Selective Mutism

[35poppy]

I'm eager to hear from anyone (particularly in Scotland) who has had a successful intervention for a child with selective mutism. LO is either completely mute or talks in a whisper anywhere that isn't home or their classroom. I really want to avoid this spiralling into an ASD misdiagnosis rather than someone unpicking and understanding the impact of hours spent in a contact centre (EP into adoption) for many years and the emotional tole this took on LO.

Is this something I could also speak to Adoption Agency about - do they offer support?

Thank you.

This would maybe come under Speech and Language therapy- has the child had any input?

I work in Scotland and have worked with children who are like this. Speech and Language should be able to help as should Ed Psych if your child is at school or nursery. There is also a useful handbook for staff. There will not necessarily be a rush for an ASD diagnosis, not least because wait times for this are really long right now but it is important to note that trauma can often present as ASD and some of the same strategies can help (e.g. around predictability and routine to make the child feel in control).

Thank you for taking time to reply. My understanding is that CBT is the recommended path rather than speech and language as Selective Mutisms route cause is anxiety not language.

I work in education and so I know the ropes. LO is able to speak in class so ed phych wouldn't be involved there as there is no suppprt needed for LO to access the curriculum. This is a wider world issue I want to support them with.

Hopefully someone has experience of guiding an LO through this either with NHS, Private or Adoption Agency support.

I would try to get whatever support you can from whatever source. Adopted children often have numerous issues but services are very much 'silo' based rather than looking at the child in the round.

In my experience, our children often tick so many boxes. What they primarily need is to feel safe and that can come from numerous people/ services and you can't always know who will make the big differences.

My younger daughter went to a specialist speech and language school. We had no idea she had a problem until we had her assessed by a SALT. The school had several adopted children who didn't quite fit the speech and language profile but it was the most appropriate place for them due to the environment.

I'm not suggesting involving all sorts of therapists, but I would definitely explore everything available. Speech and language covers a lot more than speaking. It covers social communication skills too, like playing with other childreshe n, knowing when to speak etc. My daughter spoke to teachers like they were her peers for example - she got help with this.

How old is your DD? Depending on her age CBT might not suit her because her cognitive capacity is still developing which can make it difficult to join the dots so to speak. Depending on age a play based therapy might be worthwhile in reducing anxiety overall. In my experience though services are pretty poor with selective mutism, all to often trying to address the behaviour rather than the source.

You could try a referral to community paediatrics, they’ve been the best for me at taking my DDs difficulties as a whole rather than taking a siloed approach. The initial appointment was around 90 minutes with the doctor talking to me and observing my DD, she then referred to a whole host of specialisms and coordinated their involvement in terms of my DDs immediate and ongoing need. She also had a good understanding of developmental trauma, ASD and ADHD overlap so didn’t ascribe X issue to Y cause.

@Jellycatspyjamas This is extremely helpful, thank you. LO is 6 and you are right, may not not ready for CBT route. I will look into play based therapy and also speak to GP about peadiatric referral. I recall you are Scotland based and so it is good to know that route is one available here. Many thanks.

We are still in the process of adopting. But my LO had this. It faded at around 6/7 years of age. I never got down to the root cause but we did use the schools speech and language therapist and I spent every week speaking to her teachers to accommodate the fact she wasn’t speaking. They used non verbal communication to ensure she wasn’t missing out in class.

Good luck with it all! It should go on its own. For us it took alot of making my daughter feel comfortable and meeting her where she was until she opened up.