Positive Relationships: Ask the expert ... Lack of speech

We have a three-year-old boy who has been in the nursery for two terms who does not speak, despite talking at home. He is very immature for his age in play and is only just interacting alongside his peers. I have been to his home and witnessed him talk a little and play with his brother. Do you have any ideas why this is? The mother is quite intense and said the child nearly died at childbirth.

As with so many issues concerning the well-being of children, there is often no straightforward answer to this query because there appear to be a number of factors which could be relevant for this little boy's lack of speech within the setting, including that of 'selective mutism', which I will explain later. First, we need to consider all the information given.

Many children can take a long time to settle into a new environment. The fact that he has been in the setting for two terms may indeed indicate some worries and anxieties. If these do exist, they may also provide some insight into the comments of him being 'very immature for his age in play' and 'only just interacting alongside his peers'. Nevertheless, we must always be careful when describing a child's abilities and skills in any area as 'immature', because we have to be certain that our expectations of an individual child are realistic and appropriate. Some three-year-olds are still moving from the phase of 'parallel' play into more interactive play with peers and some will still prefer to play alone, becoming engrossed, for example, in a fantasy scenario with toys. Careful observation of this child should determine whether his 'immature' levels of play are repeated in other developmental areas such as his gross and fine motor skills, ability to build with blocks or do simple puzzles and involvement with paints and crayons. His lack of verbal communication may not necessarily be associated with delay in other areas.

Observations would also indicate whether he:

- talks to toys such as teddies, dolls or puppets

- speaks with one or more of the children in the setting and how he may speak, eg. in a whisper

- simply does not communicate with the adults

- has total lack of speech in the setting.

Other key questions might be whether he interacts with his peers in situations such as at snack time, outside or in creative or messy play, and whether he welcomes or withdraws from approaches by other children or adults. For example, does he freely choose to sit next to other children, or need to be encouraged? Will he offer a toy to another child?

Interactions do not have to be verbal. Noticing his facial expression, ability to tolerate face-to-face interaction and body language when with others may provide a clue as to possible levels of anxiety or otherwise. For example, does he seem 'rigid' when with other children or when approached, or does he fidget anxiously.

Ask the mother

Also to consider is the comment that the mother is 'quite intense' and that he nearly died at childbirth. This could suggest that the mother has great concerns about his health and well-being and may understandably be very protective towards him - perhaps not encouraging him to play and explore very much in the company of other children in case of perceived danger. Such experiences may lead this child to be cautious about his involvement in play situations. Finding out more about the mother's attitudes towards his needs for independence and exploration may provide some background to how he approaches new situations, transitions and change.

A further home visit or a specific appointment at the setting to sensitively discuss this child's history may be very beneficial as well as supportive to the family. He apparently does speak at home, although on the home visit he was noticed only to talk 'a little'. However, the practitioner's presence may have made him reluctant. How comfortable he would feel in such a situation would very much depend on the type of relationship this boy has with the adults within the setting.

Questions to ask his mother could include when he actually started to speak, and whether he talks in different situations such as at a friend's house, while out shopping or when people visit. Finding out whether the situation is specific to the nursery or in other situations too will provide additional important information in considering the implications of his difficulties, which may be selective mutism mentioned at the beginning.

Selective mutism

This condition is defined by the Selective Mutism Information and Research Association as 'an emotional disorder of childhood in which affected children speak fluently in some situations but remain silent in others'. This highlights how important it is that practitioners faced with a silent child find out about their willingness to speak in varying contexts. The condition starts early in life, often triggered by a transition such as a move to daycare or school, and it can be transitory. In any situation where a child's lack of verbal communication appears to be continuing within a particular context, advice should be sought from a speech and language therapist and/or educational psychologist.

It is reassuring that this child's lack of verbal communication has been noticed, because sometimes the very quiet and well-behaved child can become 'lost' in a busy setting or their lack of speech explained by 'shyness'. It is true, of course, that a shy child may be reluctant to speak when surrounded by children who appear more verbally confident, or join in activities because of fear of rejection or not being competent in some way. For example, some children find 'circle time' stressful, knowing that they are supposed to speak at some point. Even when told they need not speak if they don't want to, the scenario can cause anxiety because not speaking may be seen as disappointing the adult.

Seeing the problem as one of 'social anxiety' can help practitioners to be tolerant with the child who may appear to be simply 'stubborn', and to not put pressure on the child to speak but give praise and encouragement when they use other means to communicate.

SMIRA suggests allowing a child a range of responses, with adults accepting a smile, a nod or putting up a hand when their name is called. Other suggestions are encouraging noisy games such as trumpet blowing and beating a drum; the child could have a 'conversation' between musical instruments. Other helpful activities include stories that require lots of actions, puppet play, puzzles, ring play and rhymes.

- Maria Robinson is an early years consultant and author of From Birth to One and Child Development from Birth to Eight: A journey through the early years (Open University Press). Her Nursery World series on child development can be bought online at: www.nurseryworld.co.uk/Books

REFERENCES AND FURTHER INFORMATION

- SMIRA - Selective Mutism Information and Research Association, www.selectivemutism.co.uk. Provides useful free guidance for schools and nurseries.

- 'Silent Children - Approaches to Selective Mutism' DVD, produced in conjunction with Leicester University and funded by the DfES, is available via the website.