The child who has SM may dread being picked for either role and it should be made clear at the beginning that only those who volunteer will be chosen. Tell yourself its safe to talk. Aim for a good pace and steady rhythm (slightly faster than one digit per second). Read a short passage, a play script, poem or magazine article, etc, alternating dialogue, lines or sentences with [A]. All routes have the advantage of allowing [N] to work initially from a comfortable setting such as home. Each week Jodie knows she will be asked four prearranged questions, and that these will be at different times during the school day. 6 Bergman RL, Piacentini J & McCracken JT (2002) Prevalence and description of selective mutism in a school-based sample, Journal of the American Academy of Child & Adolescent Psychiatry, 41(8), pp93846. 6 P PHOTOCOPIABLE The Selective Mutism Resource Manual second edition Speechmark Publishing Ltd Maggie Johnson & Alison Wintgens, 2016 463 3 HELPING CHILDREN TO COPE WITH ANXIETY 7 P PHOTOCOPIABLE The Selective Mutism Resource Manual second edition Speechmark Publishing Ltd Maggie Johnson & Alison Wintgens, 2016 464 HANDOUT 7 An advice sheet for parents, teachers and carers HELPING CHILDREN TO COPE WITH ANXIETY How to make anxious children more anxious 1 Tell them theres nothing to worry about. Exercise, eat healthily and get enough sleep. Treat the young person too delicately they enjoy banter the same as anyone else! Star stuck on a space-rocket picture as each was achieved. Either way, its impossible for you to make an informed decision about what to do next until you understand what you are dealing with. C may find this critical or unnecessary. Top landing 9/6 2 As above, plus say Hello and Goodbye to KW on the phone. 'key' : 'ace386e6628486c64d89a4020f439146', Pointing, putting hand up, touching teacher or showing work, getting another child to communicate his/her needs; waiting to be noticed; making a noise; message via parent? Name pictures or read words aloud. I understand that, during the recent parent consultation evening, one science teacher asked ______ if a private room would help; however, this has proved counterproductive in the past, and ______reports that she feels more comfortable and less obtrusive in the presence of her peers. 180.2293 810.7537 180.2293 823.7316 171.3033 825.9506 c
Touch? 'params' : {} Repeat the above activities using letter names rather than sounds, ieM (em) rather than mm; T (tee) rather than t. Adding one peer at a time, talk to keyworker and up to five peers of students choice in a structured sentence-level group activity. 61 McHolm A, Cunningham C & Vanier M (2005) Helping Your Child with Selective Mutism: Practical Steps to Overcome a Fear of Speaking, New Harbinger Publications, Oakland, CA. Focus on achieved targets 16 7 The next target is to repeat the counting activity as [A] approaches the closed door. PLEASE DO NOT: Be hurt or offended when the young person remains silent. (the truth is, they are forced by their extreme )'
The adult selects a picture from the face-down pile and mimes the action; the child sees how quickly they can find the matching picture in the pile. ! (To [N], referring to the comment) Thats a funny thing to say, isnt it? After each achievement he stuck a gold or silver star on the cartoon. Method 1: [N] and [A] start a conversation on the phone as they approach each other. Practise roll-call in small group sessions. Continue the sequence to an agreed number and then repeat in the opposite direction. P PHOTOCOPIABLE The Selective Mutism Resource Manual second edition Speechmark Publishing Ltd Maggie Johnson & Alison Wintgens, 2016 10 1b EXTENDED PARENT INTERVIEW form Continued FORM 1B Are there children living nearby of [N]s age? The other player has to make the same sequence, and keeps both sequences if they match. Let them know that they have a friend in you to turn to, if they are feeling upset. 15 Vowel sounds (eg a, e, i, ar, ee, oo). [A] now asks another question and [N] answers immediately or rings back. Key [P] = Parent or other talking partner (eg the childs sibling or school keyworker); [N] = Name of child or young person; [A] = new Adult. Reading aloud with questions R After reading out a short passage of text, the child answers one to four questions that can be answered by a single word found in the text. If [N] wants something, how does he/she get it? Each player draws a card containing questions with three possible answers, which they read out. This depends on age, eg: Children: link two or three sentences together in response to So tell me about or What happened? Young people: respond to one or more of [A]s statements, such as I saw Mike yesterday, with either a conversation filler, egDid you?, Really?; a question, egHow was he?; a reaction, eg Poor you!; ornew information, egI stayed in bed, So didI!. So the main obstacle for you is that most people have no idea that SM is a phobia and do all the things