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    #239275 07/20/17 11:48 AM
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    mom123 Offline OP
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    I have an 8YO PG daughter, who has always struggled with extreme shyness. Basically, I can't get her to talk very much outside of the house - and sometimes even inside the house. Her communication is very very limited. I'm kind of at my wit's end. I've tried speech therapy for over a year, and that does not seem to have helped. I have thought of finding a psychologist who specializes in this, and I have spoken to several, but I can't find anyone willing to take on a new patient with this problem. Has anyone found anything that works?

    Any help would be very very much appreciated.

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    Among the interventions that have some track record of success with selective mutism are:

    1. Video Self-Modeling: videorecord the two sides of a simple conversation separately, and then edit together to look like the child is engaging in a conversation with another person. This works best when there is a person that the child routinely speaks with (such as a parent or sibling). Once completed, the child views the video repeatedly. (Obviously, there's a little more to it, but this is the general idea.)

    2. Parent-Child Interaction Therapy: relationship-based strategic communication technique. Check out Dr. Kurtz's website for an explanation, and e-training course: http://selectivemutismlearning.org/

    Some resources:

    Dr. Elisa Shipon-Bloom, The Smart Center. http://www.selectivemutismcenter.org/
    Dr. Steven Kurtz, Child Mind Institute. https://childmind.org/ and https://kurtzpsychologyconsulting.wordpress.com/selective-mutism-resources/

    I have not read these myself, but colleagues have recommended:
    Angela McHolm's Helping Your Child with Selective Mutism. https://www.amazon.com/Helping-Your-Child-Selective-Mutism/dp/157224416X
    Maggie Johnson's Selective Mutism Resource Manual. https://www.amazon.com/Selective-Mutism-Resource-Manual-Speechmark/dp/1909301337/


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    Originally Posted by mom123
    Basically, I can't get her to talk very much outside of the house - and sometimes even inside the house.

    Originally Posted by spaghetti
    Then you need to look beneath the issue to a reason. Anxiety? Articulation problem? Pragmatic problem? Receptive understanding? Processing speed too slow to answer in time? A psychologist might be able to help to diagnose this but good luck.

    I'll second spaghetti's suggestion to look beneath the issue to find the reason. I have a ds with an expressive language challenge - it's not selective mutism, but it appeared to be selective not talking when he was in early elementary school. We thought it was related to shyness or something else at the time, because he seemed to be quite verbal at home, talked a *lot* to us and because of his high abilities when he talked, it was usually language that sounded like an adult. What we didn't realize was that the situations in which he was able to be a chatterbox at home were very different than the situations where he would respond with silence at school. Having a neurospcyh eval at 8 helped to a certain extent by helping us see that there was a very real issue underneath his behavior (he had a few other behavior issues at the time), but what helped the most in realizing he had an expressive language issue was, ironically, another year or so of maturing which enabled him to explain to us that the was having a hard time expressing himself.

    Our ds worked with an SLP for several years and it was a huge help, but I think we were beyond lucky and blessed to have landed with an SLP who was really motivated to help him - she said he was unlike any other patient she'd ever worked with, and a lot of her work was a bit of trial and error as she thought of things to try, some worked, some didn't. And as I mentioned, selective mutism wasn't ds' issue, it was an expressive language issue. And for all the work with the SLP and progress he made, he still (in high school) has challenges with expressive language - but he's also been very successful in school. The key for him has been understanding what the challenge is, working to remediate what you can, but at the same time making sure that there are appropriate accommodations so that the language challenge isn't holding a student back from appropriate intellectual challenge.

    Best wishes,

    polarbear

    eta - I mentioned that I felt we were lucky and blessed to find an SLP who was motivated to work with our ds - I hope that doesn't sound off-putting as in you might not be able to find anyone who can help. Once you have an idea of what type of help you need, you can call around, ask questions, network, keep seeking references etc and you'll find the help you need.


    Last edited by polarbear; 07/20/17 09:57 PM.
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    The following is assuming the child has selective mutism (can talk, but can't). This is all just my opinion, based on personal experience, my area of education, and on helping one child who also had this problem as a preschooler.

    I had a diagnosis of elective mutism as a child (which is now called selective mutism.) I believe I was 6 when I was diagnosed. I never had any issues with talking at home, only at school/in social situations. I didn't speak at all outside the home. As an adult I'm still generally the shy, introverted type, but I definitely have "recovered" from mutism.

