Please or to access all these features

SN children

Here are some suggested organisations that offer expert advice on special needs.

Selective mutism, query ASD overlap- best route for professional help?

5 replies

ilovegrapenuts · 20/04/2009 22:31

Pre school raised concerns about DD age 4. Suggested I took her to the 'drop in' speech clinic. Seen by SALT and referred for an assessment which will be 3-4 month wait. Presumably after assessment will be further wait for therapy. I appreciate that SM is caused by social anxiety and am wondering if a referral to child psychology will also be needed. And this will mean more waiting and DD starts school in Sep. I can also see that she is generally anxious - new places and social situations like parties can overwhelm her.
Even before pre school raised concerns about DD not speaking, I was wondering about ASD traits - my second DS has HFA - though not diagnosed til he got to secondary. He was similar but different!
Should I just go with SALT route or should I be raising more general concerns? With GP? DS was referred by school to CAMHs and a developmental paediatrician who diagnosed him.

OP posts:
tclanger · 21/04/2009 08:10

This reply has been deleted

Message withdrawn at poster's request.

wasuup3000 · 21/04/2009 10:37

Ask your GP to refer your daughter to both the child clinical psychology service and the paediatrician. You can self refer to the SaLT. My eldest daughter has Selective Mutism and other anxieties and my 4 year old son is being assessed for ASD. It is possible to have both ASD and SM together in one child.
There are difficulties with Selective Mutism in getting help sometimes from professionals simply because they don't much about it.
SaLT's sometimes say it's not their remit but it is listed by the Royal College of Speech and Language Therapists as being their remit.
It is listed by the Communication Trust (they have a website) as being a SLCN(Speech and Language Communication Need) and late last year the Government produced an Action Plan (in response to the BERCOW report) for SLCN providing grants and towards this area to LEA's.
HOWEVER many LEA's have Selective Mutism listed as a BESD (Behavioural Emotional Social Disorder) and have not got the message that it is a SLCN.
So SLCN support and funding is not going to children with Selective Mutism. Furthermore there are only 3 professionals in the country that offer any training on Selective Mutism despite Selective Mutism being more prevalent now than Classic Autism.
So you may find that you have to provide the SM information yourself to the professionals. You can download this from the website www.selectivemutism.co.uk

ilovegrapenuts · 21/04/2009 15:14

Thanks tclanger and wasuup. From what you say wasuup sounds best to go to the GP if there is a question of whether help for SM is properly funded as a SLCN.
I'm finding it really hard wondering whether DD has 'just' SM or 'just' ASD or both. Particularly because social and general anxiety is the prominent difficulty for my teenage son with HFA. I'm unsure what distinguishes ASD and SM - does SM mean a different type of social and communication difficulties? And I suppose ASD involves the complete 'triad of impairments'.

OP posts:
wasuup3000 · 21/04/2009 19:18

The best way to explain the difference is that a child with ASD with have the same difficulties with communication in all environments. Whereas a child with SM will be perfectly Fluent in an environment they feel comfortable.

Copied from the SMIRA site :

What is Selective Mutism? PDF Print E-mail edit
Written by SMIRA
Sunday, 20 April 2008 23:26

Selective Mutism is an anxiety disorder in which affected people speak fluently in some situations but remain silent in others. It was once considered rare but is now known to affect more than 6 in 1000 children which is about the same number of children who are affected by classic autism. Yet still very few professionals are trained in dealing with selective mutism or have very little knowledge of it. The condition is known to begin in early in life and can be transitory, such as on starting school or on being admitted to hospital, but in some cases it may persist and last right through a child's school life, possibly resulting in missed life chances and difficulties communicating in adult life. Early intervention is crucial to completely eradicating the condition in the first few years of a child's life, so selective mutism awareness for parents and professionals along with appropriate information, training and intervention techniques for selective mutism is vital. "Communication is crucial, it is a fundamental Human right" (John Bercow July 2008)

These children usually do not talk to their teachers and may also be silent with their peers, although they do communicate non-verbally. Other combinations of non-speaking can also occur, affecting specific members of the child's family. Often the child has no other identifiable problems and converses freely at home or with close friends. He/she usually makes age-appropriate progress at school in areas where speaking is not required. These children are not usually unhappy or shy in activities that don't require speech which can confuse professionals as to the reasoning behind it being an anxiety disorder. As people often think of anxiety as presenting in people with many physical symptoms such as trembling, sweating, shaking for example. However if you are afraid of spiders you do get on with your daily life so long as you don't see a spider, or if you are afraid of flying you don't have a problem so long as you take the boat. Many people with selective mutism can appear to be fine so long as they don't have to speak, unless they have other anxieties or conditions to deal with. Although some people are so afraid of situations when they think they may have to speak that their whole bodies seem to freeze up. Every child with selective mutism is unique in how they present in their difficulties.

*Many children with the condition are never reported, as they are not troublesome at school. For parents, having such a child can be very distressing as they may feel blamed for the child's mutism.

*Children who have selective mutism are unlikely to have been abused as many NSPCC adverts often misleadingly suggest.

*Children with genuine selective mutism difficulties are not usually being quiet in order to gain attention by manipulating or controlling situations or being defiant or naughty. From what selectively mute children do tell us their throats do tighten up preventing speech.

It is still worth tacking it via the Ed Psych as well, just print off the info from the communication trust that Selective Mutism is a SLCN and info from the Selective Mutism Website. Ask you LEA what their policy is on SM and give them the same information.

ilovegrapenuts · 21/04/2009 21:10

That's a helpful explanation of the difference wasuup.
I've found the SMIRA site very helpful - and totally agree with the sentence above that 'every child with SM is unique in how they present their difficulties.'
I've made an appt with GP - I think DD probably does have other anxieties - the SM may only be part of the picture.

OP posts:
New posts on this thread. Refresh page