Any experience with Selective Mutism?

[ourbabygirl]

Just got back from a meeting with DD's pre-school teacher and SLP, and the SLP gave me some paperwork about Selective Mutism, wondering if this might be what DD has. Of course, she's not diagnosing it, and they're going to have the school psychologist come and observe DD, and I'm supposed to follow up on finding a play therapist (as recommended by a child psychologist who saw DD a while back due to her anxiety).

I mentioned it to DH, and he kind of blew me off (probably not thrilled with spending more money on co-pays and such after all that we've already been through with her), but I really think this is probably what DD has (along with anxiety). She's 3 and has always been very shy around new people, even friends and relatives that she's been around lots before. She's very bubbly and chatty around us (DH, her brother, me), but clams up/ shuts down in other situations where people ask her something (name/ age/ anything else)- she just turns her head and smiles shyly. It's not interfering with pre-school too much right now because she will talk a bit and she's in a special-ed. classroom, but I can see it getting to be more of a problem later on.

Any BTDT with your own children? Or are any of you SLPs who can comment on it? Just wondering if play therapy would even be effective, or if there are better ways to treat it or help DD?

Thanks! :)

[WatchingThemGrow]

When I was doing my counseling internship, there was a 3rd grader with it. She was completely silent at school, the entire year. The counselor I worked with could.not.get her to open up.

[egoldber]

A friend of mine had a DD with selective mutism. It's gotten a lot better, but it was a long, slow therapy process.

As you know, it's a form of anxiety disorder. But it is challenging to treat effectively because the school and teachers need to be highly involved in the treatment process. I would definitely try to find someone with experience treating this particular condition. Usually that's a psychologist vs. an SLP.

[jamesmom]

My DD may have selective mutism but has not been officially diagnosed. We think that's what she has after ruling out many things. I can't tell you more at this point because she hasn't seen anyone for this yet (her first appointment is in a couple of weeks).

If you think your DD has SM, she needs to be seen and diagnosed by a child psychologist, psychiatrist, developmental pediatrician or a doctor who specializes in selective mutism, instead of an SLP. DD was seen by an SLP last year and diagnosed with pragmatic speech impairment. She has been in a social skills group for almost a year, but we now need to consult a SM specialist because we haven't seen much improvement.

Please PM me if you have any questions. Good luck!

[pinkmomagain]

I have a friend whose son was dx with SM when he was in nursery school. He did group therapy (specifically for kids with SM) for awhile and then was placed on zoloft when he was in 1st grade. He is improved. He would not be dx with SM right now, but definitely anxiety.

Definitely try to find a psychologist who has experience treating SM.

[crayonblue]

No, but I read many books by Torey Hayden about her work with kids with selective mutism. Fascinating true stories. You might want to look for her books.

[KDsMommy]

Yes, get One Child by Torey Hayden and read it....she does AMAZING work with kids with Selective Mutism. She's also on Facebook so you can friend her there (or like her page, I can't remember which). She really is incredibly gifted.

[luckytwenty]

Yes, my sister had it. It was so severe that she stopped asking the teacher to use the bathroom and had accidents in first grade. She would only talk to a small handful of people, and if someone else came into the room, she would stop speaking. She went for years without therapy. Once she did, she was put on anti-anxiety meds and they worked very well. She is still a very quiet person.

[fivi2]

Not my dc, but when I was looking for an anxiety therapist for dd, a friend was looking for a therapist for her ds who was suspected of having selective mutism. He had always been "shy" but had suddenly completely stopped talking to anyone outside of family. He was 4 turning 5.

On our therapist hunt, I started at a play therapist, while she found a therapist that utilized cognitive behavioral techniques. (apparently it is hard to find a therapist that will do cognitive behavioral therapy with young kids, but some will use techniques, as appropriate).

After a bad 5 or 6 weeks with ours, I switched to hers and we had immediate progress. Her ds also progressed rapidly. We both paid out of pocket for this person, and honestly it was completely worth it.

So, I would suggest looking for someone who will utilize those techniques (if you can).

[mom2binsd]

I'm an SLP and I agree that looking at the psychological aspect is very important, I had a little boy who was selectively mute for 2 whole years at school, but spoke two languages at home (Chinese and English). He was able to complete written work at school (K and 1st) but it was very difficult for the teachers to assess his skills. He was shy but did play with the other children. I moved away and never got to see how things turned out...

I think play therapy would be a great idea, esp if they can go off of rx from a psychological eval.

Has she always been quiet around others or did it coincide with the arrival of her brother, a move etc.???

I've heard the book mentioned earlier as an excellent resource.

[mjs64]

I don't know if this is at all helpful to you, but a guest poster on the blog "Rants from Mommyland" recently wrote about her condition here (http://www.rantsfrommommyland.com/2011/08/note-from-offspring-1.html). I think she is in her late teens now.

