Many times I have experienced young children making their ideas and thoughts heard through many different forms, be it drawing, dancing, painting with mud, singing, constructing or using gestures and props in role play. On a number of these occasions, I have had the privilege to witness some of those children begin to articulate their thoughts and ideas verbally to chosen, trusted people. Why is this special? Because these children have been diagnosed with selective mutism (formerly referred to as elective mutism) and have previously been unable to speak in all but very familiar environments. This can be debilitating socially and emotionally, but also very empowering for children who are able to overcome their fear.
What is selective mutism?
Selective mutism is a rare anxiety disorder affecting around 1% of the population, in which a child is consistently unable to speak in settings other than their home (or very familiar environments) due to excessive fear. This leads to speech-avoidance behaviours and the reinforcement of their own non-speaking identities. The prevalence of SM is increasing (Johnson & Wintgens, 2001), and the lack of specialist early intervention can lead to significant interferences in development, increased anxiety into adult years and great disadvantages in life (Coiffman-Yohros, 2017).
The good news is that children as young as two can successfully overcome SM with as little as a few days intense treatment (http://www.ispeak.org.uk) and the arts are often the trigger for enabling fully verbalised language to develop over time. But the problem is that symptoms are often not detected until a child starts school, when an acute fear of speaking and a ‘fight-flight-or-freeze’ response is triggered by the new environment. By this time, many of their beliefs about themselves as being the 'non-speaking' or 'mute' child have become embedded, often unwittingly reinforced by adults who will jump in with their own words to save them from embarrassment.
Unable to speak, children can find their needs are not properly met, leading to the build-up of frustration, social and emotional anxieties, poor attachment and high levels of stress hormones. This can result in physiological breakdown at a vital time when their brains and bodies are forming the blueprint for healthy growth and development.
What is interesting about these behaviours, however, is that similar patterns are evident in people who have Post Traumatic Stress Disorder (PTSD), into which much more funding has been invested for research and treatment. During episodes of anxiety or trauma, the rapid release of stress hormones (mainly cortisol, adrenaline and norepinephrine) causes the left hemisphere of the brain, housing one of the speech processing centres in Broca’s area, to become immobilised. This, in effect, freezes the person's ability to speak. They can still see the words they want to say in the visual cortex of their brain and can also hear the sound of those words in the auditory cortex of their brain but they just cannot express them verbally (Schore, 2017).
I'm really excited about this discovery as it opens a new doorway into the phenomenon of why the arts make such a difference to unlocking young children's communication channels. So much so that I have decided to try and put a more rigorous, scientifically tested evidence base behind my theory by studying this as part of a PhD programme in the new Biosocial Science Lab at Manchester Metropolitan University.
What will the research involve?
Specifically, this study aims to test the suitability of dance and music to help 3-5 year old children with selective mutism (SM) to unlock their creative voice using improvisation techniques that help the brain and body to construct new paradigms of expressive communication. This study will contribute to the current gap in research by building significant new interdisciplinary knowledge around SM and the importance of creativity in the processes of building expressive, creative confidence and neurodiverse communication channels for SM children. This will be achieved by:
Conducting an interdisciplinary investigation into SM therapies from the arts, behavioural, neuropsychology, pedagogic and bioscientific fields to identify the best ways for dance and music to help untangle emotional, psychological and physiological blocks to young children’s communication through voice and body (Amir, 1996; Jones, 2012).
Co-designing multi-modal, art-form-based, communication techniques with educators, artists, health professionals and parents of SM children, to empower them in the research process and hopefully ensure better sustainability following completion of the research.
Developing a new methodology to test the usefulness of these techniques that draws together methods from social and life sciences, (see below for the 'how'). We will use this new mixed-methods approach to ascertain how well arts techniques can be used by parents, speech and language, psychotherapeutic and early years professionals during home or setting based sessions with children with SM (aged 3-5 years).
Presenting the outcomes in a toolkit and workshops for parents, education and health professionals across the UK to enable arts-based interventions to be continued by non-arts specialists, and extend the impact of the research and the knowledge of positive strategies for SM.
This research aims to build vital knowledge about the place of non-verbal, embodied meaning-making for communication (Hackett, 2014), addressing a timely and pressing need for more low-cost, evidence-based SM treatment options.
Why do the arts unlock communication and how will we test this?
Neuropsychology research suggests creative interventions have been highly successful in enabling PTSD veterans to recover from anxiety based trauma by opening up new, stress-free and deeply engaging methods of communication and expression (Van de Kolk, 2014). Imagination activates a part of the amygdala that suppresses the release of stress hormones and increases brain body functionality, allowing people who experience high levels of anxiety to express themselves in powerful ways.
Lots of different art forms can enhance this process, but for the sake of the parameters of the PhD study, we are focusing just on two main art forms at this stage - dance/movement and music/singing.
Dance can increase the number of capillaries, facilitating blood flow and oxygen to the brain, increasing cognitive performance, immune function and good mental health (Sousa, 2006). As a primarily non-verbal method, it liberates a child from the stress of having to articulate thoughts and feelings (O’Connor & Daly, 2016) and provides a sensory and tactile language enabling a child to be better understood and supported.
Music and singing can stimulate a wider range of gestural expression, building rapport and confidence to gradually introduce children to new environments (SMIRA, 2017). Music also helps connect a child with their ‘inner world of imagination and feeling that is uniquely them’ (Robinson, 2012) and with their playful space that they otherwise cannot reproduce outside of their bodies (Winnicot, 1971).
Because the scientific validity of this research is important, we will be engaging three core approaches to test the changes in young children's brains and bodies as the arts interventions are used:
1. Biodata capture, including temperature, blood volume pulse, heart rate variability and sympathetic nervous system arousal through wearable microsensors that ‘engage with the body in a more distributed and unconscious way…while still mobilising embodied forces’ (de Freitas, 2017).
