The first time speech and language therapist Maggie Johnson worked with a mute child, almost 30 years ago, she used every trick she knew. None of them worked. "I tried being nice," she recalls. "I tried begging. I tried staring him out. I didn't do anything to make it easier for him, because I had no idea what was going on.
"What I did then is still the norm, until people understand that the child has an anxiety disorder, akin to a phobia. People totally twig when you say it's a speech phobia: it's like being terrified of dogs. They go 'Oh, right'. Sometimes people think the child is just attention-seeking or doing it for fun. They think it's the child's choice not to speak. In fact, the child would love to speak, but doesn't know how to get rid of this panic reaction when they try."
Selective mutism, when a child speaks happily in some settings and not at all in others, is rare, affecting about one child in 500. Its onset is often around the age of three, when children start playgroup or nursery. It is more common in girls than boys, and among children from ethnic minorities who do not speak English at home.
Mute children were often thought to be abused, an assumption that may still deter parents from seeking help for their child, even though no research evidence for this exists. Experts believe that these are anxious children, made so by a combination of factors: part heredity, part environment. They may have shy or anxious parents; they may have suffered an early separation.
Clues to their state go beyond not speaking. Their body language is often stiff: they may turn their heads away, look at the ground, hide in a corner, suck their fingers or pull at loose skin. They may stare with a blank expression. All these are physical fear responses: scientists now believe that a primitive part of the brain, the amygdala, is flooded with anxiety in these children when they feel themselves in the spotlight. The child learns to link talking with a panic response.
Small children starting school find the noise, large numbers, and unfamiliar people and surroundings stressful. Some have to make extra adjustments: those from rural or isolated families, unused to social buzz; those who bring cultural expectations that encourage reticence (Asian girls are often very quiet); those with little or no English, who feel they have a linguistic mountain to climb.
During their first month, many new pupils may not speak. Ethnic minoritiy pupils may continue to be silent: English language and new ways of interacting are going in but not coming out. They need to be watched, but not worried about.
The signal that a problem may exist occurs when the child's silence continues to be absolute beyond the first month, (Asian girls are safe if chatting happily to their friends in the playground, even if saying nothing in the classroom), and when the child either continues to be unusually fearful or, at the other extreme, shows a complete mismatch between confident behaviour and absent speech.
Registration, circle time, literacy and numeracy hours are all based on talking. Teachers expect to assess children's potential, response, skills acquisition and understanding by asking them questions. Everything assumes the child will speak; everything seems undermined when they don't.
Schools need to rule out the possibility that the child has an inherent language problem. (About 20 per cent of selectively mute children do.) That may involve screening. But it will probably be clear that the child can follow instructions and is learning, just not speaking.
At this point, says Tony Cline, professor of psychology at Luton University, teachers can feel at a loss: "You don't teach early years unless you really enjoy interacting with small children. Typically, children trust you and respond to you. So this scenario isn't just frustrating because your usual techniques don't work. It's also damaging your self-esteem."
The result can be desperate attempts to make the child speak, through nagging, cajoling, bribes or even punishments. An apparently recalcitrant child may be left dangling in silence, the focus of attention of a whole class, or refused a breaktime snack until they ask for it. It is like asking an arachnophobe to pick up a tarantula.
"It's very easy to let yourself think the child isn't interested in you or doesn't care," says Geraldine Feehally, Senco at Mellor community primary school in Leicester. "You have to be very calm and patient and not take it personally."
Much of this could be avoided by simple precautions. Parents should be asked about shyness, whether a child is upset being left at playgroup or nursery, as soon as they register their child for school, says Sylvia Baldwin, a retired educational psychologist.
If either parent or child seems nervous, they should be offered an early morning school visit or at the end of the day, when few people are around.
A home visit is not designed to get the child to speak but simply to see them in safe surroundings. Each child should have a key member of staff to observe and draw alongside them, not pressing them to speak but reassuring them. Activities should encourage talking, singing, moving in groups, rather than as individuals. Children should be able to put up their hand for the register and respond on mini-whiteboards in literacy and numeracy hours.
Children will still speak when they are ready, says Maggie Johnson. These stratagems simply make it safer for them to take the risk.
"More than half these children will sort themselves out in early years with the right softly-softly approach. You don't ask them questions. You don't say 'What's your favourite colour?'; you say 'I wonder what your favourite colour is. Mine's pink.' Then you say, 'Here you are, pick one of these'."
If none of this works, schools might feel out of their depth. It can be tempting to request expert intervention, despite lengthy waits.
Yet experts agree that waiting is a mistake. Schools can treat pupils, with telephone or email support from specialists, using the well-established resources available, and always with a gentle, non-judgmental approach.
Treated early and quickly, these children improve rapidly, says Sylvia Baldwin: "It's much easier to deal with this before 105 different people have tried to make the child talk."
The essential element is a one-to-one relationship with someone they trust, says Maggie Johnson. That person's first job is to give the child a pep talk: "Somebody needs to tell them that everybody knows they aren't doing this deliberately. You say 'Don't worry, lots of children are like this. We know how hard it is for you.'