that make phobias worse. Tell Me Quiz (Rockets Toys, age 6 to adult) R,E The child answers a question, read to them by the adult, beginning with the letter they get when they spin the wheel. General points [N] separates from the parent willingly and is confident about collection arrangements; or can travel to/from school independently Apart from rare occasions, [N] smiles frequently (and genuinely not a fixed smile) and looks relaxed throughout the day The seating position allows [N] to observe other people and not feel scrutinised [N] eats lunch with his or her peers [N] uses the school toilet [N] is not given extra attention/privileges for silence/opting out (apart from the 1:1 support necessary to address needs and move forward) [N] is allowed to experience some disappointment/frustration as a result of not speaking (eg occasionally misses out) and maintains incentive to change Staff members have access to a support network for further information about selective mutism and as a sounding board for their ideas P PHOTOCOPIABLE The Selective Mutism Resource Manual second edition Speechmark Publishing Ltd Maggie Johnson & Alison Wintgens, 2016 2 A plan is in place to address [N]s speech anxiety, which has been agreed with student and parent(s) Date Review date FORM 13 Ensuring an anxiety-free environment for children and young people who have selective mutism Child or young persons name [N]:_______________________ Completed by:_______________________________________ Purpose: to help identify and eliminate possible causes of anxiety which could be adversely affecting [N]s self-esteem and progress in communication. Add noises to some of the actions, just in case the child who has SM feels comfortable enough to do those too. 4 We comfort young children when they are in pain and convey the message Stinging nettles, broken glass and fights are bad things that you need to avoid if you want to save yourself further pain; meanwhile, I will make you feel better. Each person is given items such as play bricks, cottonreels or dominoes to add to a growing tower. These programmes are usually implemented to enable children and young people to speak to an adult for the first time, but the voice message telephone programme may also be useful for speaking to other children. Social conventions are the hardest thing for children who have SM to accomplish and are not a priority. Add a plus sign for generalisation activities, eg 6+ = single-word activity with an extra person in group; 8+ = unplanned conversation. React when the young person speaks in public. Slow to dress or separate in the morning? If something never happens, leave that line blank. PairsI Spread out one set of cards is, face-down, on the table, and place an identical set face-down in a pile. The game includes a series of question cards andabell. The Selective Mutism Resource Manual Maggie Johnson & Alison Wintgens, 2016 APPENDIX B Goal The Voicemail route Tips Comfortable toleration of sustained voice or messages being heard through voicemail Children: repeat exchanging voicemail messages with [A] (eg simple question and answer, or guessing games) until [N] can do this comfortably. Its particularly hard on anxious children and young people who are desperate to get it right first time. Please indicate, by marking distinctively, any parts of the report which you would not like to be discussed with the family. If they have been silent with the same group of people for several years, a high score for 10 is common. /Width 262
15 THE INFORMAL SLIDING-IN TECHNIQUE A technique for parents and early years practitioners working with children who have selective mutism P PHOTOCOPIABLE The Selective Mutism Resource Manual second edition Speechmark Publishing Ltd Maggie Johnson & Alison Wintgens, 2016 493 15 The informal Sliding-in Technique Continued P PHOTOCOPIABLE The Selective Mutism Resource Manual second edition Speechmark Publishing Ltd Maggie Johnson & Alison Wintgens, 2016 2 HANDOUT 15 5 If [N] continues to talk, [A] slowly moves in to join [P] and [N], sitting at their table or on the floor, closer to [P] so that [N] does not feel too overwhelmed. Do parrots paint? Have you had any thoughts about a possible explanation? I will use the friendship bench if I feel lonely or upset and to be a good friend. The pieces of paper are folded up and put in the middle of the table or in a bag. That can have a devastating effect. (a) How are you getting on with: 6 (c) What would you like to be doing 5 years from now? SLTs have the clinical skills to engage individuals and take a full case history. The players describe famous names for their partner or team in a series of one-minute rounds, without giving any rhyming clues or saying the name on the card. Does [N] eat lunch with the other students? Note: Reassure [N] that noone else will hear and, if appropriate, follow this target by listening to the recording together. For best effect, the adult should deliberately make mistakes by following instructions literally. Different thoughts require a different focus when looking for ways to move forward. 