Alison Witgens, Woodbridge based expert on the hidden problem of selective mutism
WHAT do you do if your child doesn’t speak in certain situations? Do you put it down to shyness, even a touch of bolshiness, or do you start thinking about other reasons or underlying causes?
The right course of action, suggests speech and language therapist Alison Wintgens, depends on the symptoms the child shows and the circumstances in which he or she stays silent. If the condition lasts more than a month or two and the child only fails to talk at certain times, while speaking freely in their comfort zone (usually at home with close family members), then we may be talking about what has become known as selective mutism.
“Selective Mutism is a hidden disability, and there is some evidence that it’s more prevalent in our more stressful modern society,” says Alison, who recently moved to Suffolk, with husband Peter, and is the national adviser on selection mutism (often known as SM) to the Royal College of Speech and Language Therapists. “Education,” she says “is also much more verbal now. A child can’t just sit quietly at the back of the class. He or she has to do group work and explain what they are doing. This can put a lot more pressure on the child.”
SM, she says, affects around one in 140 children, usually from the age of three or four and often spilling into adolescence or even adulthood. Since moving to Suffolk Alison is already coming across examples at schools in different parts of the county. An acknowledged national expert in her field, she has co-authored two books on SM, and was recently on BBC Radio Four’s Woman’s Hour, talking about the condition and her experiences of it, stemming back to 1990 when she started to work in a child and adolescent mental health service. “My training was in speech and language therapy so I dealt with a whole range of disorders. The most obvious of these which overlapped the two disciplines was SM.”
Alison’s invitation to appear on Woman’s Hour came because the programme had done a feature on school refusal – when children refuse to go to school because they feel stressed or anxious about some aspect of school life. A mother contacted
the programme to say that she had a ‘school refuser’ who was also suffering from SM.
In her sunlit, south-facing Woodbridge kitchen, Alison tells how she turned to writing about SM after meeting fellow speech and language therapist Maggie Johnson, at a conference. There was a spark, she notes, when they both realised they had done most hands-on work in the area of SM and decided to pool their experiences by writing a DIY manual. “It seemed to us that nobody owned a strategy to manage the condition. Most children grow out of SM if it is managed wisely so in our book we help people recognise and understand SM better, and describe specific techniques to use.”
While the Selective Mutism Resource Manual, first published in 2001, would never claim to be a best seller, it has become a definitive guide for parents and professionals alike. Such is the book’s success as a practical SM help mate – think diagnosis flow charts and the dos and don’ts of helping an SM child - that a second, even busier edition was published in 2016, including more on how the condition affects adolescents and adults, many of whom will have related mental health problems. The pair have also written a child’s eye view of the condition entitled, Can I tell you about Selective Mutism? The latter is a cleverly crafted first-person plea from imaginary Hannah.
“I have a sort of phobia about talking,” she notes at the beginning of the book, before going on to explain situations where SM takes hold of her and how people can help. The books have brought the expertise of Alison and Maggie onto the international stage. “We were invited to lecture in places like Texas, Norway and Sweden, and there was even a translation of the first edition in Taiwan,” says Alison. “Because of the success of the first edition we put off writing a second, but we knew we had so many more ideas to pass on.” Between them they combine over 60 years of practice, Alison’s including nine years in the Child Development Centre of St George’s Hospital, Tooting. Living in London, Alison came across a lot of children with SM. It is more common, she says, in inner-city areas and among migrant and bi-lingual children. She saw increased prevalence of SM, for example, in the Jewish and Islamic schools. The ideal is to catch the condition early and to educate the people who come into contact with SM children. Working as she did for a time in Wandsworth, Alison set up a training programme for both parents and professionals. There’s also a charity SMIRA (Selective Mutism Information and Research Association) which offers a wide range of information and support to those who need it.
If the silent (SM) child is the forgotten child, then people like Alison Wintgens must be congratulated for jogging our memory.
‘Most children grow out of SM if it is managed wisely so in our book we help people recognise and understand SM better, and describe specific techniques to use’
Author, Alison Witgens at her Suffolk home.
Alison Witgens is a specialist in helping children with selective mutism. Picture: SARAH LUCY BROWN