Okay...let me try to explain things this way.
It's taken me quite a long time to understand my child's intense behavior as it relates to the factors that play into it.
I think the biggest clue I ever got was from my daughter's pediatric neuropsychologist. I think she was extremely gifted and intuitive herself. After 5 pretty comprehensive sessions of testing for various developmental abilities, she sat us down and explained to us the neurobiology of what was going on in the development of the brain. Most psychologists don't go into the extra years of study to find out how what's going on at the level of the brain structures and their development and how that affects learning and behavior, so her information is a lot more detailed than I ever would have gotten from a regular pediatric psychologist.
This is what her report said
�SELECTIVE MUTISM� is on it under the diagnosis �neurodevelopmental delay with limbic mood dysregulation�. [for those that aren't aware the limbic system of the brain is the "emotional" center of the brain.]
This is how it is worded � that interrelates the SPD, the attention issues, and selective mutism:
Marked inattention characterized by overexcitation-overinhibition of sensory stimuli is evidenced resulting in heightened sensory sensitivity. This resulted in (among other things related to attention and auditory memory):
* heightened separation anxiety/generalized anxiety, which impeded social fluency. At other times, fluency of interaction was very age appropriate and fluent.
* SELECTIVE MUTISM was evidenced and highly related to heightened anxiety/startle.
All of this in the presence of INTELLECTUAL TALENT. She wanted it quite plain that her SM did no way interfere with her intelligence, only her ability to communicate what she knew.
Okay...that perhaps is a lot of psychobabble, right?
But as she explained it, and further research I did on the matter seems to confirm it, that there was a problem in the integration of normal infant reflexes, particularly those in the MORO reflex (which many of us have heard about as the startle reflex) and one called the Fear Paralysis Reflex (which many of us may not have heard about but basically amounts to the FIGHT, FLIGHT or FREEZE stress response). My selectively mute child's response to stress was essentially stuck on freeze. It was a maladaptive coping strategy.
In most people, reflexes like the rooting reflex, the tonic neck reflex, and the MORO reflex and the FPR reflex eventually "fade into the background" as the infant matures. For instance, if you stroke a newborn babies cheek, he will turn toward your finger and open his mouth - but if you stroke a toddler's cheek, they may turn toward you, or they might just brush your hand away or ignore you. They certainly wouldn't turn and open their mouths as if to nurse or expect a bottle.
Okay, so what happens if a child retains the startle reflex and her Fear Paralysis Reflex is stuck on FREEZE? You just might get a child who becomes selectively mute in certain social settings - wanting to interact with her classmates but reflexively shutting down her ability to speak and interact.
And even though you'd think a classroom setting isn't a big deal, think about it through the eyes of a child that is so "switched on" to the world around her (very sensitive to auditory and visual and vestibular sensations), the noise and chaos of being in a room with 19 other immature 3 year old was too much.
And of course, it takes a tremendous amount of energy to not speak, keep rigid, avoid eye contact and ignore someone who gets in her face, all the while thinking "everyone is watching me" and being self-conscious about everything. Even on the days when she wanted to talk, she was articulate enough to tell me when she was 5, "the words are there in my head, but they just wouldn't come out". She would come home completely exhausted from being on edge at school and meltdown because the stress just built up too much.
Because I had to know more, I spent time looking for information to back up what the neuropsych said.
So I found some resources
particularly this book by Sally Goddard Blythe
Reflexes, Learning And Behavior: A ...olving Learning & Behavior Problems Sure enough, as part of her research paper, she wrote how retained primitive reflexes can directly "cause" selective mutism.
There is a whole host of problems related to neurodevelopmental delay of having these primitive reflexes not integrated. To see a list of them, you can look here
NeurodevelopmentalTherapy What kind of problems?
SIGNS OF NEURO-DEVELOPMENTAL DELAY
Dyslexia or Learning Difficulties, especially reading, spelling and comprehension
Poor written expression
Poor sequencing skills
Poor sense of time
Poor visual function/processing skills
Slow in processing information
Attention and concentration problems
Inability to sit still/fidgeting
Poor organisational skills
Easily distracted and/or impulsive
Hyperactivity
Hypersensitivity to sound, light, or touch
Dyspraxia/Speech problems and Language delays
Motor, co-ordination and balance problems
Poor posture and/or awkward gait
Poor handwriting
Poor spatial awareness
Poor hand-eye co-ordination
Poor gross and fine motor skills
Difficulty learning how to swim/ride a bike
Clumsiness/accident prone
Slow at copying tasks
Confusion between right and left
Reversals of letters/numbers and midline problems
History of difficult birth
History of brian injury or damage
Quick temper/easily frustrated/short fuse
Bedwetting past 5 years of age
Motion sickness
Can't cope with change/must have things a certain (their) way #9;
School Phobia
Poor motivation and/or self esteem
Depression, anxiety or stress
Behavioural, self esteem and motivational problems associated with the above
In adults, symptoms include agoraphobia, excessive reaction to stimuli, anxiety, panic attacks, difficulty making decisions and poor self esteem.
So...the thing is...if you can help the child to reintegrate these things, the better able the child can help themselves.
But how?
Most psychologists tell the parents they need therapy, or medications or what not. I don't think those are bad, but they should only be a last resort.
What helps to reintegrate these things?
Movement and SPD therapies focusing on sensory calming activities.
Movement therapies include something a bit off the beaten path called feldenkrais - a very gentle therapy often used for patients who've had physical injuries.
But, I found (in our case) we didn't have to pay someone for the therapies. I asked what could take the place of feldenkrais (because even though there was someone available to do it, it was not feasible due to time and distance constraints), and I was told ballet and yoga. So I enrolled her in the nearby ballet studio, and bought a
YogaKids 2 dvd set from Target to do at home.
Then we did lots of park time for all the climbing/balancing/swinging on tire swings and read books like
Sensational Kids and
The Out of Sync Child Has Fun for things to do at home on the cheap.
I also made a
Kids Problem Solving Binder using picture stories I got from different places on the internet, coupled with books I got from the library to help her identify her strong feelings. On that link, I link to other places where I got great information about social stories with pictures, and also a great booklist for age appropriate books about emotions, from Vanderbilt University's The Center on the Social and Emotional Foundations for Early Learning (CSEFEL).
We went through the binder in between episodes of frustration (because of course no learning happens in the heat of the moment).
I can say, without a doubt, working on the physical end of things as well as emotion coaching (and frequent high protein snacks), while my daughter has the occasional outburst, it's signifcantly better.
Reducing her stress and frustration and overwhelming emotions by giving her physical outlets (which scared her as much as it scared me sometimes) and spending lots of time hugging and holding her while using her cognitive abilities to talk about her intense feelings really has made a huge difference.
It's not that she's never mad or frustrated, but she's much better able to articulate and help me work on a mutually agreeable solution than to totally flip out about it. Now, talking about what happens to her and validating her feelings goes a lot way. Her better behavior also helps me because my own sensitivities aren't triggered.
Whew...this was a lot. I hope it all makes sense. I'm going out of town this weekend and I may not get a chance to elaborate more.
