Selective Mutism

[Karen2]

I have a 4 yr old language delayed girl. Since last year at her preschool she won't talk to any of the 7 adults who work at her school. This school year she has stopped talking to all peers as well. She will talk to me but won't talk to the other SLP in my room or to any other adult at my school where she attends walk-in therapy. Her language delay is now mild, so she should be dismissed by early Fall. Any suggestions?

[judyra]

Check out the new ASHA catalogue that just came out. There is a book about SLPs and selective mutism. Most of the time I think selective mutism is considered to be under the realm of a clinical psychologist.

[SpeechyKeen]

I have a 1st grade student with Selective Mutism (S.M). I did a lot of research online about the disorder. It's an Anxiety Disorder. We can't cure or fix S.M., but we can:

a.) address what other speech and language issues the child has, sometimes by having the parents or trusted others do activities with the child when we can't; and

b.) look at alternative and augmentative forms of communication. If the child is too anxious to speak, can she gesture? sign? use a communicator?

I always have some good sensory activities at the beginning of our speech sessions. This child has some sensory differences, so we do Playdo, or an art activity. She LOVES smelly markers, and that is relaxing for her.

A lot of kids do better after repeated exposure to someone. If you do the sessions the same way every time and act like it's just for fun, not to get her to do anything, she might relax enough to start doing things that have more structure.

This little girls' mother finally took her to a psychiatrist and is trying meds, because the last speech therapist refused to work with the child any more. She thought it was a pain in the neck and a waste of time, but I have actually gotten some nice cooperation after a very limited amount of time. I enjoy working with her! I was not able to do much formal testing with her (just enough to see she has problems following verbal directions, and her teacher reports problems with phonemic awareness). We work on those two areas for now.

We do 45 min. sessions, not 30 min., because the first 15 minutes she is usually warming up.

I hope this helps!

[SpeechyKeen]

http://www.selectivemutismfoundation.org/

[wsprague]

If I can determine through various means (parent report, observation with sibs, etc.) that language and speech are within functional limits, I only give suggestions to the parents for how to stimulate and promote verbalizing reqests/answers to get wants/needs met, but I don't take the child on as a speech/language client. Also, I usually recommend following up with the pediatrician for a psych consult.

[Karen2]

Well, she just finished her preschool year and never talked to her teacher. She talks with me just fine and has only a mild delay remaining in syntax/grammar. Parent has taken her to a psychiatrist, but the family is moving this summer. Hopefully she will start talking to her kindergarten teacher in August since it's a new environment.

[SpeechyKeen]

It's an anxiety disorder and SHOULD be treated by a psychiatrist/psychologist. I would only see a S.M. child if there were communication disorders that a speech pathologist would normally see. We do NOT treat S.M.

FYI, some S.M. kids can't even point, nod yes/no, sign or use other alternative communication methods when too anxious to talk. So even picking someone up hoping to do this could be futile.