[ourbabygirl]

Thanks, Everyone.
She's always been kind of quiet and clingy to me, but I thought it was more because I stayed home with her and she never had anyone baby-sit her other than my mom or SIL. At her 18 month appt. her ped. gave us various referrals since she had so few words (probably 10 or fewer, and it seemed like she had gone backwards a bit). We had her hearing tested a couple times (turned out fine). We had a child psychiatrist evaluate her (I forgot what they're called, but someone who specializes in the brain, so maybe a neuro-psychiatrist?), and she noted DD's anxiety but didn't have any specific recommendations other than to maybe take her back in 6 months if things were worse. And we had a speech eval. done through the school district and through our health system/ insurance. Her receptive language was great (above average), but her expressive language was really low, so she qualified for both EI (birth to 3), and our private insurance. She started speech therapy at just before age 2 (her brother was born right when she turned 2, but I don't think that's the reason she was behind in talking), but because her anxiety was so bad, the SLPs weren't able to accomplish much (she would spend much of each session crying or clinging to me). Finally by the time she turned 2.5, she made a bunch of progress (language explosion, I guess :). Her anxiety is much better (not really clingy at all, just very shy around strangers- she won't answer them if they ask her a question), but obviously not perfect.
It's crazy, she's so happy-go-lucky and bubbly around us, and gets that way around relatives (and some friends) after she's been around them for a while... I guess she's even chatty at pre-school, but she won't talk to the teachers (answer their questions, make requests), and the SLP can't get anything out of her when she tries to do their 20 minute sessions each day. So in order to evaluate her on her different sounds (p, b, v, s, f, etc.), she has to just sit in the background and observe and listen for DD making those sounds in the words she says... I guess she does, except for the 'f' sound, which is typical at this age, I guess. So the SLP says that even though DD hasn't learned the sounds from different exercises, etc., she must have learned them from osmosis in the classroom and at home, etc.

So I don't know if it's an authority figure issue or what. But as long as I can remember, DD has been shy and I've always felt like I need to explain that to other people (I was embarrassed/ felt guilty for a long time, but I got over it since it's nobody's fault, it's just her personality).

But now with her getting older and closer to school age, and the holidays are coming up (she's too shy to say thank you to her relatives for gifts; she won't even say hi or good bye to them, which I need to find a way to deal with), and this has been brought up by her SLP and pre-school teacher, we need to get some help.

ETa: Woops- clicked save before I added that we took her to a child developmental psychologist who suggested starting her in play therapy, but at the time she was only 2.5 and all the places I called to get her in were either too far away, booked up/ not accepting new clients, didn't work with kids, or didn't work with kids under age 3. So I let it go for a while but realize I need to start calling around again to find a place.

[KDsMommy]

Here is a link to the book, One Child by Torey Hayden http://www.amazon.com/One-Child-Torey-L-Hayden/dp/0380542625/ref=sr_1_1?ie=UTF8&qid=1323308132&sr=8-1


I was painfully shy as a child and would not say thank you, hi, or bye to people. I had a LOT of trauma as a young child so I chalk it up to that. I did eventually grow out of it, but not until very late. I'm positive I could have benefitted from therapy when I was young. You're doing the right thing by getting your DD help.

[vludmilla]

I do have some experience with SM in young children though for about eight years now I have worked exclusively with middle and high school aged students. SM needs to be treated sensitively with cognitive behavioral therapy (CBT). It can be difficult to find a CBT therapist who is qualified to work with such a young child but I highly recommend it. An excellent CBT therapist will use "play therapy" with a young child but that play will be informed by research based CBT intervention. It is essential to make sure that the SM behavior is not inadvertently reinforced. It is so easy to fall into that trap especially with sweet, adorable children so an excellent therapist will create a very structured intervention with incremental goals.

[vludmilla]

So I don't know if it's an authority figure issue or what. But as long as I can remember, DD has been shy and I've always felt like I need to explain that to other people (I was embarrassed/ felt guilty for a long time, but I got over it since it's nobody's fault, it's just her personality).

But now with her getting older and closer to school age, and the holidays are coming up (she's too shy to say thank you to her relatives for gifts; she won't even say hi or good bye to them, which I need to find a way to deal with),

I'm glad you got over explaining away her lack of talking. She is a just a child so other adults need to be understanding. By explaining away her behavior or answering questions that were asked of her, it is a kind of reinforcement of her behavior (the not talking). When she does not answer I would perhaps say something like, oh well, DD isn't answering now, maybe she will later... As for relatives, I would not give her the easy out with not thanking them for presents. I would rehearse thanking before the event and then gently encourage it at the time, if she still can't do it, let it go calmly but don't offer an explanation to the other family members and then have her make a card to say thanks to them. If possible, have her pass the thank you card to them after she makes it.