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Expert Chat Session
End of the Year Planning for Children with Selective Mutism from March 16, 2011.
| Lmkoll | 20:53:58 | Hello and Welcome from SMG! |
| Lmkoll | 20:54:37 | We will wait a couple of more mintues for some others to join us! |
| djdeets | 21:01:31 | ok |
| Lmkoll | 21:02:33 | Let's go ahead and get started and hopefully a couple of others will be able to join us. |
| Lmkoll | 21:02:39 | # |
| Lmkoll | 21:02:58 | Welcome to our Expert Chat on End of the Year Planning Our expert for this evening is Dr. Vera Joffe |
| Lmkoll | 21:03:20 | Dr. Joffe has been treating Selective Mutism for many years. She has experienced the need to help parents learn about S.M., and also for them to have a tool to help their children’s teachers as well as other family members to read about and to understand that S.M. is a social-anxiety communication disorder# |
| Lmkoll | 21:03:38 | Along with her experience with kids who have SM, Dr. Joffe also has expertise in working with neurodevelopmental disorders, including ADHD, Tourette's Syndrome anxiety, mood disorders, Asperger's Syndrome, and other anxiety disorders such as Obsessive Compulsive Disorder, and Social Anxiety. # |
| Lmkoll | 21:04:01 | The rules for the chat room are posted on our website. To save time, I will not post all of them here tonight… just a couple of reminders: # |
| Lmkoll | 21:04:23 | Be respectful. Use a ‘!’ if you want to be called on or have a question. After you are done typing your thought, type a # so that everyone knows your thought is complete. Please do not advertise your business here without prior permission. |
| Lmkoll | 21:04:40 | Thank you, Dr. Joffe, for being our “expert” this evening. I am sure some of the attendees would like to know more about end of the year planning.# |
| djdeets | 21:04:59 | what is the best way to 'treat' a child with SM? # |
| smgexpert | 21:05:13 | Hello, everyone. This is Dr. Vera Joffe. I would like to find out the ages of your children, and for you to send me one question at a time regarding SM. I am glad to be part of the Expert Chat, also of the National Board of Directors of the SMG, and to have written a book from the point of view of a child with SM (Sophie's Story). Please, send me your questions, one at a time. Remember that I can only answer them in general. |
| smgexpert | 21:05:43 | Dear DJdeets: This is a very good question to start, and a BIG one. We are still in the beginning stages of developing research on what works best for SM |
| harrison | 21:06:05 | I have a son that is 7# |
| smgexpert | 21:06:11 | However, we know that SM is a social anxiety and communication disorder. So, we treat SM as we treat other anxiety conditions in children, and the best approach |
| djdeets | 21:06:14 | I am a special ed teacher working with a 3 1/2 yr old girl |
| smgexpert | 21:06:31 | is cognitive behavior therapy, as it works with other conditions of anxiety in children. |
| smgexpert | 21:06:53 | Good, we have a teacher (are you a parent as well of a child with SM?) and a parent of a child who is 7. I welcome your questions. smgexpert 21:07:10 If you need to know more about what "cognitive behavior therapy " means, please, ask me the questions. |
| harrison | 21:07:40 | We also have an aunt of the 7 year old, whom he still does not talk to# |
| smgexpert | 21:07:52 | Working with a 3 1/2 year old child who is in the beginning stages of socialization and schooling is a very good approach so that it works with prevention for suffering in kg and on. |
| djdeets | 21:07:58 | No I do not have a child with SM --I would just like to know as much as possible to help my student feel comfortable enough to speak in class # |
| djdeets | 21:08:24 | and YES I would like to learn more about Cognitive Behavior therapy also # |
| smgexpert | 21:08:32 | I like what you said: "feel comfortable": this is the first step in working with children with SM, NOT to tell them to speak, but to help them feel comfortable. |
| smgexpert | 21:09:04 | Let's see what "Harrison" wants to hear as well, and we can talk more about CB therapy. |
| djdeets | 21:10:01 | I've heard her speak to her cousin and grandma so I know she can talk ..she has difficulty making choices and often "shrugs" her shoulders# |
| smgexpert | 21:10:16 | This is the therapy that is proven to work with all kinds of anxiety in children and with adults. We need to look for professionals who are well versed in research in the area of anxiety in children and with S.M. as this kind of anxiety is very specific. I will give you referrences in the end on the topic. ok? |
| djdeets | 21:10:54 | great --thank you # |
