Selective Mutism

[Guest lou73]

Hi

I was just wondering if any of you lovely people out there could give me some good advice. I have a little boy on my nursery carpet who is three and does not speak during the session, although his parents say he speaks at home. He has been referred to speech and language and was seen earlier this week and the therapists opinion was that he is choosing not to speak, although his sound production is poor. I believe that he is extremely shy and this is the root of the problem and that he has got into a pattern of not speaking and now has almost backed himself into a corner. Can anyone give me any advice to help him. I have thought about using puppets and trying to increase his confidence but any advice would be greatly appreciated. Another aspect to this problem is that he is very stubborn, I really want to support him and his parents so am calling on you all.

 

Thanks Lou x

[finleysmaid]

i have a little chap like this too...though he's not the first little one ive had that does this! IMO i would never put him under pressure to answer/ avoid situations where he need to speak in a group/ narrate what you are doing and what he is doing without asking questions...or ask retorical ones/dont draw attention to his speech especially when he does say anything!/give him lots of support/try and use some sign language (or makaton) so that he is able to 'answer' without speaking.

Is he better outside?

Hope this helps

[Guest]

We have a child like this too and tend to do much of what finleysmaid has mentioned.

 

He is going on holiday next week, so I am going to give him a disposable camera and ask him to take pictures of his adventures (the family are going to China) so we have something exciting to "talk" about when he returns. It is interesting because he talks happily at home, says absolutely nothing in the setting, but yet when he is playing in the park outside pre-school with his peers, he is often seen and heard shouting out to them and engaging in verbal interactions.

 

I am hoping to pair him up with another child with speech and language difficulties as they share the same home language. I'm hoping that by sharing his photos with this other child, it might unlock something in both boys.

 

Would definately second the use of makaton pictures and a few signs too. Works well with a couple of our children. We are in the process of making a key ring with key signs on to share with the children, to save us walking around the setting pointing out the signs. I think it makes it more 'one-to-one' if they are there in your hand rather than trailing a child around and pointing to things.

[Inge]

not got time at the moment.. but do a forum search.. this has been discussed several times adn tehre was lots of really good information in the threads....

 

but the best advice is to not try to force them to speak by asking them things etc.. but to let them learn by listening and watching others.. a lot is learnt that way.. sit alongside chattering about things but not directly involving them .. in time it will come... taking the pressure off often helps... if hew talks at home then he is learning and just encourage mum to keep chattering to him about anything and everything... many choose not to talk to others at this age.. my son was one... but at home we could not stop him ..

 

I often thought it a good thing... after all he was never going to chat to strangers in the street...

[Upsy Daisy]

The most important thing to remember is that selective mutism is linked to anxiety. This child is not choosing not to speak in your setting he is unable to speak due to anxiety. He may very much want to be able to speak to you. Children with this condition need professional intervention so it is good that he's seeing a SALT.

 

Your role is to build up his confidence and, as Inge says, not to put any pressure on him to speak. Support his communication in other ways so that he can feel as relaxed and happy in your setting as possible and if he does speak just accept it quietly without a fuss.

 

You could try creating a small quiet space for a little bit of one to one time for him. Perhaps a tent or den with cushions and sensory toys to help him to relax where he feels a bit more confident and has less of an audience. If he has a comfort object you could encourage him to take it in there too.

[Guest lou73]

Thanks so much for all your advice I have also done a little reading about this today and now understand a little about the subject. I have a Makaton dictionary so am going to find some signs to help him communicate in his own way and also think the suggestion of talking about activities to him without expecting him to answer is probably the way forward. I am also going to think about ways of supporting him to feel less anxious. I will be meeting mum and dad next week so i can talk to them about what we will be doing in the setting which they can also do at home to help unite nursery and home life. I was thinking about suggesting if he had a comforter/ teddy that he might like to bring that in so he has something from home to hold at carpet time.

 

Thanks lou X

[Guest]

hi Lou,

I agree with everything the others have said and just wanted to emphasise that building his confidence is probably the way to go. Try not to focus on his speaking but rather do things that will make him feel more confident and eventually he will feel comfortable enough to speak. Could you invent and important job for him that only he can do? Make him feel special. I'm sure you do this with all your children but make a bit of extra effort with him. Maybe get him a special cap/ badge or something to wear when he does his job and make a big fuss of him for doing it. Let him know that you really appreciate what he's done and how helpful and useful this is to you. And when he does utter his first words even though you'll feel like jumping up and down and screaming, try really hard not to!

Good luck with this. I know it can be really frustrating when you know he can talk but he isn't doing, but when he finally does it'll be well worth all the waiting!

