Alternative options to speech therapy?

[Seasonofthewitch83]

DD is 33 months and we have currently started private speech therapy. Both NHS and private assessment referred her for autism diagnosis but its a two year wait!

She is verbal with good understanding but doesnt talk outside of the house - she speaks at therapy but as soon as we leave she will be mute until we get home etc.

I am not sure what I expected speech therapy to achieve over the six sessions we booked - we are working towards her being able to describe what is happening in a picture in a 2-3 word sentence and understand and verbalize the routine we do at therapy. But this wont fix her lack of speech outside the home - including nursery - and i worry that as she spends most of her time during the week at nursery that its also impacting her progression with speech in general, so its a bit of a vicious circle.

What other options are available to help DD with speaking outside the home?

Psychology. Look up Situational Mutism/Selective Mutism. Im in Ireland but here the psychologists manage this.

Thank you! Weirdly, the speech therapist seemed to discount this and instead seemed to push towards autism being the reason and that anxiety/being overwhelmed is what stops her talking and her having a solid routine will apparently help this....

Autistic kids can be situationally mute and situationally mute kids can be Autistic but one doesnt automatically equal the other if you know what I mean. The psychologists here are good at teasing this out. Its worth a referral.

I wouldn’t have thought 6 sessions was enough to have any meaningful impact. What does the SALT say?

The selective mutism is likely due to anxiety, given how young she is maybe play therapy could help.

If the main concern is not speaking outside the home, then the therapy needs to take place outside the home. Can the private SALT do sessions at nursery? 6 sessions for a child is not enough at all, it really needs to be an ongoing basis. Try not to put any pressure on her to speak outside of the home as this will result in her going the other way. Try to see if you can make her laugh when you're out somewhere as even just making a noise outside can be a step in the right direction.

She's just 2. Support her but don't stress. I thought Autism can't be reliably diagnosed at that age.

If you're still waiting for an assessment when she reaches 4 then Caudwell Children often assess within 3 months.

My DN is Autistic and was selectively mute at that age. She did better with a Childminder and spoke there after a while.

It's not unusual for Autistic people to have situational mutism. Equally she can have situational mutism because of something like anxiety, none of these things discount the other. I'd be weary of someone who isn't open to there being various possible reasons. Plus a speech therapist really doesn't have diagnostic experience in this area.

Psychology is not necessarily helpful at this age, unless you can find someone that does play therapy. Finding an Occupational Therapist or speech therapist that can see her at daycare might be more helpful. An OT can't help with speech but if they see her at daycare they can help bring her into games and help her interact with her peers and provide scaffolding and encourage her to work towards verbal interactions. My DS both had OTs working with them in this way when younger. For my DC at least therapy at daycare/school has been a lot more effective. Mobile therapists do usually charge more to cover time getting to/from appointments, but it's been really worth it for my DCs.