Christopher A. Kearney is a Professor of Psychology and Director of UNLV Child School Refusal and Anxiety Disorders Clinic, University of Nevada, Las Vegas. His new book, Helping Children with Selective Mutism and their Parents, provides information that can help readers better understand and combat selective mutism. In the excerpt below, Kearney provides some techniques to help children cope with their anxiety about speaking.
Breathing
A simple way to help children reduce physical feelings of distress is to teach them to breathe correctly. Many children experience shortness of breath, breathe shallowly, or hyperventilate when upset. Doing so actually makes the feeling of anxiety worse, so helping a child regulate breathing is important. Have the child sit before you in a comfortable position. Then ask the child to breathe in slowly through the nose (with mouth closed) and breathe out slowly though the mouth. As the child does so, encourage him to breathe deeply into the diaphragm (between the abdomen and chest and just below the rib cage.) The child may need to push two fingers into the diaphragm to experience the sensation of a full, deep breathe. The child can then breathe slowly out of his mouth. Parents may even join the process to help their child practice at home.
For younger children such as Austin[age 6], you may wish to create an image during the breathing technique. Austin could imagine blowing up a tire or pretend he is a large, floating balloon. As Austin breathes in, he can imagine filling up with fuel and energy. As he breathes out, he can imagine losing fuel and energy (or tension). The child must come to understand the difference between feeling tense when the lungs are full of air and feeling more relaxed after breathing out. The following breathing script adapted from Kearney and Albano (2007) may be helpful:
Pretend you are a hot air balloon. When you breathe in, you are filling the balloon with air so it can go anywhere you want. Breathe in through your nose like this (show for your child). Breathe slowly and deeply – try to breathe in a lot of air! Now breathe out slowly through your mouth like air leaving a balloon. Count slowly in your head as you breathe out…1…2…3…4…5. Let’s try this again (practice at least three times).
Key advantages of the breathing method are its ease, brevity, and portability. The child can use this method in different stressful situations and usually without drawing the attention of others. I recommend that a child practice this breathing method at least three times per day for a few minutes at a time. In addition, the child should practice in the morning before school and during particularly stressful times at school. Some children benefit as well by practicing this technique whenever they are around other people and an expectation for potentially speaking is present. For example, a child could use the breathing technique prior to and during a church service.
Muscle Relaxation
Another method of helping a child reduce physical feelings of anxiety is progressive muscle relation (PMR). Youths such as Austin are usually quite tense in different areas of their body, especially in the shoulders, face, and stomach. Different methods of muscle relation are available, but a preferred one is a tension-release method in which a child physically tenses, holds, and then releases a specific muscle group. For example, a child may ball his hand into a fist, squeeze as tightly as possible and hold the tension for 10 seconds, and then suddenly release the grip (try it). When this is done two or thr