| smgexpert | 21:10:55 | When is that? When does she have difficulties making choices? When she is "on the spot", when she is put in a position to "speak up quickly? |
| smgexpert | 21:12:03 | sometimes children with SM also have difficulty with "coming up with words" when under pressure of time whereas when they speak spontaneously, it is easier for them. We don't know what comes first, the anxiety, or the difficulty with fluency and with retrieving words fluently. So, we start the process of helping them feel more comfortable by approaching them |
| smgexpert | 21:12:21 | in a way that they don't have to respond to questions under pressure of time, and not under the "spot". |
| djdeets | 21:12:31 | choices about what "centers" she would like to go to or when she is given the choice to pick a library book. Choices are repeated and she is given time to think about where she wants to go. |
| smgexpert | 21:12:44 | Does it make sense? I would like to find out what "Harrison" would like to ask. |
| harrison | 21:13:12 | my son enjoys playing with his aunt, he started making noises to her, but not speaking yet. How do we move to the next step. we have tried pictionary, board games etc. # |
| smgexpert | 21:13:19 | I cannot speak for the specific case, but some children have a hard time making a choice: What's the best one? |
| smgexpert | 21:14:01 | Dear Harrison: Who does your son talk to? It's good that now he is making noises to your aunt. Making noises of animals, then noises that sound like objects |
| djdeets | 21:14:19 | How can I make it easier for her to make a choice ?? # |
| smgexpert | 21:14:30 | that maybe "guessing games" with noises would be great. The fact that he makes noises is already good because he is not afraid to let her hear him. |
| harrison | 21:15:10 | one set of grandparents, some adult friends, teacher, 3 of his classmates only# |
| djdeets | 21:15:23 | Will harrison speak in pretend play --dollhouse or puppets ? I find my student speaks when she is role playing in the dollhouse . # |
| smgexpert | 21:15:27 | Now, the next step will be to make approximations to noises for "functions", for instance. Guess what I am thinking of: and start making a noise of something that is in the room, etc. Say some sounds, or the beginning sounds of an object, etc. Always an approximation to the end, to make the sound of a word. |
| smgexpert | 21:16:17 | I am glad that your son speaks with his teacher, and with some of his classmates. I would invite other classmates to the house. Also, does your son speak with the teacher in front of other kids? This would be another step. |
| smgexpert | 21:16:53 | I am sorry I was off the chat for a second |
| harrison | 21:17:01 | I know with my son, sometimes he has a difficult time making choices because he doesn't know what to expect from the person# |
| smgexpert | 21:18:02 | What the two of you are saying is very accurate, as it relates to ANXIETy. Children with SM, some of them, or most of them, have a perfectionistic approach to everything. So, they go like this: "is this better? no, this is better, but what if I choose this?" |
| harrison | 21:18:06 | We have friends come over and play but I'm finding it takes longer for him to talk and we have tried charts but it does not work.# |
| harrison | 21:19:03 | He does talk to the teacher but mostly in whispers when the other children are around but will talk to the teacher in normal voice when they are alone# |
| djdeets | 21:19:26 | My student also whispers to me # |
| Lmkoll | 21:20:27 | Dr. Joffe is experiencing some technical difficulties, she is in the process of logging back on. |
| harrison | 21:20:39 | Sometimes it works when I use a walkie talkie with his friend but not always. Once he starts talking he is fine. It is getting him to speak the first word that is hard.# |
| Lmkoll | 21:22:12 | Thank you for your patience. Hopefully it'll just be another minute. |
| smgexpert | 21:22:13 | I am sorry I went of line. Dear Harrison: When you say: Charts, what do you mean? Behavioral charts? ALso, since your son |
| smgexpert | 21:22:42 | is in school already, I would like to know if you have a 504, or an IEP for your son, and how he does with testing, etc. |
| harrison | 21:22:52 | reward chart# |
| smgexpert | 21:22:56 | Is the teacher able to test him, and to evaluate him? |
| harrison | 21:23:50 | Yes. We do have a 504 plan but have not had to use it. He is fine with testing. # |
| smgexpert | 21:24:08 | And let me tell you that the fact that your son talks to his teacher, and to the children (whispers) is already a good sign in the "bridge of communication" (as mentioned by Dr. S. Bloom). So, sometimes, the teacher can act like a little "silly" (white lie) and say: I have an ear ache today, and I am congested, I can't hear you. |
