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Ask The Doc Archives

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If you've reviewed our archives and have not found the answers you need, we encourage you to submit an "Ask the Doc" question. Please keep your question brief, providing only the background information that is needed to answer your question. We reserve the right to post all questions and answers on the website unless you request that your question not be published. Please note that all identifying information will be removed prior to posting. Please remember that "Ask the Doc" is not a substitute for therapy and that individualized treatment questions cannot be answered. You should receive a reply by e-mail within three weeks.
Sections
  1. Diagnosing Selective Mutism
  2. Nature of SM / Not Manipulation
  3. Treatment Strategies
  4. Handling Comments from Peers / Others
  5. Co-Diagnoses / Comorbidities
  6. Establishing Treatment
  7. Medication
  8. Weaning Off Medication
  9. School Placement
  10. School Interventions
  11. Pressuring To Speak
  12. SM and Everyday "Stuff"
  13. Soiling / Wetting / Toilet Training
  14. Older Children, Teens And Adults
Diagnosing Selective Mutism View section in full
  1. Do you recommend Meds for my daughter?
  2. Does my daughter have SM?
  3. Is it typical for a SM child to outwardly appear happy?
  4. Should we seek professional help?
  5. Where do we start in helping my daughter through this?
Nature of SM / Not Manipulation View section in full
  1. Do we just not focus on her behavior and hope that she'll get past it?
  2. Do you think this is a power struggle with her anxiety?
  3. How can we build up his self esteem and confidence?
  4. Should we hold our son back for another year?
  5. What can you tell me to help me understand?
  6. Will medication help my daughter talk?
Treatment Strategies View section in full
  1. Could you tell us where to go from here?
  2. How do I know when it's time for medication?
  3. Should I go to a therapist who has experience with SM?
  4. Should we pursue a different therapist?
  5. What do you suggest if she doesn't like the sound of her voice?
  6. Where do we turn for help?
  7. Will her SM manifest into something else?
Handling Comments from Peers / Others View section in full
  1. How do we handle situations where she is with us and expected to speak?
  2. Should I intervene and answer questions for her?
Co-Diagnoses / Comorbidities View section in full
  1. Do other anxieties typically develop with SM?
  2. How can a child with a diability get out of the whisper mode?
  3. How do we ease the transition to school?
  4. Is decreased muscle tone associated with SM?
  5. Is it common that she won't answer open-end questions even to her parents?
  6. Is self mutilation a condition of SM?
  7. Is this seratonin deficiency inherited?
  8. Should we address her speech and language disorders, or SM first?
  9. When it is autism and when it is not?
  10. Will the anxiety resolve itself slowly as she gets older?
  11. Would Paxil be more effective than Prozac for my son with SM and OCD?
  12. Would you suggest an occupational therapist for treating SM?
Establishing Treatment View section in full
  1. Do language barriers play a role in her confidence?
  2. Do you feel we are doing all we can do for our child?
  3. How are these therapy tactics transferred to the classroom?
  4. How do we reduce her anxiety so she'll speak in kindergarten?
  5. How often and by how much do we increase the dose?
  6. Is the audio feedforward technique worth trying?
  7. Should I expose my daughter to fear?
  8. Should I let her fall asleep with me to alleviate her fears at night?
  9. Should I question my child when he tells me he spoke?
  10. Should our pediatrician be working with us?
  11. Should she be aware of the goal of therapy with the psychologist?
  12. Should we create goals to get her to speak?
  13. Should we hold our kindergartener back?
  14. Should we seek psychological help?
  15. Why does my daughter speak louder when the teacher leaves the room?
  16. Will she keep improving slowly, or should I seek professional help?
  17. Would it be beneficial to bring my son to your center in PA?
Medication View section in full
  1. Are there cases of children under 3 who've been successfully treated with medication?
  2. Are there specific guidelines for giving medication that we should know?
  3. Are you an advocate of medication, and what kinds?
  4. Do you recommend medication after we've tried everyting else?
