Where next with extreme inhibition/shyness in DD 10

[Corialanusburt]

Both school and I have decided it's time that we get some help to support DD with her social interaction. She never initiates conversation with other children and stands alone at playtime if her friend isn't there. She has one friend in school and 2 out of school. she isn't unhappy apart from a general residual feeling that she'd like to have friends. Her academic work isn't suffering. She puts her hand up in class but she doesn't really interact with e other children. This I think is due to extreme inhibition and anxiety about whether she'll be rejected.
The local speech and language therapy service have told me that they wouldn't be able to provide DD with support as their social interaction support would be for children on the autistic spectrum e.g. To help them understand nuances in conversation etc.
I plan to ask GP for a referral, but to where and with a view to what? Do we want CAMHS, a paediatric specialist, a clinical psychologist, an ed. psych? Should we be seeking an assessment, and if so what could be the diagnosis. She doesn't fit ASD description apart from the social interaction. She doesn't quite fit selective mutism as she will put up her hand and speak in front of class. She's not depressed or at risk.
I just want her to learn to learn to interact. She does this fine at home by the way but shuts down immediately in most other situations.
Any suggestions. I'd be grateful for advice. Thanks

[GlassCircles]

It sounds a lot like low profile Selective Mutism from what you've said. Some SM kids can put their hand up if they are confident of the answer, but the fact that they can't initiate is key.

Have a look at this:
smira.org.uk/wp-content/uploads/2015/10/High-Low-Profile-SM.pdf

Have you found the SMIRA website and Facebook page? Lots of sources of advice there, and a really good place to start. Also if you post in SN Children I think you would get more replies as more people post there.

CAMHS seem highly variable as to how helpful they are - might be worth a try if your DD suffers from other anxieties as some do good CBT interventions. I think you'd be lucky to find a CAMHS practitioner who truly understands SM though.

Speech and Language Therapists need to be specially trained in SM to be any help, which lots aren't. Might be worth contacting more than one NHS SLT centre though in your area to ask about this, and I think you can self-refer. There will probably be some private SLTs around too if that's an option.

[Corialanusburt]

Thanks so much glasscircles. That's really useful info.

[Corialanusburt]

I had previously joined the SMIRA website and have been googling selective mutism support on the North West. I'd appreciate any recommendations.

[GlassCircles]

There's a website called HelpWithTalking.com where you can find SLTs in your area who have SM as a specialisation. Also look at the Files section on the Smira FB page, there's a doc called do's and donts for secondary which is really good for giving to school.

[GlassCircles]

Have school suggested or can they arrange an ed psych assessment? That would be a good step to take re addressing anxieties within school.

[AliMonkey]

DS has SM although a bit different to your DD (didn't speak to a teacher for 4 years, spoke to nuclear family and one grandma and a small group of friends and two TAs a bit but no one else). What has worked brilliantly for him was the school working through a Maggie Johnson programme of small steps - was in the SM Resource Manual but I think they originally got hold of it via ed psych. Basically did sessions with a TA 2-3 times a week (playing board games, doing jigsaws, etc) gradually building his confidence, talking more to her then brought another child in then two, then different activities with her and then around school in different rooms then corridor then outside etc. Took a year or so but transformed him. Key is really small steps and lots of patience. See if you can find a copy of the programme and talk to school about it - it can be adapted depending on the child's particular issues.

[NightNightBadger19962]

There are some helpful things I have heard of schools doing, for example arranging a series of small group drama sessions or small group on social skills (disguised) with the affected child and a couple of other children to build confidence. Sometimes they let the child identify others to invite. Does she do brownies or anything? If you think she is open to working on it, could you make a ladder of mini goals for her, such as starting a conversation with her friend, joining in a conversation with a friend and one other, asking someone if she can join in a game. Work out some rewards and be really positive when she manages something, but encouraging and relaxed when it doesn't go to plan. Try to get her to think about her worries as a bully, telling her things that aren't true, and then get her to think of a friendly voice reminding her it will be ok, you can do it etc. Get her to think 'what is the worst that can happen' - the most exaggerated scenario, and then how she would cope, what she can do. A book called the anxiety gremlin might be relevant. If you think there are some ASD traits, in the social communication area, then she might benefit from things like practical ways to improve eye contact, or conversation starters. I'm sure you do, but noticing strengths and positives helps a lot too. Not sure if this advice is on the right track, but hope you get somewhere supporting her. She sounds like she is getting on very well though.

[Corialanusburt]

Thanks everyone. I actually gave had the selective mutism manual, bought it several years ago with the idea of working through it. DD really hates me trying to help her with this though. I'm a teacher and she probably senses me going into teaching mode.
She goes to an independent school meaning that we won't get free ed psych assessment and support. School would like me to see gp though so will see what he can recommend.i will look at helpwithtalking glass circles.