"Adults mustn't pussyfoot around. Sometimes they say 'I can't talk to them about it. It makes them worse and they run and hide.' But that's because their idea of talking to the child is to say 'Why? Why can't you do this? Why don't you talk to that nice lady?' The child doesn't know why. You tell them 'I know why, it's hard for you. It happens to lots of children and it will get better.' "
FADING AND SHAPING
Having built up trust, the adult needs to work with the child little and often on two key techniques: fading and shaping.
The latter involves helping the child take tiny steps towards speaking. At first they are asked to communicate non-verbally: to point or nod. Then to make a sound (perhaps an animal noise) Then to whisper speech sounds, then to voice a sound, a syllable, then a word, then a sentence.
All this is done playfully, in short sessions over several terms. The goal is to keep stress levels as low as possible, while encouraging tiny changes.
Fading exploits the fact selectively mute children speak in some circumstances and not others (often at home and not at school) and to some people and not others. If the teacher visits the home to begin the shaping, then the child is in a setting where it is safe to speak; if the shaping is begun by the parent in school, then the person is safe even though the setting is not.
Fading involves just this kind of breaking of rules which the child has made about speaking. Gradually, places and people can be extended: walking or driving towards school, walking from a side room along a corridor, eventually into the classroom. The class teacher can stand in the doorway while the child reads or plays a word game, then stand closer, and eventually sit at the same table. Individual classmates can be faded into a counting game in a quiet room. In every case, the principle is to make tiny changes, while keeping the child's anxiety at a level they can manage.
FLEXIBILITY AND IMAGINATION
Rewards for success during shaping and fading should really be rewards, not bribes, says Maggie Johnson. A sticker or a tiny treat creates no extra pressure; saying 'Do this and you'll get that' does. But what these children need most is flexibility and imagination.
Sylvia Baldwin recalls one home visit when a timid child spent the whole session under the kitchen table: "I'd taken some toys and I left one there, saying I would come back the next day. As I left I saw a hand come out from under the table and grab the toy. It was like taming a grey squirrel."
Maggie Johnson's favourite story is of an older boy who had begun to speak:
"The whole school was rooting for that boy. He had a trick camera which squirted water, and the deal was he had to say to the caretaker 'Can I take your picture?' When the caretaker said 'Yes', he got squirted in the eye.
Watching that boy's glee was wonderful."
The same principles extend to working with parents, which can be difficult.
Sometimes parents fear accusations of poor parenting or abuse. Sometimes they cannot cope with school meetings: "Parents may seem unapproachable and difficult, when in fact they themselves are acutely shy," says Sylvia Baldwin.
Parents may be over-anxious, checking every day whether their child has started speaking. Or they may simply be bemused, says Geraldine Feehally:
"Parents don't necessarily believe what you are saying. They have a busy, noisy little girl at home who plays with her sisters, chats, doesn't seem to have a problem. To us she's a child who arrives at school and doesn't speak until she gets home. It can be really difficult to work alongside parents when you don't appear to be talking about the same child."
Treated supportively, most of these children will speak in school by the age of seven or eight. Those who remain silent into their teens are very rare and in much greater danger, says Sylvia Baldwin: "People give up on you, and then there are very few ways of asking for help. They may become social phobics. They may be psychotic or suicidal. They need expert, possibly psychiatric intervention."
Enabling middle years children to avoid that state involves scrutinising their social relationships. Try not to allow them to gain status as "the silent one" in the class, exploiting classroom management and transition times between classes and between schools - these may be stressful, but allow the chance of a fresh start. Seat the child where they can see others rather than others seeing them. Let them know you intend to ask them a question later in the lesson. Offer them a range of possible answers: Yes, No or Maybe, rather than stark alternatives. If they freeze, move swiftly on, saying you will come back to them later.
Although psychological assessment is useful, schools should not fear intervening, says Tony Cline: "These youngsters have developed a very strongly established way of dealing with life as a school child. Their pattern of relating to other people will be consistent, absolute, difficult to shift: 'I talk to him; I don't talk to her.' Sometimes they talk to a shrinking number of people or in a shrinking number of settings. What is unhelpful is for lots of different people in school to set up spontaneous, impulsive, 'I'm going to make this work' reward systems. But a gradual fading approach is at the very least not going to do any harm."
RESOURCES AND TRAINING
* Selective Mutism Information and Research Association (Smira). Helpline 0116 2127411. Silent Children in book, video, DVD (pound;10,11.50,15.50).
Information pack pound;3.50. Email firstname.lastname@example.org
* Selective Mutism in Children, by Tony Cline and Sylvia Baldwin (1994), Whurr, pound;27.50
* The Selective Mutism Resource Manual, Maggie Johnson and Alison Wintgens, Speechmark Publishing, pound;37.50
* For courses contact Maggie Johnson: tel 01843 824069; email email@example.com; www.selectivemutism.org