| smgexpert | 21:24:40 | Little by little, the teacher (and you, dear Preschool teacher who is on line as well) can stay further away from the child, and he will get used to projecting his voice more |
| smgexpert | 21:24:49 | What do you think? |
| smgexpert | 21:25:09 | HOw is the preschool and your child, Harrison, in playground, in PE, and at lunch? |
| smgexpert | 21:25:20 | I often say to school officials that ALL involved with the child need to know about SM |
| smgexpert | 21:25:35 | Some children do not get lunch, or ice cream (on Fridays" because they are afraid to ask |
| smgexpert | 21:26:08 | Also, another aspect is bathroom and when the child is hurt: they have to be able to communicate to someone on these two occasions. I am glad that your child, Harrison, can talk to the teacher. |
| smgexpert | 21:26:30 | And your child, the preschooler, can slowly learn to become more independent to do those things as well. |
| smgexpert | 21:27:02 | I have to take a minute to congratulate a teacher who is concerned about her student, and the parents must be very lucky to have you as a teacher. |
| smgexpert | 21:27:20 | Education of teachers and of medical professionals is really important. Please, refer them to our website. |
| smgexpert | 21:27:41 | Do you live close to a center or professionals who are experienced in the area? |
| smgexpert | 21:28:09 | I am glad that your son, Harrison, has a 504. It is important to look not only at the academic areas, but also at the social, emotional, and physical areas as well. |
| harrison | 21:28:11 | in PE, he loves running around, at lunch he sits with the one boy he talks to, when that boy is not around he mimes his answers to other children, the other children find it difficult to communicate to him# |
| smgexpert | 21:28:36 | All of this is good, but it would help to find out who these other children are |
| harrison | 21:28:38 | My son has had trouble writing I think because he does not know what the teacher would like from him or he is afraid of letting them know his thoughts. In the beginning he would not write anything, but when the teacher says that he needs to and it will affect his grade, he would then try to write something. # |
| smgexpert | 21:28:58 | who sit next to him so that you can invite them over to get more comfortable with them in his own environment. |
| smgexpert | 21:29:29 | I think that his anxiety is not only with SM, but it looks like more of a general anxiety that he experiences, with wanting to be perfect with all |
| djdeets | 21:29:46 | I am a special ed teacher who sees the student "J" in her classroom ..( they call it a seit teacher in NY --I dont know where you are located ) # |
| smgexpert | 21:30:18 | Although I cannot diagnose, but it sounds like a more general anxiety is affecting him academically as well. I have developed some strategies with other children who will not write during writing class due to the same reason. They fight their anxiety, and feel good about it. |
| harrison | 21:30:18 | We have invited a few boys and a few girls over and some will ignore him or they get bored because he does not talk to them and others it does not bother and they just keep on playing# |
| smgexpert | 21:31:08 | I would say: FInd an activity that will require less talking more interaction (such as more physical, like going to Chuckie Cheese, or a sport place for kids), something he is good at |
| djdeets | 21:31:17 | I am just trying to learn what else I can do for her . I use the "earache" line and also the " I cant hear anything because the other children are too loud " etc... tricks . Sometimes they work and sometimes she just "shrugs " her shoulders. # |
| smgexpert | 21:31:20 | and that would be good for the other child as well. I would not invite two at a time, |
| smgexpert | 21:31:27 | but one at a time. |
| smgexpert | 21:32:07 | For DJDEETS: I would not ask her to make so many choices, and I would just make a "menu" of her activities so that she will feel more comfortable and not freeze because of it. |
| harrison | 21:32:17 | Yes, we only invite one child at a time# |
| smgexpert | 21:32:25 | Then, I would start helping her make choices, once she feels more comfortable. |
| smgexpert | 21:32:59 | That's good. What does your son like to do? I would not do the computer games (they are bad), but something outside, outdoors, that is active, and that the other child would like |
| harrison | 21:33:38 | He does enjoy going other children's home also, even if he does not talk to them# |
| smgexpert | 21:33:45 | I have written a book on SM from the point of view of the child, and in the end I explain to parents and to teachers: the way to start the slow approximations is to find three elements: PLACE, PERSON, and ACTIVITY |