[twinthinguk]

just found this thread, dragged it up because I have a little boy at pre-school who has been diagnosed with selective mutisum, he is being assessed in various places, and we have noticed some progress in his overall development which is good, he very rarely talks or vocalizes, he stays very close by his key worker or me, occasionally will engage in some independent play but not very often. We have had advice from our local visiting team, and have some strategies in place to help with his anxiety. He will not eat, drink or use the toilet with us, he will do all these things at home. My question is, the development matters are not suitable for him, I am able to create steps for him, but how do I assess his age in months? currently he is 38 months but sits in 16-26 for some aspects, and speaking is impossible to assess. Is there any documents that have more gesture based next steps? he uses eye contact and gesture and some ( but rare) vocalization but no words. We are currently waiting referral to Educational physiologist but I would like to try to work on this learning journal before that happens, thanks.

[SueJ]

Have you looked at the early support early years journal? I have put a link to this below:

http://www.ncb.org.uk/early-support/resources/developmental-journals/early-years-developmental-journal

I've also uploaded a couple of bits and pieces that I have about selective mutism that you might find useful

Helping children with selective mutism.pdf

Selective Mutism - Small steps programme.pdf

SelectiveMutismPracticeGuidelines.pdf

 

[Guest]

Michael Jones worked with us on the ECAT project and has this website with lots of info about selective mutism on it

 

http://www.talk4meaning.co.uk/selective-mutism/

Hope it's useful

[twinthinguk]

wow thanks both of you for that. I will read through them later x

[Guest]

Interestingly, Selective Mutism affects more girls than boys and children with EAL are more prone to it. The children I've met ranged in severity from a 3 year old girl with no non verbal or verbal communication at all within the setting (heartbreaking to observe her levels of anxiety and fixed expression) to a 4 year old girl who spoke confidently to her peers and used non-verbal communication with staff.

The Selective Mutism Information and Research Association http://www.smira.org has some really useful information and if anyone you work still thinks that children with Selective Mutism are being stubborn, I highly recommend the DVD you can order form SMIRA called "Silent Children" where adults with Selective Mutism speak about the condition. Early intervention is crucial, otherwise children with Selective Mutism grow up to become adults with Selective Mutism.

Approaches and expertise vary between areas. When I worked in Herefordshire, there was a specialist Speech and Language Therapist who was wonderful and worked with the child, family and setting. In Birmingham, the Speech and Language Therapy department regarded Selective Mutism as a psychological condition so we had to refer children to the Child and Adult Mental Health Team (CAMHS) and you know what that waiting list is like ....

I used to ask parents to film their child at home (with a phone) as this way, you get to see the "real" child. Don't let the child realise that this has been done, it's just a great way for you to see the child relaxed at home and helps you to appreciate how anxious they are with you.

Also think about how the child can ask to go to the toilet or let you know that they've hurt themselves or want to play with a certain activity or that they have a favourite member of staff. Parents can chat to them at home about this and help to identify solutions.

I've attached some downloads from the SMIRA website. As has already been said, at no point should the child be "made" to speak and if they do speak, don't draw any attention to the fact. This can be difficult with children and the child can quickly be identified as "the child who doesn't speak" so all staff really need to have the same response ready when a child says "he doesn't speak." Ideally, this should be decided with the parents and any involved professionals.

Good luck and let us know how you get on!

Helping children with selective mutism.pdf

SelectiveMutismPracticeGuidelines.pdf

[Guest]

Sorry, I've just noticed that you said his speech production is poor. When I worked at a Pre-School Speech and Language Unit we had lots of children attend who were silent for the first month as their confidence was shattered by well meaning people who kept correcting their speech. It's a completely understandable strategy as far as I'm concerned! Lots of action based songs and rhymes helped, particularly when we made up songs based on their interests.

[twinthinguk]

well today we had a break though......he chose me to spend time next to, after about 40 mins he started to vocalise, started with grunts and then the occasional "NO" he got louder and began saying random words and phrases, in a loud sing song voice, "byebye, go away, nanny coming, up,down" whilst he stood next to me. He seems to rather like blowing raspberries too! but as soon as another adult looked over he would close down! he is utterly fascinating! he uses gesture and facial expressions that are very hard to read at times, lots of scowling and grunting, but he will laugh if he finds something funny. I can't wait to see what will happen next. thanks for all the information, I am due to have a meeting with mum and find out what is happening with speech and language.

[Guest]

Brilliant! Here's hoping that 'the first step is the hardest' is true - good luck with the rest of the journey.

[Guest]

That's brilliant news, well done you for building the trust. I've attached a spontaneous speech sample form I've found useful in the past.

Spontaneous Speech Sample.docx

[sunnyday]

well today we had a break though......he chose me to spend time next to, after about 40 mins he started to vocalise, started with grunts and then the occasional "NO" he got louder and began saying random words and phrases, in a loud sing song voice, "byebye, go away, nanny coming, up,down" whilst he stood next to me. He seems to rather like blowing raspberries too! but as soon as another adult looked over he would close down! he is utterly fascinating! he uses gesture and facial expressions that are very hard to read at times, lots of scowling and grunting, but he will laugh if he finds something funny. I can't wait to see what will happen next. thanks for all the information, I am due to have a meeting with mum and find out what is happening with speech and language.

Well that's great news :1b