Selective Mutism

Screen Shot 2018-11-27 at 3.09.18 PMYears ago I was assigned as a short-term sub for a colleague who had been injured in a fall.  When I entered a 4th grade learning support classroom, the teacher introduced me to each student.  When she came to a girl I’ll call Tara, she said, “This one doesn’t talk at school.  Come on, Tara! Say something for the new speech teacher!”  Then the teacher shook her head with a scowl and said, “She’ll never talk.”   Tara looked at the floor in silence as the other students giggled.  As for me, my jaw hit the floor.  Horrified, I returned to the speech room to look up Tara’s records.  The narrative on her IEP stated that Tara talked a lot at home with family and friends, and her articulation was good, according to her mother.  However, since entering kindergarten, Tara increasingly refused to speak on the bus or in school.  Clearly, she fit the definition of a selective mute.

Through conversation with her teacher and observation of Tara in various locations in the school, it became apparent that nearly everyone in the school badgered Tara to talk:  the teaching assistants, the art/music/gym teachers, the librarian, the cafeteria lady, even the bus driver and principal.  Perhaps they thought they were giving her encouragement.  What they were really doing is bullying her, making her stand out in front of her peers, and setting up a situation in which, if she WOULD ever say a word, one might expect fireworks, a brass band, and a ticker-tape parade to break out.  Talk about pressure!

I had a phone conference with Tara’s mother to verify that mom didn’t detect any problems with Tara’s speech or language.  Indeed, her mom reported that Tara talked up a storm at home. She wasn’t able to shed any light on why Tara refused to speak in school, but did say it had been a growing problem since kindergarten.  I shared some information about selective mutism during our conversation and followed up by sending an article home for her mother to read.

The next step was to take the pressure off the student by educating the staff.  I gave a brief inservice at the next staff meeting, and provided everyone with the same article I had shared with Tara’s mom. I provided Tara with communication boards with core language and fringe words/phrases she would likely use in the classroom.  In her individual speech therapy sessions, we played board and card games, again using communication boards with game-related vocabulary so Tara could name, request, refuse, comment, and direct actions. I provided verbal models as I used the boards during the games, and considered it a very positive step when Tara started using the boards appropriately during her turn.  However, I reacted calmly as though this was commonplace, expected behavior, and didn’t put any pressure on her to also use her voice.  I also spent several sessions in her classroom, helping to facilitate communication there and modeling for the teacher the kinds of interactions that would be engaging but non-threatening.  Because SM is more of a psychological issue, I tried to engage the school psychologist in her case.  Unfortunately, the district only used the psychologists for testing and attending meetings, not for counseling the students, so this went nowhere.  Ugh.

I’d like to report that Tara eventually began speaking, but after a month of subbing, the regular SLP returned and I went back to my assignment on the assistive technology team.  Before I left, I shared all of this information with the SLP and hoped that it would be followed through.  Unfortunately, the student later moved out of the area so I have no idea whatever happened to her.

As I said, this all happened years ago before the Internet (yes, I’ve been an SLP for that long!), so information was much more limited.  Today, there are many resources on the topic of selective mutism that SLPs can share with parents and school staff.  Here are some you should know about:

The SMart Center:  loads of information in their newsletters (definitely sign up!), professional development trainings and webinars, CommuniCamp for group treatment, and lots of downloads of research and intervention strategies.

What Teachers Need to Know About Selective Mutism:  informative article by We Are Teachers that would be great to share with school staff.

Selective Mutism Association:  books, articles, newsletter, and other supports for parents and professionals

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One thought on “Selective Mutism

  1. Thanks for highlighting this area, and for your proactive stance to support this student!

    I think it’s really important for people to understand that selective mutism is an *anxiety disorder*, which puts it in a different category than most of the communication needs we encounter with other children. As an anxiety disorder, it needs to be treated by a person who is trained to address anxiety disorders (a child psychologist, mental health therapist, etc). SLPs play an important role, but we should be primarily referring to or consulting with someone who has training in treating mental health and anxiety disorders whenever possible, unless we have this training ourselves.

    I’m glad that student had someone in her corner, even so long ago when we understood much less, and it sounds like resources were slim.

    Like

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