By Dr Melodie de Jager.
Selective Mutism is a term used to describe a person who can speak, but doesn’t speak.
Selective Mutism occurs most often after some form of trauma. Trauma doesn’t have to be something as hectic as Mary had experienced: it can also be the result of a big fright; having been in hospital; the arrival of a new baby in the family; a scary movie; an intense allergic reaction; a near drowning, etc. Selective Mutism is most often the body’s way of telling us that a person is experiencing intense anxiety.
Selective Mutism is also associated with an aberrant Moro reflex. A Moro reflex is a primitive reflex that triggers the fight, flight or freeze response. In a foetus and young baby, the Moro reflex acts as a survival reflex that jolts the entire nervous system into action. Around six months after birth the Moro reflex should go to rest, when the higher brain centres are more able to determine if something is a or not. Once a Moro reflex has gone to rest, it can become active again due to illness, trauma, injury or any other incident that the brain codes as life threatening.
When the Moro reflex is triggered, the Vagus nerve redirects energy away from the speech organs and metabolic system in support of the vital organs – heart and lungs. Heartbeat and breathing rate increase, the pupils dilate and the calf muscles contract in readiness for action while the eyes, ears and nose scan the environment to determine where the threat is coming from.
The effect of the Vagus nerve is known to most people as a dry mouth and butterflies in the tummy. This same effect is responsible for children who often complain about a sore tummy before school or who experience Selective Mutism.
For some children who present with Selective Mutism, breath-holding becomes second nature. Instead of breathing fast and shallow when they get a fright, there is a sharp intake of breath and their breathing ‘gets stuck’ – they do not breathe out. Because rhythmic breathing is needed for speech, breath-holding and fast, shallow breathing impacts negatively on speech.
Language and speech are found in the higher brain areas, while the survival response is part of the lower brain area. When a child feels unsafe or threatened, the survival brain takes over which means action becomes more important and speech becomes less important.
Sometimes it is very difficult to pinpoint the cause or origin, but even without pinpointing it, there are a few things a parent or therapist can do to help a child to relax, feel safe and regain full access to their speech centres.
Mind Moves (De Jager, 2009) is a movement programme that can be utilised on a daily basis to build neurological networks to address specific barriers. Mind Moves can be done to improve breathing and activate the speech organs and help the child to relax and feel safe and secure. All Mind Moves should be done while breathing slowly and deeply.
If it is obvious that the child’s breathing is difficult, fun activities to improve breathing can be done. Practise breathing daily by blowing out candles. Systematically increase the distance between the child and the candle so the child is challenged to take a deep breath, but experiences success. Blowing up balloons and blowing bubbles are helpful too.
The following Mind Moves can be done to address Selective Mutism:
The Mind Moves Power ON stimulates the Vagus nerve to direct energy to the speech organs (and to metabolism), while slowing down the breathing rate and heart rate. A sip of water would be a great idea at this point to soothe the dry mouth and throat.
Rub the indentation just below the collar bone in line with the left eye.
This move re-establishes the electrical flow via the Vagus nerve to the speech organs and stomach to help relax butterflies and talk with ease.
The Mind Moves Leg Workout lengthens the calf muscles to relax the Tendon Guard reflex (tight calve muscles), while the Lip Workout activates the speech organs.
Sit on a chair and straighten both legs in front while resting the heels of the feet on the floor. Raise both legs off the floor. Flex and point feet and notice any tightness in the calf muscles. Rest the left leg on the floor and flex the right foot. Hold for a count of eight in the flexed position. Relax the foot. Repeat the move at least three times. Rest the right leg on the floor and flex the left foot, holding for a count of eight in the flexed position. Relax the foot. Repeat the move at least three times. Raise both legs off the floor. Flex and point both feet and notice any difference in the tightness of the calf muscles.
This move, as well as climbing up a ladder, horse riding or walking on the heels lengthens the calf and hamstring muscles, reduces hyperactivity and improves impulse control.
Say “cooee”, pull the lips into a wide smile while stretching the “eeee” sound for the count of eight.
This move improves muscle tone in and around the lips for clear pronunciation.
The Mind Moves Massage and the Rise and Shine move create a sense of internal safety and security and the ability to face the world with courage. The “planting” of the feet during the massage grounds the child while activating the higher centres of the brain.
Child must stand upright and hold both arms 90° to the side of the body. Stand behind the child and firmly trace the outline of the body from head to toe. Hold the feet for a eight seconds before repeating 3 times.
This move develops tactile awareness, gravitational security and a positive sense of a sense of self.
Fling the arms wide open while breathing in deeply and slowly. Close the arms over the chest in a hug, breathe out deeply and slowly. The parent may simultaneously hug from behind.
This move boosts relaxation, rhythmic breathing and a sense of wellbeing.
Amazing results have been found when these five Mind Moves are done twice a day for a period of six weeks. Every move should be repeated three times before the next move is done.
Mind Moves do not replace any other therapy but have been found to be supportive of other therapies to ease a child out of Selective Mutism.
De Jager, M. 2009. Mind Moves – moves that mend the mind. Johannesburg: Mind Moves Institute