Empowering Your Anxious Child’s Voice

Veronica Raggi Ph.D.

Some children speak abundantly and easily at home but demonstrate minimal speech in social settings outside of the home. These kids are often chatty and have good communication with people they feel comfortable with but restrict their speech when anxious. They carve up the world into distinct boundaries for who, where, and when they will speak. For example, a child may feel comfortable talking to their grandparents, but will not talk to neighbors or anyone in the community. Another child may talk to everyone in the community but exhibit no speech in school. Some kids will talk to select adults at school, but not to peers.

This predicament can be overwhelming and stressful for both kids and parents alike. It is easy for parents to feel uncertain about how to navigate this scenario and resort to short-term solutions that inadvertently maintain the problem. For example, parents and teachers may answer for the child when he is asked a question, rescuing him from his anxiety in the moment. Over time, rescuing by adults leads to an over-reliance on gestures to communicate and an even lower likelihood the child will respond verbally.

What can parents, teachers, and other concerned adults do to break this cycle? Here are some specific evidence-based guidelines for working with your anxious child to break the sound barrier.

Resist Asking Abrupt Questions at the Start of a New Interaction

Give your child time to warm up in any new social setting without prompting them with an immediate question. For example, when you arrive at the birthday party, don’t encourage your child to say “Happy Birthday.” Instead, explore the birthday area with your child, giving them freedom and positive attention without expectation or demand.

Provide Positive Attention and Let Your Child Lead

Use specific statements that demonstrate positive attention to the child’s actions and speech. That is, narrate your child’s actions and reflect any speech you hear. For example, “I see you checking out the birthday presents. Wow, those are some really colorful packages.” When you hear your child speak, repeat back what she shares with you. “Ahh, you are telling me you think there are Legos in that package.

Many parents and teachers initially feel it can be awkward or uncomfortable to converse with children without leading, instructing, or asking questions. But with a little practice, this approach starts to feel natural and intuitive.

Consider Your Physical Proximity to Others

When your child has warmed up, start asking questions at a distance from the others present. The goal is to make it easy for your child to respond verbally because they are focused on talking to YOU and having fun. “Do you think Max’s cake will be vanilla or chocolate? I wonder if there will be a clown or magician?” Once your child is consistently answering your questions, start to move your conversation closer to others at the party. As your child becomes more comfortable with other adults and peers overhearing them speak, the likelihood they will answer others directly will increase.

If your child is still silent, take him to a quieter area (this may only need to be a few steps away or with your body blocking the visual view of others) and prompt again. When your child answers verbally, share your child’s response with others. “Ben said he would like the chocolate cupcake. Thanks, Ben for letting us know.

This action is what psychologists refer to as “shaping” a behavior. When a child is having difficulty demonstrating a preferred skill or behavior, we often work towards the desired behavior by approximating it or developing it in smaller steps. Saying the words verbally at a distance or whispering into the ear of the parent is an approximation of the ultimate goal, that of full speech with the adults and peers at the party.

Praise and Reinforce All Verbal Behavior

There is a general rule in child behavior that whatever we give our attention to will increase in frequency. When a child responds verbally, it is important that this behavior is attended to and praised. You can reinforce speech by using both a reflection (repeat back what your child said) as well as specific praise (compliment aspects of her sharing). For example, your child says that she wants the chocolate cupcake. You say, “You want the chocolate cupcake. Thank you for letting me know what you want.

It is important that any praise is natural, specific to the situation, and delivered in a manner that is comfortable for the child. Instead of saying, “Good job!” try statements such as, “I really like that idea. Thanks for telling me”, or “It is so helpful when you tell me what you want. Now I know just what to do.” Also, consider whether your child appreciates praise delivered calmly and nonchalantly or more enthusiastically. Many anxious children prefer praise that is relaxed and not too dramatic.

What Are My Next Steps?

Helping children work through a pattern of non-speech in community and school settings takes energy, time, and attention from all involved. If you are struggling to make progress and/or these concerns are causing distress to you and your child, consider seeking an evaluation from a mental health professional.

Children who speak expressively and easily in situations where they are comfortable, but display minimal or a lack of speech in situations when they are anxious, often meet the criteria for an anxiety disorder known as Selective Mutism (SM). Children with SM are speech-phobic and typically hyper-attuned to their social environment. They may feel frozen or panicky when speech expectations are present. Additionally, they often display broader self-conscious and socially anxious behavior, feeling easily embarrassed and disliking being the center of attention.

A full evaluation can determine whether your child meets the criteria for SM and support in the development of treatment goals and a specific plan to address it. The strategies presented above are part of an evidence-based program known as Parent/Child Interaction Therapy for Selective Mutism (PCIT-SM). Many children with SM and their parents benefit from working with a specialist to learn the techniques and strategies in a systematic way that is consistent with best practices and most likely to lead to success.

It is important to note that a full evaluation should also assess for other conditions that may be contributing to or explain the lack of speech. For example, developmental delays, deficits in receptive or expressive language skills, a social communication disorder, or struggles with second language acquisition, all can impact speech behavior. Understanding why your child is not speaking is an important precursor to having a treatment plan that works for your child. When children have other comorbid conditions, or the lack of speech is due to another reason, other interventions may be warranted and/or most appropriate. This post specifically covered tips and strategies for developing and increasing speech in children with primary anxiety.

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