Reach­ing out

Ali­son Wit­gens, Wood­bridge based ex­pert on the hid­den prob­lem of se­lec­tive mutism

EADT Suffolk - - Inside -

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

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