Have you observed your child is comfortable speaking in some settings like at home, but has difficulty speaking or communicating in other settings like school? Has your child’s teacher raised concerns regarding your child’s lack of speech You many have conducted some research online but wonder how to raise these concerns with your child’s pediatrician.

Here are a few tips for having this conversation with your child’s doctor:

1. Book the appointment as a consult as opposed to a “sick visit” or an additional concern at a routine well visit. Booking as a consult will allow for more time with the doctor.

2. Show your provider videos or pictures of your child when they are enjoying an activity or speaking to someone they are familiar with vs settings where they are not speaking or anxious.

3. Bring in emails or notes from school discussing any social difficulties that the child is experiencing. For example, a fully toilet trained child having accidents at school, because they did not feel comfortable to ask the teacher to go to the bathroom, would be a good example to provide. If applicable, please include report cards and assessments from school, perhaps going back several years which may refer to your child’s communication skills and social behavior.

4. Be prepared to review developmental milestones such as when your child started to speak and walk, etc. You may be asked to run through a typical day and answer questions about your child’s eating and sleeping habits.

5. Don’t be surprised if your pediatrician performs additional tests. Your pediatrician may perform hearing and vision tests in the office as well as developmental screenings/surveys.

Your pediatrician may not always be familiar with Selective Mutism or may not be convinced that your child needs treatment. Below are some common scenarios you may encounter and suggested responses.

If your pediatrician believes your child may have another condition like hearing/speech impairment, developmental delays, or other anxiety conditions, please explore each avenue as recommended.

If your pediatrician is not familiar with Selective Mutism you should refer them to the Selective Mutism Association website to learn more and request a referral to a treating professional.

If your concerns are dismissed or you are asked to wait for improvement; request a timeline for follow up or request a referral to a treating professional, child psychologist, child psychiatrist, speech therapist.

Your pediatrician can be a valuable resource on your child’s journey with Selective Mutism.

Monique Mondesir, MD, FAAP
SMA Board of Directors