A biotechnological approach will reveal physiological traces of stress, engagement, interaction and performance as well as capturing the physiological synchrony between the child and the adult (Hernandez et al, 2015). Data can be triangulated against times and frequency of non-verbal or verbal communication, with and without the arts intervention, to ascertain relational patterns.
2. Levels and frequency of independent (non-verbal) creative expression, including embodied languages, agency, mastery and engagement using the Leuven Scale (2005) to measure involvement and well-being.
3. Frequency, range and quality of verbal communication and social interaction with peers, family members and key professionals around the child.
This will enable us to explore a sociological understanding of children’s responses within a biosocial framework that takes stress, fear and environmental toxins into account (Youdell, 2017), and provides a much needed, robust evidence framework to underpin future research in these disciplines.
Empirical data will be gathered according to Van Leeuwen’s (2005) principles of ‘collecting, documenting, and systematically cataloguing’ the behaviours of SM children through observations, photographed moments, coded videos and children’s creative expressions in dance or music, reflecting their authentic voices.
What impact are we hoping for?
Despite a plethora of evidence pointing to the importance of creativity in children’s learning, critical thinking, social interaction and self-regulation, it is barely mentioned in the early years curriculum, or in the training of early educators and health professionals (Robinson, 2012). The lack of exposure to arts and creative processes has serious implications for future learning and development. Not least because neuroscience is revealing how, when synaptic pruning starts around the age of three, the synapses that are predisposed to attunement, imagination and creativity can be pruned away if not already established (Schore, 2017), making it harder for a child to build strong, communicative relationships in the future.
Through the publishing of conference papers, articles, workshops and a toolkit, the outcomes of this study will contribute important knowledge in Early Childhood Education about the crucial role of creativity to brain and body development, especially for children without oral speech, with implications for future teaching and learning. It will also contribute methodologically to the field, developing a new approach to interactive natural and social scientific methods.
Can anyone get involved?
Yes! Trial groups of SM children and families will be recruited in 2019 but do get in touch if you already support children with selective mutism using any art forms or creative methods, as we would love to hear about approaches that have worked for you. In between quarterly E-bulletins, we will also post updates on this research in our Linked In Group, including questions for test pilots who would like to try out ideas for us, so please do join the group if you haven't already.
Amir, D. (1996) 'Experiencing Music Therapy: Meaningful Moments in the Music Therapy experience', in M Langenberg, K Aigen and J Frommer (eds), Qualitative Research in Music Therapy: Beginning Dialogues, Phoenixville, PA: Barcelona Publishers.
Coiffman-Yohros, S, (2017), ‘Helping a Child With Selective Mutism’, Selective Mutism Foundation, Inc.: https://www.selectivemutismfoundation.org/info-on-selective-mutism/sound-advice. Accessed 08.01.18.
De Freitas, E (2017). ‘The biosocial subject: sensor technologies and worldly sensibility’, in Discourse: Studies in the Cultural Politics of Education.
Hackett A (2014) ‘Zigging and zooming all over the place: Young children’s meaning making and movement in the museum’. Journal of Early Childhood Literacy 14(1) 5–27
Hernandez, J., Riobo, I., Rozga, A., Abowd, G. D., & Picard, R. W. (2014). ‘Using electrodermal activity to recognize ease of engagement in children during social interactions’. In Proceedings of the 2014 ACM International Joint Conference on Pervasive and Ubiquitous Computing (pp. 307–317).
Johnson & Wintgens (2001). ‘The Selective Mutism Resource Manual: 2nd Edition’, Oxon: Routledge.
Jones, K (2012) ‘How intense is this silence? Developing a theoretical framework for the use of Psychodynamic Music Therapy in the treatment of Selective Mutism in Children with English as an additional language: A heuristic case study’ British Journal of Music Therapy 26(2) 15-28.
Laevres, F (2005) ‘Leuven Scale for Well-being and Involvement’, Research Centre for Experiential Education, Leuven: Belgium.
O’Connor, A., Daly, A. (2016) ‘Understanding physical development in the early years: linking bodies and minds’, Oxon: Routledge.
Robinson, K. (2012) Keynote Presentation at the Earlyarts UnConference 2012: https://vimeo.com/53456183 (accessed 08.01.18)
Schore, A. N., Marks-Tarlow, T. (2017) ‘How Love Opens Creativity, Play and the Arts through Early Right Brain Development’, in Marks-Tarlow, T., Siegel, D. J., Solomon, M. (eds) Play and Creativity in Psychotherapy (Norton Series on Interpersonal Neurobiology), New York: W. W. Norton.
SMIRA (Selective Mutism Information and Research Association) (2017), at www.selectivemutism.org.uk (accessed 10.01.18).
Sousa, D. (2006), ‘How the arts develop the brain’, The School Superintendents Association, http://www.aasa.org/SchoolAdministratorArticle.aspx (accessed 31.08.17).
Van de Kolk, B, (2015), The Body Keeps The Score – Mind, Brain and Body in the Transformation of Trauma. London, Penguin.
Van Leeuwen, T. (2005), ‘Introducing social semiotics’, Oxon, Routledge.
Winnicott, D.W. (1971) ‘Playing and Reality’. UK: Tavistock Publications.
Youdell, D (2017), ‘Bioscience and the sociology of education: the case for biosocial education’, in British Journal of Sociology of Education, 38:8, 1273-1287.
Written by Ruth Churchill Dower, Earlyarts Director, May 2018
Photos by Ammie Flexen (1 + 3) and Rachel Brooke (2 + 4)