Quitting the Quiet: Program Helps Selectively Mute Children Overcome Anxieties
Selective mutism is an extreme anxiety disorder combined with social phobia.
Dec. 16, 2011 -- At home, Jake Semmel acts like a happy-go-lucky 6-year-old who loves "Star Wars" and fire trucks. At home, Maya Walker, 7, is a chatterbox.
But in public, Jake will only speak to a select few adults in his life and can't even talk to his grandparents. At school, Maya hasn't said a word in class for an entire year. She doesn't move a muscle when she's on stage during the school pageant. She could never blow out the candles at her own birthday parties.
"I kind of describe it like a Jekyll and Hyde," said Maya's mother, Tessie Scroggins. "She's your normal 6-year-old at home, talkative and being a ham and dancing and singing. Outside of the home, if other people look at her, it seems like she's a depressed kid."
"People make assumptions about people who don't talk," added her father, Vincent Walker. "That they are shy, that they're not as intelligent."
While many quiet kids like Jake and Maya are misdiagnosed with autism or Asperser's, child psychologist Dr. Steven Kurtz said he believes these children suffer from "selective mutism" -- an extreme anxiety disorder often combined with social phobia.
"Selective mutism" is different from extreme shyness. Kurtz explained that shy kids will benefit from "warm up time" in ways that kids with selective mutism do not.
To treat kids with this condition, Kurtz created an intensive week-long therapy program in a simulated school-like setting for the Child Mind Institute in New York City. There are only 22 coveted spots for the five-day "boot camp," of which both Jake and Maya made the cut, and it could change the course of their lives. Some kids are prescribed anti-anxiety pills, but others, like Jake, take no medication.
"Our goal is to get out into the real world as quickly as possible," Kurtz said, "gradually exposing them to and giving them a lot of reinforcement, providing kind of training wheels, until they can do it confidently on their own."
From day one, the first rule is for the counselors to let the painfully long silences continue long enough for the kids to answer questions. It's not what the question is, but how the question is asked. Yes/no questions lead to nodding, but forced choice questions prompt verbal answers -- and every mumble is praised. The hard part begins when the group leaves the building to interact with strangers. At the end of the day, kids are rewarded with stickers they earn at the "prize store."
Part of the therapy session is to re-train the parents to ignore their protective instincts to spare their child a painful silence.
No parent likes to see their child suffer, but Dr. Kurtz said that's essentially the answer. When any kid develops even a mild phobia, parents too often rescue them too soon. Instead, the grown-ups are taught to stop over-protecting their children, and simply wait five seconds before jumping in.
READ: Dr. Steven Kurtz's tips for parents.
Both Jake and Maya made dramatic progress their first day in the program with responding to questions in short answers, but Maya suffered a setback when the anxiety overwhelmed her. But the camp is called "Brave Buddies" for a reason. After a change of clothes, Maya mustered up the courage to try again.
On day two, Jake still struggled to make eye contact, but then shocked everyone when he said a full sentence. Maya, who didn't utter a word for an entire school year, aced a "show and tell" of her Smurf doll.
The next day, with guidance of a Brave Buddy, Jake was able to order ice cream by himself for the first time, but his nerves got the better of him. By day four, Maya, the girl who was once terrified to blow out her own birthday candles, finally did it, but even by the last day, there were still moments when Maya disconnected and went mute.
After being shown videos of their once-quiet kids suddenly chatting away, some of the parents had tears in their eyes.
"I'm so proud of her," said Maya's mother, Tessie Scroggins. "It takes a lot of courage to-- If you have seen where she was two years ago, definitely not the same child."
While the five-day camp is over for Jake and Maya, the real test will be if they can keep up their new-found confidence at school. One month into the school year, Jake was still tripped up in talking with a new teacher, but he eventually triumphed over his fear. Maya had trouble joining the crowd at recess, but in class, her voice was finally heard. In time, she became more social with other children.
"You want to make sure that your child is happy and to see your child smiling," Scroggins said. "That's another thing Maya didn't do in public. Maya didn't smile much."
"Brave Buddies" have not only helped Jake, Maya and other kids find their voices, but also helped them find their smiles.