Selective Mutism

For this weeks post I will be discussing Selective Mutism.  Selective mutism typically occurs during childhood years. A child with selective mutism does not speak in certain situations, like at school, but speaks at other times, like at home or with friends.

What are some signs or symptoms of selective mutism?

Symptoms are as follows:

  • consistent failure to speak in specific social situations despite speaking in other situations.
  • not speaking interferes with school or work, or with social communication.
  • lasts at least 1 month (not limited to the first month of school).
  • failure to speak is not due to a lack of knowledge of, or comfort, with the spoken language required in the social situation
  • not due to a communication disorder (e.g., stuttering). It does not occur exclusively during the course of a pervasive developmental disorder (PPD), schizophrenia, or other psychotic disorder.

Children with selective mutism may also show signs of anxiety, shyness, embarrassment or social isolation.

How is selective mutism diagnosed?

A child with selective mutism should be seen by a speech-language pathologist (SLP), in addition to a pediatrician and a psychologist or psychiatrist. These professionals will work as a team with teachers, family, and the individual.

The educational history review seeks information on:

  • academic reports
  • parent/teacher comments
  • previous testing
  • standardized testing

The hearing screening seeks information on:

  • hearing ability
  • possibility of middle ear infection

The oral-motor examination seeks information on:

  • coordination of muscles in lips, jaw,and tongue
  • strength of muscles in the lips, jaw, and tongue

The parent/caregiver interview seeks information on:

  • any suspected problems (e.g., schizophrenia, PDD, etc.)
  • environmental factors
  • child’s amount and location of verbal expression/ interaction with others
  • child’s symptom history (e.g. onset of behaviors)
  • family history
  • speech and language development

The speech and language evaluation seeks information on:

  • expressive language ability
  • language comprehension
  • verbal and non-verbal communication

What treatments are available for individuals with selective mutism?

The type of intervention offered will differ depending on the needs of the child  The child’s treatment may use a combination of techniques, depending on individual needs.

A behavioral treatment program may include the following:

  • Stimulus fading: involve the child in a relaxed situation with someone they talk to freely, and then gradually introduce non familiar listeners.
  • Shaping: use a structured approach to reinforce all efforts by the child to communicate, until audible speech is achieved
  • Self-modeling technique: have child watch videotapes of himself or herself performing the desired behavior to facilitate self-confidence and carry over this behavior into the classroom or setting where mutism occurs

If specific speech and language problems exist, the SLP will:

  • target problems that are making the mute behavior worse;
  • use role-play activities to help the child to gain confidence speaking to different listeners in a variety of settings; and
  • help those children who do not speak because they feel their voice “sounds funny”.

Work with the child’s teachers includes:

  • encouraging communication and lessen social anxiety
  • forming small social groups that are less intimidating
  • helping the child communicate with peers in a group by first using non-verbal methods and gradually adding goals that lead to speech
  • working with the child, family, and teachers to generalize learned communication behaviors into everyday living

 

Hope you found this weeks post interesting!

 

-Lindsay

Information retrieved from: http://www.asha.org/public/speech/disorders/SelectiveMutism.htm#2

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