Introduction 

Selective mutism (SM) is a condition in which the child consistently does not speak to certain people, often teachers and strangers, in specific social situations, frequently in kindergarten/school, while speaking in other situations, such as to parents and siblings at home. SM is described in DSM-V (APA, 2013, p. 195) with the following five criteria:

1. Consistent failure to speak in specific social situations in which there is an expectation for speaking, (e.g., at school) despite speaking in other situations.
2. The disturbance interferes with educational or occupational achievement or with social communication.
3. The duration of the disturbance is at least one month (not limited to the first month of school).
4. The failure to speak is not attributable to a lack of knowledge of, or comfort with, the spoken language required in the social situation.
5. The disturbance is not better explained by a Communication Disorder (e.g., childhood-onset fluency disorder), and does not occur exclusively during the course of autism spectrum disorder, Schizophrenia, or another Psychotic Disorder. 

SM is considered a challenging condition to treat. There is controversy among professionals and researchers about the conceptualization and treatment of this group. Clinicians and researchers seem to be highly influenced by their own theoretical orientations when carrying out assessment and planning treatment. Because selective mutism is a low frequency condition, the helping agencies frequently lack the expertise to provide high quality advice (Omdal, 2014).

Background and aims

The review of the SM literature has identified some striking gaps:

1) There have been few qualitative observations of interaction in the natural environments of home, school and kindergarten.

2) Researchers have seldom compared the SM child’s communication in various settings, and they have rarely observed family interactions in much depth.

3) The SM child’s own perspective and information from formerly selectively mute persons is largely absent from the literature.

4) Few researchers have focused on how teachers could help the SM child to speak through the daily routines in mainstream schools and kindergartens.

The aims of the study are therefore:

1. To search for the meanings of the silent behaviour from the perspectives of formerly selectively mute individuals, parents, teachers and selectively mute children themselves;

2. To identify characteristics of interaction between the SM child and other children and adults in the natural surroundings of the home, kindergarten and school;

3. To identify implications for the conceptualisation of SM and the assessment and treatment of this group.

Research questions

The research questions of the study are:

1. What social interaction can be observed between children with SM and other children and adults in kindergarten, school and home?
2. What is the SM child’s experience of self and others, and of interactions at home and at school? And how do adults who have recovered perceive SM?
3. What is teachers’ and parents’ experience of interaction with the child who fails to speak?
4. What special support do children who are verbally selective need in their interaction with adults and children, and how can their communication be encouraged through interaction within the natural environments of kindergarten and school? 

The results are interpreted as suggesting how professionals, including teachers, may conceptualize SM as a specific phobia and treat it with principles consistent with graded in vivo flooding, a cognitive behavioral approach. In this approach the child begins with the least threatening situation and builds on experience of success, gradually progressing to more frightening situations (Omdal & Galloway, 2008). Successful inclusion in kindergarten and school seem to reinforce verbal communication (Omdal, 2008). Inclusion makes it possible for the child to develop new personal expectations and new self-interpretations in social interactions (Omdal & Galloway, 2007).

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