Our daughter K. has been diagnosed with SM, she is now 6 1/2 years old. She was seen by a psychiatrist, who did admit he had never treated a child with this before. We did all the standard things: sticker chart, awards, then went to negative reinforcement (made things much worse). We stopped going to the doctor and have just been working with K’s teacher. K started off first grade great. She whispered for 4 days in a row at school after only one week. So, we rewarded her (grandparents took her to dinner and movie). We thought “Hurray! She cured herself”. Well, since we made this big deal she has not said one word, whisper, or noise at school. School is the ONLY place she cannot talk. We have decided to stop mentioning her not talking at all, just ignoring it. Her teacher has her tape oral assignments and does not call on her at school to answer any questions that cannot be answered with gestures. Is this okay or are we enabling her too much? I am not sure if meds are the right way to go since she was talking until we made such a big deal out of it. I guess what I’m asking is, should we continue to “ignore” the problem, keep things how they are at school, or do we need to put some pressure on her, consider meds…?? She states she absolutely loves school and is eager to go every day, is very comfortable with her teacher, and has lots of friends.

Answer

Excellent question! I believe the reason your child stopped talking after the rewards and the ‘big deal’ was because she felt ‘pressure’. She did not want to let you down, and probably put too much pressure on herself, causing increase an in anxiety..hence, Selective Mutism. I have seen this happen quite a bit…just like you have described.

My advice is to stop talking about ‘talking’. Just let it go a bit. If you truly have done everything you can to help her with her mutism and she is not making much progress after some time, then I would consider a trial of medication. These kids truly have severe anxiety, and meds work great in the many cases of Selective Mutism. You are not enabling her mutism by allowing her to communicate nonverbally, you are simply allowing her to feel more comfortable and at the same time participate in the class. But, with the nonverbal communication, you will still need to encourage verbalization.

You mentioned she is taping lessons on the tape recorder. My advice would be to tape them at school! Perhaps after school you could just sit with her in the classroom after everyone has left. Tape the lesson right there! What you are doing is promoting vocalization in school. Since this is where her difficulties are, you need to work on vocalization in school. I also suggest going to school with your child and spending time in the room talking about all her school work and projects. These are just some of the many ideas you can do to help promote vocalization in school