10 Please state help or advice you would like from this service and any other suggestions you would like to make. Ask them which method they prefer for different activities. It is then the second players turn to request a card. 16 The Sliding-in Technique A technique for parents and staff working with school-aged children and young people who have selective mutism Steps 1 [P] or [A] explains to [N] that they know how hard it is for [N] to talk to new people. 6 ADDITIONAL ASSESSMENT AND HELP To what extent is the school Special Educational Needs Coordinator involved? Mentors can help by using the service themselves and writing down the available menu options or scripts that are used. If you are using school or clinic premises, arrange a quiet place and time for [P] and [N] to play, read or talk together uninterrupted, possibly over several sessions, as the Sliding-in Technique cannot start until [N] is comfortable talking to [P] in this setting using their normal speaking voice. All steps begin with a reading or turn-taking activity to get [N]s voice flowing. If the duration of )Tj
(No single cause has been found for selective mutism, but most sufferers display )'
Mrs Kane has related the questions to classroom topics, meaning that Jodie can respond during a relevant activity, rather than speaking only in designated reading sessions. [A] leaves the room while [N] records an agreed sound set by [A] or chosen by [N] from a choice of three to five sounds. Resources Selective Mutism Anxiety Research amp Treatment April 27th, 2019 - The SMart Center director Dr Elisa Shipon Blum Dr E pioneered early effective treatment approaches to . b) sleeping? Dimensions : 8.2 x 0.8 x 11.2 inches 69.9608 483.9729 TD
Likewise, [P] may accompany [N] to the next session but leave the session for longer periods. If no answer, F smiles and calmly moves on, saying something like I think it must be Licky because shes got a nice pink tongue or I expect Ill remember soon or How about I choose then?. Dwell on what the young person cant do. Some sessions were held during morning assembly, when most of the children were in the main hall, so that Sian could work in the empty classroom. Make hands-up, thumbs-up or eye contact and a nod generally acceptable at registration if the young person is struggling to answer. Say that they can start talking as soon as they feel ready but, until then, just have a good time! If the adult also nods or head shakes rather than speaks, a lot of natural eye contact will be generated. This can be done in one or several steps, depending on [A]s starting point. Choose sounds that can be described with one word initially (egcat, hammer), then gradually include sounds that could take the child to Stage7 (egbaby crying, dripping tap, man laughing). Picture version For non-readers, play this with two piles of pictures of body parts. A shared focus on completing a task will naturally generate talking points. Well talk to him as if hes always spoken. Some of us find it hard to speak when there are lots of people around. 1 TALKING TO THE CHILD ABOUT SPEECH ANXIETY Advice sheet for staff and parents of children who have selective mutism P PHOTOCOPIABLE The Selective Mutism Resource Manual second edition Speechmark Publishing Ltd Maggie Johnson & Alison Wintgens, 2016 453 WHAT IS SELECTIVE MUTISM? With decades of effective clinical experience of SM between them, the authors have . 0.0000 -13.4056 TD
What is his/her name? They show that children are having a go, trying hard and giving themselves and others the opportunity to learn. They must say Yes please or Nothank you and then take one for yourself. Little by Little by Amber Stewart (2008), Oxford University Press. Continue to support and monitor progress until the child speaks freely and independently. Once [N] is talking to [A], [A] enters [N]s room as they continue to talk. This could be a letter sound or an animal/transport sound, etc. What is your door number? 20 My brother or sister gets me to agree not to talk to other people or vice versa. Then everyone writes the next item, folds the paper over and repeats. But just believing they are possible is the best start you can make. A child stands in each corner of the hall or playground and runs on to the next child to pass the message on. Handout 10a Creating an anxiety-free environment for children who have selective mutism Handout 10b Creating an anxiety-free environment for young people who have selective mutism Establishing and generalising speech through small-steps programmes The principles of graded exposure. Ifthe child completes the gallows, the adult loses. Children who have selective mutism are no more likely to have been abused than any other child. Say that they can start talking as soon as they feel ready but, until then, there are plenty of other ways to get the best out of school, college or work life or their chosen activity. Turn up the volume Play games such as Alphabet Strings, Hangman and Battleships, sitting either back-to-back or on opposite sides of the room. Bossy? For example, option2 on UK TrainTracker goes to a National Rail customer service agent, or private train operators such as Virgin Telesales will ask very similar questions if [N] says they need to check a ticket price. The adult works through the pile, one picture at a time, and describes each one. 21 0 obj
