Selective Mutism...anybody got any advice?

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My DD is 2&1/2 (3 in August) and it has recently come to light that she has SM, I had always put it down to shyness but after attending a nursery for about 6 months and still never speaking a single word to anybody, adult or child, it's clear that it's more than just being shy.

At home she is chatty, confident, funny and her speech is very well developed for her age.

But when we're in crowds she won't even speak to me, she just rests her head in my shoulder and won't give me eye contact or answer me if I ask her a question.

She also has a tendency to stick her tongue out when she's feeling nervous or anxious.

I have been her main carer all of her life until a few months ago when I decided that she needed to gain some confidence and get more used to being around other children her own age.
So I put her in nursery for two half days per week but she never settled and in the end I have had to pull her out after something was said to her which I feel was detrimental to any progress she was making.

So now I'm not sure what I should do? I've read about the 'sliding in' technique and now I'm wondering whether I was asking too much of her by sending her to nursery?
Her anxieties are around 1) being in crowds/groups and 2) being without me.

Would it be better if I try and get her used to crowds and groups whilst with me? And then gradually start leaving her places?

I'll admit I've been really rubbish at going to playgroups etc with her. She's always been a very easy and content child so has never needed entertaining that much so our days have mostly involved playing at home, visiting friends etc.

She's due to start nursery school in September so I would like to try and tackle this as much as possible before then.

My DS goes to the school already and I know they're really good at offering extra help and support to any children who need it so I'm hoping that it'll be a positive step.
Her anxieties are also a lot less when she is with my DS, is there anything I can do to use him to help her?

The HV has referred her to a group called something like Toddler Talk? It's supposed to build confidence etc. But that was about a month ago and I've still not heard anything regarding an appointment.

Is there anything I can do to push for a diagnosis and get her some help?

I think nursery probably was too much at once. I would try and find a couple of small-ish playgroups/singing groups and try and attend with her every week.

I wouldn't reference her shyness/not talking in front of her, don't make a big deal of it. Just let her come round in her own time.

How is she with other people she knows? Or at friends houses/other activities outside of your house?

I don't know a lot about SM beyond knowing someone who has it.

Does she speak to anyone else at home when you are there?
I am wondering in an amateur-ish way if portage would pay for someone to be in the house maybe a different room and creep closer and closer until dc was able to keep talking to you when they were there and maybe even engage with them.

What does your GP recommend? A GP would at east have to come up with some kind of specialist to refer on to.

I could find out from my friend who is a SALT if there is anything she would expect, although might not get an answer straight away.

The things you are thinking about sound sensible to me, so fingers crossed you get some better informed ideas

Thanks for the replies.
outraged yeh I've found a couple of lovely groups at our local sure start centre - a story rhyme time which i think she'll really enjoy and a music and movement class which we went to yesterday, although she didn't speak she joined in and didn't ask me to pick her up which was quite a big thing, it showed that she really enjoyed it.

I've been trying to not talk about her shyness in front of her but sometimes others make comments like ''aww isn't she really shy?'' or ''oh are you sticking your tongue out?'' and I feel like just telling them to shut up!

I haven't actually spoken to the GP about it, just the Nursery Nurse from the health visiting team who did her 2 year assessment, she didn't seem to think it was much of a problem because she can speak. She gave me some tips about how to handle it but said that she doesn't think speech and language would accept a referral.
I think I will see my GP with her though, as my friend said (ex HV), it's who ever shouts the loudest gets the help.

senvet she is fine with me/DH/her siblings/MIL, but she is shy around everybody else and if we had a guest at our home she would just sit on my knee being shy, but maybe after a little while she would relax, but would rarely be totally herself around others.

She's such a fun, funny, confident little girl with us, it's quite upsetting that other people don't get to see what we do

oh and if we go to other people's houses she will usually sit on my knee being quiet but then may relax after a little while. She would probably play but maybe not speak very much.

If DS is with her she is usually much more confident than if he wasn't, but still not 100% herself.

I'm a nanny and I've had a couple of charges like this. Both girls and both grew out of it around 3/3.5yo, so the nursery nurse could be right. They may not view it as a 'problem' until she's a little older. It doesn't hurt to ask and make sure you know what's available though.

I also know a 9yo who is selectively mute (also a girl). It's obviously a problem and a worry for her parents, but she is surprisingly happy and copes very well. She goes to school and has friends and does after school activities etc. it doesn't seem to be that problematic for her iyswim.

My DD1 had SM and didn't speak for the whole of pre school and a term of reception. She had a breakthrough moment when it was a special day and they all took an outfit for a disco later that day...getting changed, she suddenly began to speak to the teacher who was helping her...animatedly and happily.

All I can think was that the thing she loved most then was dressing up....it improved slowly from there. The teachers worked with me...to find other things which she reacted to...she loved sewing and DD and I made a little soft toy which she took in to show the teachers who made an almighty hoo ha about it...and pinned it up for all to see..heaping praise on DD.

