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Selective Mutism - Creative Communications

Wed 5 Apr 2023 - Joanna Turner
Joanna Turner is a Music Therapist in Wiltshire and Somerset who leads a team supplying bespoke therapy packages for under 25s. Joanna has worked with many children with Selective Mutism. Since her own child was diagnosed in 2020 she has concentrated on exploring and researching this rare condition and campaigning for therapeutic pathways to be put in place across the UK. 
Tags: CYPF // Music Therapy
Joanna has appeared on several BBC radio and TV programmes discussing Selective Mutism and the current treatment pathways in the UK. She runs parental support forums and peer supervision groups for Music Therapists in the field of Selective Mutism.
Selective Mutism - What is it?
  • Selective Mutism (SM), also referred to as Situational Mutism, is a high anxiety disorder resulting in a phobia of speaking in certain situations. SM affects 1:140 children in the UK and is categorised as being high or low profile depending on the Individual’s presentation. If left untreated, SM can persist into adulthood.
  • A child or adult with selective mutism does not refuse or choose not to speak, they’re literally unable to speak. Children’s vagal nervous system enters a ‘Dorsal Vagal state’ or ‘freeze state’ whereby they become frozen, unable to speak and communicate. Many children also experience effects in their digestive system and respiratory systems. Experiences of this state can show similar presentations to that of a child who has experienced trauma.
  • Children talk freely and happily when in a comfortable environment and can often be of above average intelligence
How can Music Therapy help?

Music Therapy has a unique innate quality that identifies the social, emotional, physical, mental and spiritual aspects of humankind. We use rhythmic intervention to calm the nervous system and access inner parts of the brain and nervous system to reduce anxiety. We can explore melodic spaces to echo emotions as well as human experiences, stories, unconscious communications, self- expression and creativity.  We work in a respectful, honest and open environment that allows plenty of space for musical wonderment, choice and exploration. 

For many children with SM, Music Therapy offers a place to create sound, communicate emotions, and explore imagination free of judgement and fear. As therapists, we offer children a beautiful space in which to have conversations without spoken words.  Instead, our instruments and sounds help the children to speak all the words they need to say whilst we listen and respond to the world they allow us to join.

Where do referrals take place?

Referrals can be made via school, health visitor, GP and speech and language services. Parents can also refer their children to speech and language services in their county. 

Currently speech and language therapists assess for selective mutism but, unfortunately, many discharge on. We hope, through campaigning for a standardised care pathway across the UK, we will start to fill those gaps with educated professionals and a range of treatments for parents to access, including Music Therapy.  The NHS has recently updated their website to reflect changes in support and information discussed in our campaign. 

Conclusion & Links

Selective Mutism is a multi-layered condition that requires different approaches to help treat. There is a need for a multi-disciplinary approach to find and support treatment pathways across the UK. Music Therapy has a lot to offer children/teens and adults with this condition and their families, and we hope to raise the profile and use of Music Therapy as care pathways are developed. 

All Music Therapists are welcome at the Selective Mutism Clinical Excellence Meetings, information on upcoming meetings is available at the RCSLT (Royal College of Speech and Language Therapists.).

Support to professionals and parents is available at SMIRA, Joanna is proud to be a trustee of this international organisation:



Music Therapy and Selective Mutism peer support group can be found on Facebook (Selective Mutism: Creative Communications)  

Selective mutism - NHS

National CEN in Selective Mutism, RCSLT