The Selective Mutism Treatment Guide: Manuals for Parents Teachers and Therapists. Second Edition: Still waters run deep by Ruth Perednik

Author:Ruth Perednik [Perednik, Ruth]
Language: eng
Format: epub
Published: 2018-10-01T04:00:00+00:00

Stage 3: School-Based with Therapist and Friends/Teachers

Once the child is comfortable speaking to the therapist alone in the therapy room in school or kindergarten, the next variable to change is the people present in the room, usually starting by including peers in the sessions. At the beginning of therapy, the parents were encouraged to invite the child’s friends to their home and to ensure that pleasant activities took place during these play-dates. Now with input from the teacher, the parents, and the child, the therapist determines who are the child’s best friends and with which friends he speaks at home and at school. If he speaks with certain classmates at home or in school, these should be the first ones to join in the therapy sessions. Permission must be requested from the parents of the children to be added to the sessions, as well as from the teacher.

A similar process occurs in this stage to that outlined in Stages 1 and 2. The therapist invites children to join the sessions, changing one variable at a time so that the games are similar, but an extra person is added. Once the child speaks with the therapist and one child, another child is added. To illustrate this process, here follow postulated Stage 3 sessions.

Session 3-i

Location: School therapy room

Aim: Child should speak to therapist and classmate in therapy room.

A classmate is invited to join in the session. It is preferable that this is a child with whom the child speaks at home and whose company the child enjoys. The plan in this session is to go from taped speech, to whispered speech, to rote speech, to spontaneous speech. Here again, the child may pass through all these stages in one session, or several sessions may be required.

Activities: It is advisable that the session begins with playing a video, WhatsApp voice message or iPad game featuring the voice of the child that has been used in previous sessions. In this way, his voice will immediately be present in the room. The next activity could be Chinese whispers, where the child with SM is always the middle child so that he only has to whisper and not say the word out loud. The next activity could be a game employing sounds or rote speech out loud,such as throwing a ball and saying your name as you throw it. The following activity could be playing happy families where a certain card must be asked for.

Some children will not progress through more than one of these stages in the first session, and others will go through to spontaneous speech with the classmate in one session. If the child stalls at one of these activities, it is a sign that he may require a few sessions to get through all the stages. In this case, the pace must be slowed so that the child may have one session in which a tape of his voice is heard and simultaneously engage in games in which nonverbal communication is called for.

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