    As a person who suffered through it I can tell you that any mention of the lack of speech or any bribes, praise, or punishments associated with speech are likely to make the problem worse. It is anxiety based and those methods are only going to increase anxiety. If a child has an extreme, debilitating phobia, would you bring up the item they were afraid of throughout the day and shame them for it? Would you constantly place demands on them to face their fear? I'm not talking about regular fears here, if you know someone with a phobia (which I also have), you know there is no logic or reason involved. I would jump out of a moving vehicle to avoid the thing I am afraid of... and likely die. And it's something relatively harmless. Fear and anxiety are not reasonable reactions and therefore can't be reasoned away.

    Teachers and others whom the child has a hard time talking with should accept any response from the child. Pointing, nodding, writing, whispering, etc. If there is another child or person the kid is comfortable talking with that person can take whispered communications and relay them. The goal should be to reduce anxiety, which is the most likely way to see an increase in speech over time.

    I remember when I had this condition and there was nothing that could have made me speak. I wanted to. I just couldn't. I was able to verbalize in my head what I wanted to say, but my body was frozen. I feared saying it wrong, my voice sounding funny, sounding stupid, being wrong, etc. At least at home I was comfortable enough to speak to my family. I do not remember them ever saying anything to me about the problem. At school I gradually got better when they switched my teacher to a much more accepting and kind person who never made an issue out of it.

    My whole life I have been shy and reserved in public and that is not likely to change. But now I am able to talk to other parents and speak up at IEP meetings and even answer questions in a group setting. I still prefer to spend my time at home with my family, but I am a functional adult, able to hold a job and raise my 2E son. I even passed college speech class! I suspect the pressure of speech therapy and knowing that my parents were at their wits end with me would have pushed me in the opposite direction. If your DD has selective mutism she needs your support and understanding. Reduce her anxiety, reconnect as a family, treat her the same way you would if she was talking.

    Obviously this only applies for selective mutism, if your DD is not talking for a different reason this will likely not be the best plan of action. I hope she's feeling better soon smile

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    Originally Posted by SaturnFan
    Obviously this only applies for selective mutism, if your DD is not talking for a different reason this will likely not be the best plan of action. I hope she's feeling better soon smile


    Actually, I cannot imagine a reason for these behaviors where bribes, punishments, or shaming would be more effective than support and understanding.

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    My son was selectively mute at age 3. Spent a four day weekend with my parents who he knew and loved and who loved and spoiled him and didn't say a word the whole weekend while they babysat him. They did activities, played, ate, swam and he didn't say boo.

    He spent a year in an ESE preschool and had one utterance the entire year ...I think it was something like "she (meaning the teacher) said get in line". The next year, same teacher, some of the same kids, some new kids and he was fine. Quiet sometimes, chatty other.

    He is in high school now. He speaks when needed but is mostly quiet in class. Texting is terrific for helping his social life. He has friends. He is slow to warm up but has been in new situations his whole life.

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    Not selective mutism but a couple of years ago my DD – now 12 – just stopped talking to anyone she hadn't known and been very comfortable with for at least a couple of years. Prior to this she was an over-the-top extrovert. She had always made friends with everyone she met and had no problems asking questions either privately or in any large group setting. She was the kid who reached out to the child sitting by herself and tried to make them feel comfortable. Then suddenly she just stopped talking to people. She has been diagnosed with dysarthria and her speech is very difficult to understand. I assumed she just got sick and tired of people not understanding her or nodding their heads with a glazed over expression pretending to understand. She still talked with friends she had known a few years but would not talk to new people.

    Two things helped. First she met a new friend who would simply not take no for an answer. This girl was like a battering ram breaking down DD's defenses. Once this friend got DD to let her in another shy, quiet girl snuck in behind the wall too. She talked, laughed and giggled with these two new friends just as she always had before. The first girl – a bit quirky and socially oblivious – is now one of DD's best friends. She is quite anxious and has learned to rely on DD to be a calming, stabilizing influence in her life. It's been an interesting dynamic to watch. Really any. new friend she has made in the past couple of years has been the human equivalent of an overgrown puppy dog - so exuberant they don't understand their size. But in this case it's enthusiasm not size. Big personalities who are drawn to DD's sweet nature. Once they make it past that wall she has no problem talking to them...

