More than Selective Mutism?

[pannetone]

DD 6 has a diagnosis of SM - it was made just before she started school. For the last year she has had half an hour speech and language therapy each week in school. The SALT has worked on supporting her in increasing the number of classmates she speaks to, and on targets like answering the register by putting her hand up or using cards. DD has made progress - doesn't speak in class but will talk to her teacher when class are outside.

However, having seemed to settle relatively well into Year 2, tearfulness in class is increasing and she is unwilling/unable to attempt many pieces of work. DD can't commmunicate what her difficulties are to her teacher, and if I try to find out at home I only get 'I don't like school' or 'I don't like work.' She is very capable academically but now often won't attempt tasks that are within her ability.

Her teacher is a loss as to what to do, having tried explaining tasks, encouragement and sticker charts. Her SALT has suggested a referral to CAMHS which will take time. I am confused as to how much of her behaviour at school can be accounted for by her SM, or whether the SM is part of a 'bigger' anxiety disorder. Then ASD has been mentioned too - she obviously has significant social and communication difficulties. But I considered those to be because of the SM! My DS2 (older) is on the high functioning end of the autistic spectrum. His difficulties are rather different to DD's- but the spectrum is huge!

Is CAMHs the best route for further advice? DD was seen by a paediatrician when the SM was diagnosed - I asked for a referral as was concerned there was more to DD's difficulties - it was when older DS was being diagnosed ASD. DD was seen then discharged just to be seen by SALT. (Not that DD had much NHS SALT input - DD's school employ an independent SALT who sees her - and others - each week.) Should I ask to be referred back to the paediatrician?

And in the meantime what should the class teacher be doing or not doing? I know that for SM any pressure for DD to talk should be removed - the teacher has been good about this. Should the same apply for classwork? No pressure which would mean no 'I know you can do this' encouragement to DD and no stickers or fuss when work is completed. Do I take the work for her to complete at home - or is that pressure too? I really want to prevent the current situation escalating - DD is evidently anxious at school and also demanding at home.

There are assessments a SaLT can do on the celf tests your DD would just need to write her answers rather than say them. There is also a non verbal WISC that an ED Psych could use for assessment purposes.
CAMHS may want your DD to see the paed first or vica versa it depends what the route for assessment is in your area. Obviously and ADOS would be impossible to complete but some answers can be written down so it can be partially done to get a picture.
A lot of ASD strategies work well for a child with SM, so if the teacher knows any of these then that could be useful.
Keep a diary of the behaviour that is demanding, what caused it and what calmed your DD down as this maybe useful for those that do assess further.

Thanks wassup - but despite having gone through assessment process with DS (he was 14 when diagnosed - don't know if that makes a difference?) I am not up to speed with the different tests. What are you suggesting the SALT could do? And DS was never seen by an Ed Psych - should the school be arranging this for DD? I get the impression school don't get much Ed Psych time and DD may not be top of their list.

Don't know if class teacher knows ASD strategies - but they have considered getting the complex communication service advisory teacher in to observe DD and give advice.

With your DD having selective mutism, the anxiety could be due to ASD. The SaLT could establish your dd's receptive and expressive language skills and the EP could assess your child's cognitive ability.

I would maybe suggest ask the school about getting your daughters needs assessed or ask the LEA to assess your child yourself.