How to Help a Child with Selective Mutism

By Greg Baer M.D.

September 3, 2024

Ms. Thorvald, a high school teacher called me to describe Sophia, a student in her class with selective mutism, a complex anxiety disorder characterized by a consistent failure to speak in social situations where speech is expected—like school. It is described as a “disorder” in the DSM-5, the “Bible” of describing mental health problems.

Traditional Treatments for Selective Mutism

Sophia had “suffered” from selective mutism from age six. She spoke only to certain members of her family—even then not consistently—but never to anyone outside the home. She had been in therapy for years, attended special classes at school, and successfully avoided any verbal interaction with teachers or other students. She was steadily falling behind academically and socially.

Ms. Thorvald asked me how she should treat Sophia. “Are there any techniques I should know?” she asked.

Mental health professionals believe selective mutism to stem from a combination of genetic, temperamental, and environmental factors, requiring cognitive-behavioral therapy, speech and language therapy, and sometimes medication.

Treating Selective Mutism with Real Love®

But my experience with these kids strongly points a need for us to recognize and treat the simple pain and fear that most children experience because of a lack of Real Love®.

I recommended that the teacher treat Sophia as though she had no problem at all. I suggested that Ms. Thorvald:

  • Look directly into Sophia’s eyes every time she spoke. Anxious children feel disconnected from people. They need the intimacy of direct eye contact.
  • Casually touch her head or shoulder as she passed by while wandering through the class.
  • Ask Sophia direct questions—against the advice of the child’s team of advisors. The teacher would not insist on a response, but she would still ask questions AS THOUGH Sophia were going to answer. If Sophia didn’t answer, Ms. Thorvald would provide the answer or move on to another student with no sign of disappointment.
  • Ask Sophia questions where the answer was obviously either “Yes” or “No, which would give Sophia an opportunity to answer non-verbally with a nod or shake of the head.
  • Always thank Sophia for her participation in class as she was leaving, no matter how little she had actually said or done.

Ms. Thorvald followed these suggestions consistently and persistently, but never aggressively. Sophia did begin to answer by moving her head in response to Yes or No questions.

And then, one day, when she was asked a question, Sophia gestured with a curved finger for the teacher to come closer. When her ear was right next to Sophia’s mouth, she whispered the answer.

Then Sophia began to mouth the answers without Ms. Thorvald moving closer, and—finally—she whispered her answers very quietly in open class.

Eliminating Selective Mutism with Real Love®

At the end of the year, Sophia gave Ms. Thorvald a letter, which follows and is accompanied by my comments.

“Ms. T, I want to thank you for all your help this semester. A big part of this semester I've been wondering how you have put up with me and why you have wanted to help me. I still don't really get it, but I am really grateful for it.”

Observe how articulate Sophia is in writing despite little speaking in class.

Later research revealed that Sophia had been traumatized all her young life by the simple absence of unconditional love. Nobody DID anything obviously harmful to her. No screaming, hitting, sexual abuse, alcoholic parents. 

No, her injuries was far more “innocent” than that. Her parents simply did not know how to love their daughter. Mostly they parented with quiet disapproval, a critical word here and there, or just an inability to address or even notice their daughter’s pain. Sophia learned that she just was not worth loving, but Ms. Thorvald was a light in the darkness of that belief.

Sophia: You are the most caring person that I've met and you always make me feel less alone.

Sophia had strong feelings toward Ms. T despite the teacher spending only a few hours a week with Sophia, far less than the time consumed by the extensive team of counselors and therapists.

Sophia: Sometimes it feels like people are afraid of me and afraid of speaking to me, because they know that I wouldn't answer anyway. So they give up on me, but you haven´t been like that, and that has helped me a lot.

Almost uniformly, we are afraid of what we don’t understand and what we cannot control. Sophia could feel people’s fears, ironic in light of the diagnosis of fear (anxiety) that other people gave to HER.

Sophia: I don't know how I would have managed this semester without your help, so thank you for being such a good teacher and a person who really cares about students.

We are quick to apply mental health labels to children we don’t understand and can’t control. As we do this, we can avoid much of the responsibility as we pass it off to a team of specialists. And we don’t have to feel bad if our efforts are fruitless.

These children all need love. Further, I have personally witnessed that most children with presumed mental health problems actually lose their symptoms and diagnoses when surrounded by the love they needed in the first place.

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About the author 

Greg Baer, M.D.

I am the founder of The Real Love® Company, Inc, a non-profit organization. Following the sale of my successful ophthalmology practice I have dedicated the past 25 years to teaching people a remarkable process that replaces all of life's "crazy" with peace, confidence and meaning in various aspects of their personal lives, including parenting, marriages, the workplace and more.

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