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Is my child just shy or does she suffer from mutism?

Everything was just fine, Laura laughed, talked and told at breakfast. On the way to kindergarten, she talks to the mother and father; she suddenly falls silent a few meters from kindergarten. In the kindergarten, where she has been going for 2 years, she does not speak a word, neither with the teachers nor with the children. She stands petrified and watches the game without actively participating.
If she is spoken to accidentally, she lowers her eyes, turns away and the long blond hair falls on her face and covers it. When picked up by the mother or father, they can see how their daughter is isolated.
If they leave the kindergarten together, it gushes out of their daughter, she has watched everything, she can replay everything, she has memorized all the songs and she sings them on the way home. Tomorrow, the parents know, their daughter will tell stories on the way to kindergarten and again hours be silent in kindergarten.

Silent for hours

Troubled and full of worry, the parents call the Mutismus Advice Center (MBZ). In conversation with Ms. Emmerling, they hope to clarify this special feature of their daughter. The MBZ was founded 12 years ago by Ms. Emmerling, a systemic family therapist. The MBZ is called annually by 150-180 parents from home and abroad. The average consultation time is between 30-45 minutes. The offer is free and is gladly accepted by parents.

The way Laura is doing, around 400,000 people are doing in Germany. They suffer from selective mutism, a psycho-social phobia with personality peculiarities. The ICD-10 (International Classification of Mental Disorders) lists this disorder under the number ICD10 – F94.0.

Selective mutism refers to the inability of children to speak in certain situations when they can speak. Girls are affected a little more often than boys. "In some situations – for example at home – the children speak quite normally, fluently, but in other non-family situations hardly or not at all for emotional reasons," explains Irmgard Emmerling. "A mutistic diagnosis often reveals other personality traits such as social anxiety, withdrawal, pronounced sensitivity or a tendency to resist and defy."

The kindergarten is the first social outpost since language acquisition; that’s why a mutistic disorder is often noticed here for the first time. It is often the kindergarten teachers who point out to the parents that their child behaves conspicuously silent and passive in kindergarten, does not seek contact with other children, refuses play offers and does not play with the other children but with them.
Many children do not eat and drink in kindergarten, refuse to go to the toilet or do not cry if they have hurt – because all of this would be associated with loud voices or noises. "In consultancy, we often experience that problem has been misjudged for a long time, ”Irmgard Emmerling regrets.

Treat in time

Some teachers do not want to get involved or their advice is not really taken seriously; the pediatrician often advises to wait and the parents themselves tend to appease – after all, their child speaks normally at home. In many cases, it takes the U9 check-up before a mutistic disorder is diagnosed. Between the appearance of the first symptoms it can take up to 5 years to diagnose (Prof. Dr. Steinhauser, KJPD Zurich).
The parents are then often given speech therapy, occupational therapy or curative education, although a psychological cause is responsible for the behavior.

Valuable time has already passed by the U9, i.e. by the age of 5. "The first phase of personal development and socialization takes place in the first years of childhood until about school maturity", emphasizes the consultant. "Adults often fall back on these first childhood experiences later in life. That is why it is so important that a stable social and emotional foundation is laid in these first years." A mutistic disorder therefore needs professional treatment.

If a child is silent for three to four months in non-family situations, it is no longer pure shyness. The World Health Organization (WHO) even advises diagnostics if a child does not speak outside the home for more than a month.
The earlier a diagnosis is made and treatment begins, the better the prognosis. In the case of a child who has been silent for many years, however, the disorder will usually solidify. Then a narrowing of intellectual and social development as well as massive uncertainty in contact with peers can often be observed. Conversely, peers often react to the mutistic child with helplessness and lack of understanding, rejection or anger, or other children take on a helper role and speak for the mutistic child. This distribution of roles can even cement the silence. The family often centers their lives on the affected child, who, contrary to the mutistic behavior, can show uninhibited and dominant, sometimes even aggressive, at home.
Because mutism is often misinterpreted, diagnosis and the start of effective therapy are often delayed. It is entirely conceivable that the affected child can master kindergarten and elementary school in silence, at the latest in the higher classes there is often a cognitive slump in addition to the socio-emotional one.

Children who do not participate in the classroom, do not ask questions, and who constantly monitor themselves, so as not to speak, in order not to make a sound, whose energy capacity drops more and more. It can happen that the child becomes increasingly poor at learning with a very good cognitive potential.
Timely therapy can counteract a chronic course. The ignorance of the environment, the doctors and the pedagogues as well as the frequent consolation “This is still growing” often inhibit the activities of the concerned parents, because they trust that specialists have more knowledge than they do.

This was one of the motivations that led Ms. Emmerling to found the Mutism Counseling Center. She is a good partner for parents looking for sound advice, quick diagnostics and effective therapy. The MBZ has closed a gap in free advice on selective or total mutism and has been doing so for 12 years.


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Christina Cherry
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