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Selective Mutism:

Selective Mutism:. Finding My Voice. Lory Greer, MS Licensed Psychological Examiner Shelly Wier, MS, CCC-SLP Speech-Language Pathologist. Easter Seals Outreach Program. What is Selective Mutism?. Childhood anxiety disorder Inability to speak in school and similar social settings

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Selective Mutism:

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  1. Selective Mutism: Finding My Voice Lory Greer, MS Licensed Psychological Examiner Shelly Wier, MS, CCC-SLP Speech-Language Pathologist Easter Seals Outreach Program

  2. What is Selective Mutism? • Childhood anxiety disorder • Inability to speak in school and similar social settings • Age appropriate speech at home or with parents

  3. DSM-IV-TR Diagnostic Criteria • Consistent failure to speak in specific social situations • Interferes with educational achievement or with social communication • Duration is at least 1 month • Not due to lack of knowledge of, or comfort with, the spoken language required in social situation • Not better accounted for by other disorders

  4. Selective Mutism Is Not . . . • Just a refusal to speak • Defiance or stubbornness • Just shyness • Outgrown over time

  5. Selective Mutism vs. Shyness

  6. Social Anxiety Disorder • Discomfort in the spotlight • Avoidance or refusal to initiate conversations, perform in front of others, invite friends to get together • Avoiding eye contact • Speaking very softly or mumbling • Minimal interaction and conversation with peers • Appearing isolated or on the fringes of the group • Sitting alone in the library or cafeteria, or hanging back from a group in team meetings • Overly concerned with negative evaluation, humiliation, or embarrassment • Difficulty with public speaking, reading aloud, or being called on in class

  7. Selective Mutism

  8. Anxiety Disorders in Children 18 % 16 14 12 10 8 6 4 2 0 7 % 2-5 % 4 % 1 % School Avoidance

  9. Prevalence of Selective Mutism 27 24 21 18 15 12 9 6 3 0

  10. Anxiety Timeline Peripheral in Peer Play Onset of Panic Disorder Reactive Infant Inhibited Toddler Social Fears/ Social Phobia Age (years)

  11. Fight, Flight, or Freeze?

  12. Sensitivity to noise and crowds Difficulty separating from parents Difficulty sleeping alone Introspective and sensitive Creative and artistic Perceptive and inquisitive Moodiness, rigidness, procrastination, tantrums, bossiness Bedwetting, enuresis, encopresis, fear of public restrooms Other Associated Characteristics

  13. Do’s and Don’ts • DON’T wait expectantly for the child to speak • DO accept any (or no) response as OK and move on • DON’T pressure, punish, or bribe • DON’T overly praise or otherwise draw attention to communication attempts • DO respond positively, as you would to any child’s communication

  14. How Can You Help? • Accept the child as they are • Visit the child at home before the school year begins • Allow the child to become familiar with his classroom prior to the first day • Every day, meet the child in the room before the other students arrive

  15. How Can You Help? • Use of hand signals • Use of classroom objects or signs • 3x5 cards with pre-printed messages • Word rings with pre-printed messages • Wipe off board for writing messages

  16. How Can You Help? Use visual aids to allow the child a hands on method to show their work Allow adequate time for responses (verbal or nonverbal) Emphasize creativity, imagination and artistic expression in all subjects Form small groups for discussion Form a small group to include children that the child with selective mutism is most comfortable with

  17. How Can You Help? • Seat child next to children they are comfortable with • Use computers to present materials visually • When partners are needed, assign a partner to the selectively mute child • Set gradual communication goals, with the help of a professional

  18. How Can You Help? • Identify a safe place • Develop relaxation techniques • Modify stressful social situations • Educate all staff members

  19. Treatment Options • Medication • Cognitive/Behavioral Therapy • Speech/Language Therapy

  20. Neurotransmitter

  21. Additional Information • www.selectivemutism.org • www.aboutourkids.org (Search: selective mutism-profiles in silence) • www.adaa.org Anxiety Disorders Association • Easing School Jitters for the Selectively Mute Child and The Ideal Classroom Setting for theSelectively Mute Child both by Elisa Shipon-Blum • Helping your Child with Selective Mutism by McHolm, Cunningham, Vanier. • Augmented Self Modeling as a Treatment for Children with Selective Mutism (1998) by Kehle, Madaus, Bratta, & Bray in Journal of School Psychology, 36:3, pp. 247-260. • Selective Mutism in Elementary School: Multidisciplinary Interventions (1997) by Giddan, Ross, Sechler, Becker, & Bonetta in Language, Speech, and Hearing Services in the School, 28:2, pp. 127-133.

  22. Contact Us Easter Seals Outreach Program 3920 Woodland Heights Road Little Rock, AR 72212 Lory Greer Shelly Wier (501) 227-3687 (501) 221-8415 lgreer@ar.easterseals.com swier@ar.easterseals.com

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