I Say! You can help to bridge this gap by (a) having a private word with students to show that you understand and (b) avoiding situations which put unnecessary pressure on them to communicate in front of their peers. Repeat with [N] answering the phone and holding the handset throughout. 1 STRENGTHS AND DIFFICULTIES Tell me about some things that you enjoy or are going well Whats not going so well? Ideally, N will make the call at a prearranged time but may need a text prompt. He said [enter a question or comment]. Tell me about your parents? Treatment is likely to take the form of a behavioural programme designed to reduce the childs anxiety about speaking. Good job! Cant talk PRESSURE Increased anxiety from self, family, teachers and wider community Even harder to talk AVOIDANCE of specific situations PHOBIA cycle PANIC FREEZE Relief from anxiety (but increased dread of talking) Sadly, the longer you live with SM, the more it threatens to alter your self-image. Tell children about times you felt worried and considered backing out, but faced your fear and gave it a go or found a solution. This includes asking for help or clarification, seeking permission, using social greetings and making friends. P PHOTOCOPIABLE The Selective Mutism Resource Manual second edition Speechmark Publishing Ltd Maggie Johnson & Alison Wintgens, 2016 7 FORM 1B 6 SPEAKING PATTERN WITH DIFFERENT PEOPLE IN DIFFERENT SETTINGS communication. Give the young person a means of sharing good news and letting you know if anything has upset them, eg through email, a liaison book or a go-between. Repeat the recording and playback activities using letter names rather than sounds, eg M (em) rather than mm; T (tee) rather than t. By anchoring your fears to specific people (eg PANIC FREEZE Relief from anxiety (but increased dread of talking) Sadly, the longer you live with SM, the more it threatens to alter your self-image. HANDOUT 14 2 Smile Continued Check your face! How well does [N] understand the different languages spoken around him or her? However, if [N] is reporting low anxiety, it can help for [A] to join [N] sooner with the next group of activities and, from there, move quickly to Stages5 and 6. Review ET
If [N] professes to hate the sound of their voice, see Desensitisation using voice recordings in Chapter9 (page 157). Dwell on what the child cant do. Stage 5 Using voice to make sounds or read aloud The Stage 5 activities can be bypassed unless the child is using a shaping or reading approach to elicit speech. Put on a blindfold or simply shut your eyes and wait! By making activities simpler or shorter, providing a distraction or phasing out support, realistic expectations can be set and children can be assured that all they need is the courage to have a go. How often this happens J 05 L 3 It would be weird if I spoke at school now FORM 11 Name: Date: ASSESSMENT SUMMARY Parent interview carried out? If it is too ticklish on the palm, try the back of the hand, or trace the character on the persons back. Its natural to fall back on these modes of communication when children become silent but, unfortunately, these strategies actually strengthen fear of speaking. When [N] does particularly well and uses a louder voice, for example, feel free to give two stickers! The children receiving exposure therapy made a significant gain in functional speaking which was retained three months post-treatment; no significant gains were made by the control group.5 In a survey of 123 cases of SM treated by an SLT service, using behavioural techniques taken from The Selective Mutism Resource Manual,35 the techniques were effective in 91percent of cases, rising to over 96percent if both the SLT and the childs parent and/or school had attended a training day around programme planning and homeschool liaison.36 Small-steps intervention programmes must be delivered in the context of an overall approach to anxiety management SM is an anxiety disorder and failure to talk is the main behavioural symptom.1, 85 Treating this symptom with behavioural interventions can completely overcome communication difficulties, particularly if they are The Selective Mutism Resource Manual Maggie Johnson & Alison Wintgens, 2016 433 APPENDIX E implemented at an early age.35 However, individuals with SM are likely to have a genetically determined predisposition or vulnerability towards developing fears and anxiety disorders in general. document.write('
