Selective Mutism: Rapport Building in the Classroom

As a Speech-Language Pathologist, you might be the first person to raise a red flag when the teacher mentions a student that has not uttered a single word the first month of school. A psychologist or psychiatrist will be the specialist to complete a battery of assessments to confirm the diagnoses, but then what should we do? How can you advocate for this child as they navigate the school environment with this debilitating diagnosis?

The American Speech-Language-Hearing Association describes Selective Mutism (SM) as an anxiety disorder in which a child does not speak in certain settings or to certain people, but the child is able to speak with ease when in other settings and/or situations. The most common setting for children with SM to experience difficulty is during school. While treatment largely falls within the scope of a clinical psychologist, some children with SM have a co-occurring speech and language disorder and it is important to be able to advocate for these children.

Below are some of the strategies adapted from Child’s Mind Institute that educators report being helpful when interacting with a student diagnosed with SM:

• Nonverbal Communication: If the child is able to use gestures and hand signals (pointing, nodding, and thumbs up/down), nonverbal communication is a great way to help kids participate in class. The goal is for the student to eventually move beyond relying only on nonverbal communication, but in the meantime, it is still an effective way for him/her to get their needs met and for you to show the student that their participation is valued.
• Pairing with a Friend: If a child has a particular friend that he/she is already verbal with, arranging for them to sit next to each other may decrease inhibition and increase the chance the child with SM will speak up.
• Focus on Interests: Students may feel more confident when topics of interest are being discussed. Be sure to work with the student’s caregiver to determine what might interest their child and work to incorporate identified interests in small group work or during one-on-one interactions with the student.
• Small Groups: Using small groups to complete a task can be beneficial in that a student diagnosed with SM may feel less anxiety and more open to sharing information and thoughts with peers in a small group setting rather than in front of the class.
• Fading Yes/No Questions: As rapport is established, the teacher can begin to fade yes/no questions and begin encouraging verbal responses by asking forced-choice questions (e.g., “Do you want to use a pen or a pencil?”, “Do you want to sit by the window or at your desk?”). The final goal is for the student to eventually feel comfortable answering open-ended questions (e.g., “What do you think about…”).

Speech-Language Pathologists have a role to play in being an advocate for students who are unable to communicate effectively. SLPs are in an excellent position to coordinate intervention for children who carry a diagnosis of SM because of our knowledge and skills in skilled communication therapy.

Author: Julianne Evelti

Additional Resources:

Selective Mutism. (n.d.). Retrieved September 6, 2018, from http://www.asha.org/Practice-Portal/Clinical-Topics/Selective-Mutism/

Teachers Guide to Selective Mutism. (n.d.). Retrieved September 6, 2018, from https://childmind.org/guide/teachers-guide-to-selective-mutism/