Any advice on how to approach SALT referral with DD 10 Yrs??

[chocrolos]

DD age 10 has always been selectively mute in certain situations. She has friends and can talk to children she knows, but cannot talk to adults and is not big on conversation even with grandparents or us as her parents. We thought she'd grow out of it, was 'just' shy etc etc but a few things alarmed me over the past year or 2, so I approached the speech and language therapy service and had my telephone appointment with them yesterday.

I can now see that some of her personality 'traits' could also be classed as autistic traits. The lady on the phone spoke to me at length about her communication issues and said they'd like to see her in person next week.

My question is, how do I approach this with my DD? How do I get her on board with coming to this appointment? I don't want her to feel there is something 'wrong' with her. She won't grasp the benefit of trying to get some help, and the benefit of treating the anxiety around talking before she gets too old.

I haven't spoken to her about autism ever at all. We have had a fair few conversations about trying to answer even just 'yes' or 'no' or to smile and nod when people ask her questions (in shops, her friend's parents etc) but I haven't broached the idea of getting professional help.

Any ideas how I can approach this with her so that she'll actually come to the appointment?

Just take her to the appointment. You are the parent. It will be helpful for her to attend.

But how to word it? 'We're going to see a professional as you can't speak to people' I know I'm the parent, but I don't know how to word it in a way that she doesn't feel like a freak!

It's easy to say we are going to the opticians or the doctors or dentist, and I'm trying to find a way to compare it to that.

I think you need to be honest. Tell her that you know she finds it hard to communicate with adults. You are going to meet someone who may be able to help her.

I have a dd with autism and selective mutism. It was easy for us to broach the subject because she had speech therapy when she was younger and so knew she was different.

Has she ever had a conversation with you about her feelings? Any struggles? Any way she feels different. In an ideal world you’d be able to mention something she’s already told you and then say that you would like her to meet a professional to help. You don’t need to give labels at this stage.

Maybe you could find some simple information about speech therapists to share with her. Talk about the different people they see and why.

Have you never discussed with her her difficulties? Has she never expressed them? A teacher? No one?

you saw this appointment is to help when you find it difficult to talk to others.

that this appointment can help with understanding more what’s going on for dd, will give you as parents more tools to help her, especially as she gets older and more independent as secondary coming up.

i wouldn’t mention Autism, just focus on this being about helping dd

Does she ever express frustration about not being able to talk to others? Or does she ever talk about being anxious about it?
if she does then I’d use that to lead in to it.
‘Do you remember when we talked about how you find it tricky to talk to adults sometimes? I’ve found a lady who has met lots of people who have experienced the same thing. I’ve booked us an appointment to go see her as she’ll have lots of ideas to help you feel more comfortable in those kinds of situations’
The way I approached my youngest going for an autism assessment at age 10 was to take the opportunity when she was upset about not coping too well in a supermarket. In the car park after she said ‘WHY does this happen to me?’ And I said ‘funny you should say that. Some people who are autistic have struggles like you do and lots of them are good at similar things to you too so it might be because you are autistic. I’ve actually booked an appointment to see someone who will be able to help us work out if you are autistic too. It just means your brain works in a slightly different way and knowing is good because then we will know better how your brain works to make things easier for you. What do you think?’
She was actually very excited to think there was an explanation for her feeling different.

Hi, I really wish we had got her therapy earlier, so this was not such a big thing. But she has never mentioned feeling different or spoken about the fact she can't talk. She doesn't talk about her feelings, emotions or general life experience at all. If she did it would be easier to raise it. I'm worried she doesn't want to face up to it or be different in any way. Perhaps she'd rather ignore it and bury her head in the sand. Far easier to get help for someone who wants to be helped.

Please do tell her. I have a 10yo dd and she found out from a friend at school about an upcoming therapy course (friend recognised letter and also had one) .
My dd was so cross with me.

That's a good idea, thanks.

And this does sound like my dd. She cried and told me she didn't want to be different when I tried to explain why the therapy might help.
She's being assessed for adhd, asd and dyspraxia.
I still think it needed saying though.

Unfortunately, no, she has never talked about her difficulties. I have talked to her about it but she is pretty unresponsive. She hasn't asked for help.

Thanks for posting. That's all really helpful, and has given me some ideas.