I think that this helped her self worth. Nobody ever tried to make her speak either. She's 10 now and fine.

I should add that at home Dd was very articulate,...an advanced talker. She spoke in full, clear sentences at about 18 months....first words at 12 months. So this was unexpected to say the least!

Thanks it does really help me to hear these stories of children over coming it.
I'm confident that it is something she will over come, but for now, it's hard to see my DD struggling with something that other children don't, you just want your children to be happy and I can't imagine she is happy when she feels so uncomfortable.
Mrs flannel- that's exactly what DD was like, I could have a full conversation with her at 18 months, at home she loves singing and making us all laugh with her funny dances and funny faces etc, she's the total opposite to what others see. This was definitely a surprise.

My DD (now 10) has SM. It was picked up at pre school just before her 4th birthday - she had been attending and not speaking for almost a year. So at least your DD's SM has been recognised - though if it was the nursery it is a shame that they then said something that meant she couldn't make progress there. But I agree that a supportive setting is vital and sadly, in our SM journey we have learnt that misguided 'support' can be quite detrimental.

A few points

_ I would check if Speech and Language will accept a referral - maybe ring them. In my area I went to the drop in clinic (no GP referral needed) and they took DD onto their caseload - though having made the diagnosis their job was advising school staff (DD was about to start reception) rather than any direct work with DD.

_ Yes, definitely keep working on encouraging her to be out and about with you - but I'd hold off the 'leaving her' bit for now.

_ I think it will definitely help your DD to have her brother there at nursery when she starts - and that will help her manage the separation from you. My DD had 3 year older DS at school when she started and that helped her settle - though not to the point of her speaking! Would it be possible for one of the nursery school staff to visit you at home a couple of times before your DD starts - she may not speak to them even at home at the moment, but it may help to break down the 'barriers' between home and relaxed speaking, and school and silence.

_ When people commented that DD was 'shy' I would say that she would talk when she was ready, so it 'affirmed' DD could talk, and all that was needed was patience from the person commenting!

_ I would be wary about the Toddler Talk group - SM needs to be dealt with in a specific way with no pressure being put on the child to speak, so I'd want to know that the group was 'SM friendly'. 'Standard' speech and language groups in school haven't ever been suitable for DD.

My DD still has SM but is making really good progress now she is in a school with very small classes - for the first time she is talking to teachers and her classmates in the classroom. And no one would describe her as shy having heard her speak! She can be chatty and opinionated and has a great sense of humour!

There is an active SMIRA group on Facebook which has lots of info.

I agree with Pan re. Toddler Talk. I also looked after a child with delayed speech and we went to a Toddler Talk type thing, run by speech therapists, but it was very much aimed at children who couldn't talk or who couldn't talk clearly. It was very focussed on doing lots of talking and making sounds etc. so maybe not the best if she is anxious about speaking.

I did wonder about how the toddler talk would work, I'm sure it's something that's been put in place to try and tackle the problem of children who are starting school who can't talk.
That is far from our problem, her speech is at the level of a 3-4 year old, so no actual problem with her speech at all. It's a confidence/anxiety issue.

I'm going to see the GP and push for a referral to speech and language and try and get a proper diagnosis and hopefully some support.

It's definitely worth getting something on paper if you can, otherwise you may find that her nursery and school staff will take the attitude that she will grow out of it rather than actively trying to understand and address what is going on. From experience, it's also very easy to be over-optimistic that things are improving 'as she settles in' when you're not there to see it day to day.

SLT provision seems to vary a lot from area to area - some won't deal with SM at all and some will offer proper support. I think that's because SLTs aren't SM trained as a core skill, it's an 'extra' specialism. Having said that there is a bit more awareness now, so they may be able to at least diagnose and give some info leaflets to nursery/school, even if they won't provide treatment. If you're hitting a brick wall maybe consider a private SLT, even if it's just for the diagnosis and bit of paper.

If SM is still present, even mildly, when she starts school, I would push to have her put on the SN register and given an IEP (Individual Education Plan) - or whatever the equivalent will be then. That means that the school will have to put together a treatment plan, track progress and demonstrate improvement - because being unable to express herself through speech will impact her education and development, even if she is bright enough to cope academically and able to do basics like reading to the teacher.

I'd second the SMIRA Facebook page being a good source of info and support.

I've just had a huge flashback and wonder whether this could have triggered DD's SM...
She was probably about 10 months old ish (it's hard to be certain how old she was tho), but I suppose at an age where her speech was developing a lot, a neighbour where we used to live came up to me screaming and yelling and me (she wrongly thought I had reported her to social services), i was holding DD at the time when this happened.
She seemed unaffected by it at the time, DS was also there and was very upset and still gets upset by it now, nearly 2 years later.
I was wondering whether this could have triggered her fear of strangers?
Although her fear seems to be more around groups?
Maybe she's just this way through nature, I was very shy as a child too.