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SLoPinions (get it??):  Selective Mutism and Communication Setting

10/31/2017

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Yesterday, one of my Doobs* sent a message saying she had a conference with SLPs for her work. She said they talked about how teachers should "identify students who may have speech and language needs and how to best support them in school" and particularly selective mutism, as they have a student at their school identified as selectively mute. Her students are ages 11-16 (some of the BEST communication  years, in my opinion). I read from a 2010 article by Wang for some updated information- 38% of kids identified as selectively mute also have co-morbid communication disorders (e.g. language, fluency, PDD, etc.). 

I can expand on this a little more some other time, but to be basic:

1. A child is not selectively mute if they are not selective. In other words, they must talk in some contexts and not in others.

2. In my experience, people who have selective mutism are more comfortable in 1:1 (one-to-one conversations) or small groups, and low pressure scenarios. See the picture I illustrated, if you're a visual learner  (below)!

3. We should work in teams with social workers and psychologists, and recognize that communication disorders are not the CAUSE of this mutism (otherwise it couldn't be selective, as we do not turn disorders on and off) but may be co-occurring (e.g. stuttering, expressive delays, etc.). Similarly, anxiety or other social/psychological concerns may be present, but shouldn't be the reason this person isn't able to talk.

4. Which leads me to a very important note: drop the idea right away that this a refusal or choice (like a toddler who is having control issues and won't eat something off his dinner plate)-- this is a true inability. Imagine if you felt unable to do something but someone told you you were choosing not to. Would you make a child who could not walk run laps for gym? Of course not.

Selective Mutism isn't a field that SLPs seem comfortable treating, but we might have some of the best strategies and knowledge about a) alternative communication options and b) how to scaffold limited communication into functional communication. We always start with the person first- we have to understand them and their feelings before we can dive in and give any suggestions.

Remember, quiet kids are okay, but my goal is always to help with setting goals and provide a structure for functional communication to live a happy and independent life.

How would you color these environments? How well can you color someone else's environment? In this case, can we follow the Golden Rule, and 'treat others the way we would like to be treated', or should we first work hard to think of how they might be different from us? Thoughts and continued discussion is welcome in the comments below!

Please no names or specific references to individuals without their consent.

*This is a very good friend, and we call ourselves the "Doobs" after a theologian who has the first name Doob- this group met in the UK studying theology. We are a group of actively engaged women who value active research and intellectual growth. We are amazing friends and also send silly pictures and stuff. 

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    Katie Wilkie is a licensed  Speech-Language Pathologist in Oak Park, Illinois.

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