    Second, when DD got very into reading biographies I had her read about Maya Angelo. We discussed how Maya Angelo had learned that a person's voice had significant power. How she learned to speak slowly and clearly and distinctly in order to hold people's attention. We discussed how she had made the choice to stop speaking for a period of time when she felt that speaking up had cost somebody their life. When I told DD's SLP about this she said "I literally just got goosebumps."

    DD has worked very hard on her articulation issues and now if she speaks slowly and clearly she can be understood most of the time. However if she gets excited it is almost impossible to understand anything she says. She will speak to waiters in restaurants but remains on the sidelines with new people and still tends not to talk to them in situations like summer camp programs. But she is 100% comfortable on the stage and now writes short stories, plays and songs all the time. I think it's her way of giving voice to her thoughts. It's interesting to watch this dynamic as well. When she performs a song she has written the kids she has not been talking to go out of their way to make more of an effort to get to know her. To try to get her to talk to them. I guess maybe they realize that there is some serious substance behind her quiet facade.

    Interestingly DD visited a new 2E school that opened recently and within a couple of minutes she was comfortable asking questions in class. On a second visit she was running around with the other kids laughing and talking. By the third visit she was 100% comfortable. I *think* she stopped talking because she did not want to be treated like "a special ed kid". When people recognize her intelligence I think she is more likely to talk to them. But she's not willing to have to try to prove herself to strangers.

    I don't know if any of this helps you with your situation. I did recently have to make a deal with DD that we would only do a special summer program that is a great inconvenience to the rest of the family if she agreed that she was going to make an effort to speak to the other kids there. She agreed but as it's drawing closer I think is getting more reluctant. Its hard to guess what will happen. She spent an entire year in her TAG program apparently not talking to anyone there – not even one of her best friends who was in the class with her. However the week after school got out she ran into one of the girls at a local park and the two ran off together playing for hours. Did not share a word during the school year but happily played for hours once the school year was over. I just can't explain it...

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    I don't mean to presume that my experience would be helpful to you, but I'll share it just in case. My DD was never diagnosed with SM, and she doesn't have any issue with it now at the age of 8. She used to be mute for at least an hour when brought to new places, or even in familiar places that were hectic (like preschool).
    I believe there was a turning point for her when she made her first friend, which was another shy, gifted girl. Perhaps you could create pressure-free opportunities for a friendship to spark, involving the type of person with whom a friendship would be plausible.
    For my daughter, that would exclude anyone who would:
    Introduce themselves to her.
    Appear to want anything from her.
    Raise his/her voice (even in excitement).


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    My DD (age 12, PG) was DX with Selective Mutism when she was 5. It confirmed what we knew from 18 months of age. I don't recall her ever talking in public. She was a super verbal baby/child (and still is...scored 99.9+ centile on IQ) but no one outside of the three of us ever heard her speak.
    Now, at the age of 12, she will speak in small, short sentences to a few friends. Her track coach of two years has never heard her talk. But, she has one friend who hears her as we do...non stop, constant, funny, articulate, sarcastic, enthusiastic etc.
    She also has a DX of Aspergers, Social Anxiety and an IQ of 170 (extended norms). We tend to work a lot more on the social anxiety and dealing with every day situations like trying to order her own food in restaurants, paying at shop counters etc. We do not focus on the mUtism as it draws attention to herself and she feels she is letting everyone down.
    Remove all the pressure to speak, let her speak through you and you may see some improvements.
    However, we are now at the stage where at 12, this is affecting her whole life and she is missing opportunities due to not talking or being able to participate in activities. She refuses to go to therapy as 'why would you send me to therapy to do something I don't want to do...I don't want to talk' but in your case
    I would be seeking therapy rather speech therapy, before she decides to refuse to speak to anyone about it.

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    https://raisingsmartgirls.wordpress.com/

    I used to enjoy following this blog. The writer has a daughter who had selective mutism.

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    Originally Posted by ElizabethN
    Originally Posted by SaturnFan
    Obviously this only applies for selective mutism, if your DD is not talking for a different reason this will likely not be the best plan of action. I hope she's feeling better soon smile


    Actually, I cannot imagine a reason for these behaviors where bribes, punishments, or shaming would be more effective than support and understanding.

    In my experience these things don't work for anything exceot very short term goals when the child is not really struggling/resisting. Put your shoes on and you can have x may work or it may end up with the shoes and x being thrown out the window. I guess behavoir charts work for some kids but not generally the ones we have.

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