I have been aware of my daughter’s selective mutism since 09/01. She is 4 and has been under the treatment of a psychiatrist w/experience w/SM since 02/02.(these dr.s are hard to find.) Office visits are every other week alternating 45 minutes to 1 1/2 hr. Longer visits started recently -my idea. We meet at restaurants or the park-my idea. The dr.is 1 hr away so we travel there. After a warm up of about 5-10 min. C will speak with the Dr in a whisper unless she forgets herself and will speak normal tone. Our concentration has been to build her self esteem-(dance lessons) & to have her feel comfortable @her daycare. I spend 1 afternoon there per week and she will whisper to me in front of others. She doesn’t like crowds-too many kids she just walks away. What’s next? I felt that after 7-8 months of Dr visits it would be more than playtime-them getting comfortable together. What should the Dr be doing w/ my daughter? The Dr & I email as I do not discuss in front of C who believes the Dr is my old friend. We’ve discussed meds for the future-she likes Paxil. How do I know when it’s time for that? We have not set any goals but I feel we are at a standstill. I need directions-am I doing enough?

Answer

I have some questions for you:

  1. You mentioned that it is your idea to GO places with the DR. What is the DR doing to help your child ‘lower anxiety’ and build coping skills’ when in the social settings that you go to.
  2. You mentioned that for 7-8 months the goal has been to build comfort with the DR. That is great, however, what is being done to help YOU and your child in school, other social situations, etc. In other words, other then ‘playing’ and having fun, what recommendations are being suggested to help your child in school, other social settings, etc? You need to work with your child to help with methods to gain comfort in social situations. HOW TO FUNCTION…etc.
  3. You mentioned that you and the Dr e-mail so that your child does not HEAR what you are talking about. That is fine in some situations. But does your child ACKNOWLEDGE and understand her anxiety? Until your child understands her feelings in various situations, she will have limited progress. ADMITTING and understanding that she ‘cannot get the words out’ is KEY and the first step in helping the CHILD overcome her anxiety.

I cannot possibly tell you ‘what should be done now’ simply because I do not know your child, but I can say that the goals of overcoming SM start with the child ACKNOWLEDGING and gaining control of her feelings of being ‘uncomfortable’, ‘scared’, etc. in social situations. Then, with the help of a treating professional and involving the child in the treatment goals, various tactics are used to help lower anxiety, build self-esteem and increase confidence in social situations. Hope this helps 🙂