I've thought about this, and really want to avoid any dishonesty. Also aware that the therapist could ask her if she knows why she's at the appointment!

How is her selective mutism now? Did it improve with therapy?

I broached this with my 11 year old DD in this way.

"I know you struggle to communicate sometimes, and I know you're very self conscious about this. There's a lady called a Speech and Language Therapist who says she can help. In fact, she helps lots of young people, so you aren't alone. She isn't looking to fix anything, but is going to help others understand why you struggle. This means that people (like teachers) won't push you to try and do things you aren't comfortable with"

It was fortunate that I'd had the initial chat with our SALT and she was lovely, so I was able to say to DD that the lady was kind and that I thought she would like her and get on with her. I also said that the SALT had explained that DD could meet her at home, school or wherever she chose. She could also communicate via notebook or whiteboard or drawing if she was unable to physically speak to her.

This was around for months ago. DD has now met her three times, the SALT has attended school meetings with me every six weeks and she has also carried out whole school teacher training on Selective mutism. Teachers are now fully aware not to expect DD to "learn to communicate" as they were previously pushing her to do so. SALT has been worth her weight in gold.

Just to add that DD has an Autism diagnosis (which came a couple of months before SALT referral) and now has an official diagnosis of Selective / Situational Mutism. DD also has severe anxiety, and it was because of this (and other issues) that I originally broached things with DD always framing it as me trying to get her the best help, understanding and support possible, because I think by that point it was the lack of any understanding DD was feeling from school that was getting her down.

It feels like a bit of an impossible situation to be in, I know. You don't want your DD to feel different, but they are likely to struggle badly if they don't get help, and therefore already probably feel different anyway, so you kind of have to go there. It's just best to deal honestly and head on and get support in place.

That was very rambly. Sorry. Hope it all makes sense.

Just to reiterate, SALT specific therapy for Selective mutism is mainly about coping strategies and working with school regarding expectations, not 'fixing' the mutism issue itself. Although therapy can include confidence boosting, it's more around learning different methods of communicating. It's part of DDs autism and I am very clear with her that there is nothing 'wrong' that needs to be fixed with her, it's support, awareness and understanding from others that's important.

its difficult to describe her selective mutism, I wouldn’t say it’s improving because her anxiety is so bad at school that I’m thinking of home schooling her. She has some lovely friends who she’s bubbly with but freezes in conversations with teachers and sometimes relatives she doesn’t see very often.

The selective mutism isn’t something I focus on because I see it as a consequence of anxiety so I do my best to reduce her anxiety levels in the hope the mutism will improve. She’s had other issues such as lower vocabulary than is normal and until recently wasn’t able to describe her feelings so I focused on those first. we have also done role play on different situations as i think the anxiety of being in an unfamiliar or noisy or crowded situation makes the mutism worse. So with me she is much more able to articulate how she feels about things so from that perspective there have been huge improvements in the last two years (she is 13 now).

if you do think she has autism and anxiety you might find it helpful to discuss what’s going to happen to her. ‘We’re going to see a doctor. We’ll be in an office in name of town which has a nice Starbucks, we can get you a cake afterwards, or there is a shop that sells Lego.’

So we had an appointment with a professional before Christmas, it was a town we hadn’t been to before so I’d looked it up, worked out which shops she’d liked and generally planned it. She couldn’t speak to the medical professional but whispered in my ear so it was a success.

@RainbowZebraWarrior Enormously helpful, thank you so much for taking the time to help! I know I need to get help at this point and we have to face up to it. I just feel I have to tread very carefully, but you have given me lots of ideas of how to word it. Thanks again

Thank you and best of luck. It's so difficult to navigate, so if you have any more questions or want to chat going forward, happy to do so. Like I say, we are only four months into therapy, so early days still for us.

@stealthninjamum That is all really helpful, thank you! Your DD sounds very similar to mine. I do worry for the future. I remember going out and getting my first job at age 13 and I can't currently imagine her ever being able to manage that, let alone at a young age. Her siblings are the complete opposite so it only serves to have her communication difficulties stand out.

My DD has anxiety and a fair amount of medical appointment. She always takes a cuddly toys with he and a book for the waiting room. She also like to know what will happen step by step eg we will park at the hospital and then find the right part of the hospital, you can help me read the signs then we tell the receptionists we are here…