee, David., & Sanders, Louise (2018) “A reluctant speaking and selective mutism resource pack”. Retrieved from: https://www.leicestershire.gov.uk/sites/default/files/field/pdf/2018/8/21/Selective-Mutism-Resource-Pack-Aug-2018.pdf

Fernald, Joleen R. (2017)  Psychometric properties of the selective mutism sensory processing questionnaire. Fielding Graduate University, 1-82.

Gabor Maté, MD. When the Body Says No: The Cost of Hidden Stress. Knopf Canada, 2011

Heilman, K., Connolly, S., Padilla, W., Wrzosek, M., Graczyk, P., & Porges, S. (2012). Sluggish vagal brake reactivity to physical exercise challenge in children with selective mutism. Development and Psychopathology, 24(1), 241-250. doi:10.1017/S0954579411000800

Johnson, Maggie; Wintgens, Alison, The Selective Mutism Resource Manual (Bournemouth, Routledge, 2016)

Klein, Evelyn R., et al. "Social Communication Anxiety Treatment (S-CAT) for children and families with selective mutism: A pilot study." Clinical child psychology and psychiatry22.1 (2017): 90-108.

National Health Board (NHS), "Selective Mutism" last modified August 27, 2019. https://www.nhs.uk/mental-health/conditions/selective-mutism/

Porges, Stephen. The Polyvagal Theory: Neurophysiological Foundations of Emotions Attachment Communication Self-Regulation. New York: W.W. Norton & Company, 2011

Rao, V. Chandra Sekhar. "A brief study of words used in denotation and connotation." Journal for Research Scholars and Professionals of English Language Teaching 1.1 (2017): 1-5.

Schwenck, C., Gensthaler, A., Vogel, F. et al. Characteristics of person, place, and activity that trigger failure to speak in children with selective mutism. Eur Child Adolesc Psychiatry 31, 1419–1429 (2022). https://doi.org/10.1007/s00787-021-01777-8

Vogel, F., Gensthaler, A. & Schwenck, C. Frozen with Fear? Attentional Mechanisms in Children with Selective Mutism. Cogn Ther Res 46, 629–645 (2022). https://doi.org/10.1007/s10608-021-10289-3

Vogel, F., Schwenck, C. Psychophysiological mechanisms underlying the failure to speak: a comparison between children with selective mutism and social anxiety disorder on autonomic arousal. Child Adolesc Psychiatry Ment Health 15, 81 (2021). https://doi.org/10.1186/s13034-021-00430-1

Welch, Denice E., and Lawrence S. Welch. "The importance of language in international knowledge transfer." Management International Review 48.3 (2008): 339-360.

Wong P. Selective mutism: a review of etiology, comorbidities, and treatment. Psychiatry (Edgmont). 2010 Mar;7(3):23-31. PMID: 20436772; PMCID: PMC2861522.

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