  5. Do you think medication is a beneficial part of the treatment?
  6. Do you think this is too much medication for my little girl?
  7. Have you ever heard of the use of Zyprexa in children with anxiety or SM?
  8. Have you ever used Xanax in treating SM?
  9. How long should my daughter be on medication?
  10. How long should we let this problem progress before trying meds?
  11. If medication acts as a disinhibitor, what happens when she's off of them?
  12. Is a drug like Paxil dangerous while a child is still in development?
  13. Is there a model to help parents see medication as a treatment option?
  14. Is there a way, without medication, that she can progress on her own initiative?
  15. Is there an average dosage of medication for a child of 4?
  16. Is there any connection between a brain deficiency and SM?
  17. Is this a strong enough dosage to do any good?
  18. Is this dosage ok, and how long should we keep her on it?
  19. Is this too high of a dosage to start at?
  20. Should I start her on medication, even though I am seeing positive improvement?
  21. Should we go back to Prozac after trying other medications?
  22. What are the differences between Prozak and Zoloft?
  23. What are the short and long-term side effects with Prozac?
  24. What are your thoughts about using St. John's Wort in treating SM?
  25. What has been your experience with Celexa?
  26. What is the highest dose you would recommend for my 8 year old?
  27. What meds do you suggest, and what are the short and long-term side effects?
  28. What signals/milestones we should look at before considering medication?
  29. Which medication should we consider?
  30. Why is Prozac effective for some but not others?
Weaning Off Medication View section in full
  1. Is it appropriate to decrease medication?
School Placement View section in full
  1. Do you feel children with SM should be in special Ed?
  2. Do you have any advice to a homeschooling parent of a SM child?
  3. How should we address SM with our son who has skipped a grade?
  4. Is it a good idea for a relative to teach my SM daughter?
  5. Is it too early to send my daughter to school?
  6. Should a gifted SM child be with a nurturing teacher or his intellectual peers?
  7. Should we consider a Montessori school for our daughter?
  8. What are your thoughts on Montessori vs. a public classroom setting?
  9. Would you recommend a small private preschool or a public school at this point?
  10. Would you suggest the EMT process or retention for my daughter with SM?
School Interventions View section in full
  1. Are there common behavioral patterns amongst SM children other than not speaking?
  2. Is videotaping in school a good practice?
  3. Is whispering a common behavior of an SM child?
  4. Should I intervene in situations where she struggles to avoid a setback?
  5. Should my daughter be separated from the only girl she can comfortably talk to?
Pressuring To Speak View section in full
  1. Do we need to put some pressure on our daughter or consider meds?
  2. How can we help our daughter feel comfortable speaking around us?
  3. How do you use rewards and encouragement without increasing the "pressure" to talk?
  4. Should I consider a therapist who isn't skilled in treating SM, but eager to learn about it?
  5. What are the next steps for my SM son who still struggles with SM?
  6. Who can you recommend in the Cleveland area who really understands SM?
  7. Will talking about speaking create pressure or anxiety in SM child?
SM and Everyday "Stuff" View section in full
  1. Would you recommend a sleep away camp for my daughter with SM?
Soiling / Wetting / Toilet Training View section in full
  1. Does my daughter's toilet training issue affect her SM treatment?
  2. Is his bedwetting related to SM?
  3. Is there evidence of tricyclic antidepressants being successful in treating SM?
  4. Should we talk with our son about his severe SM, or not make an issue of it?
  5. Should we try behavior therapy before addressing the toilet training issue?
Older Children, Teens And Adults View section in full
  1. Have you ever used or are you familiar with CES or EMDR for treatment of anxiety disorders?
  2. How can I help my teenage daughter who has social difficulty in high school?
  3. What do you think is the best treatment plan for my 14 year old son?
  4. What is the difference between child SM and adult SM?
  5. What success rate is given to treating teens with SM?
  6. What treatment is available for a teen who has great difficulty expressing her needs to anyone?