| djdeets | 21:33:46 | some days she will point to the center ( art, writing, kitchen etc...Should we accept the pointing or make her verbalize the center ? |
| smgexpert | 21:34:27 | So, you start with the most comfortable, and then play around with the three elements the are above. So, at home he is more comfortable, so invite a kid over, then find the activity that he loves the most. Can you tell me some examples? |
| harrison | 21:34:30 | He loves running around and most times he is up to playing what ever the other children are playing# |
| smgexpert | 21:35:03 | I would certainly let him go to the other children's house. But the parents need to know that he is not being rude when he does not speak. |
| smgexpert | 21:35:26 | And I would want to know that you know that parents well because your child does not know how to defend himself as much due to the anxiety and SM. |
| smgexpert | 21:36:29 | If your student verbalizes to you, then she can tell you which center to go. HOwever, I think that you should start with not giving her too much choice of which one (as she is anxious with that), so concentrate in helping her feel less anxious with CHOICES, and give her directions of where to go, and then interact with her verbally when she is at the centers as well |
| smgexpert | 21:36:49 | Some young children need directions, and feel overwhelmed if they have too many choices at the preschool age. |
| harrison | 21:36:59 | Yes that is a good ideat about getting to know other parents.# |
| smgexpert | 21:38:06 | Does your student have sensory integration difficulties with sound, touch, and place? It sounds like she needs directions, and sometimes children with some of the above difficulties may have either gross motor coordination, visual processing, etc, and they may feel overwhelmed, and not know where to go. |
| smgexpert | 21:38:38 | THis is not the case for all children with SM, and all children with anxiety. EVERY CHILD IS A SNOW FLAKE, as somebody said once. So, we need to take a look at every child at a time. |
| smgexpert | 21:38:58 | Does it make sense to all of you? Lisa, please, your input is also welcome, and thank you for being in this chat. |
| djdeets | 21:39:02 | She will also NOT ask for supplies , ( paper, glue , pencil etc ) Sometimes we purposely leave out an item to see if she will tell the teacher she needs something .... Is that a good idea or is that too much pressure ??# |
| harrison | 21:39:43 | My son was tested and got into the gifted program at school. This has been the second week he has been going. So I have not heard from the teacher yet about his progress from the gifted teacher.# |
| smgexpert | 21:39:57 | I think it is. However, we need to pick our battles. Putting "barriers" is good IF THE CHILD IS ALREADY comfortable in a situation. |
| smgexpert | 21:40:08 | Dear Harrison: Are you saying that your son changed classes? |
| smgexpert | 21:40:19 | So, he should have an IEP by now. |
| smgexpert | 21:40:52 | I hope that the teache knows that he has SM |
| harrison | 21:41:11 | He changes class for math (the gifted program), the class has a different teacher for music, art and pe# |
| smgexpert | 21:41:21 | and she/he should communicate with the previous ones. |
| smgexpert | 21:41:28 | So, the math is the gifted program? |
| smgexpert | 21:41:33 | Is he happy about that? |
| harrison | 21:42:01 | Yes, the gifted teacher is aware of it, but I do not think that the other teacher are aware.# |
| smgexpert | 21:42:06 | I am for parents being "proactive" and talking to teachers before, I am for prevention, etc. You can see that from what I write and advocate for |
| smgexpert | 21:42:21 | More reason to have a MEETING with ALL the teachers. The 504 meeting should have included all the teachers. |
| smgexpert | 21:42:50 | Also, if he qualified for gifted, he should go from a 504 to an IEP (for gifted eligibility) and then include the SM in the IEP |
| harrison | 21:42:52 | He was very happy about it. When he was going to take the test we told him and he was excited. # |
| smgexpert | 21:43:01 | This is really important. |
| smgexpert | 21:43:15 | I think this is a great step, and in Math it will be easier for him. |
| harrison | 21:43:29 | I am not sure what an IEP is# |
| smgexpert | 21:43:37 | I would go to school and ask for a meeting with ALL the teachers (do not forget pe, art, and caffeteria as well see above). |
| smgexpert | 21:43:54 | Individualized Educational Plan: when a child qualifies for gifted program |
| smgexpert | 21:44:09 | he is in need of "special education", and he needs to have a different curriculum |
| smgexpert | 21:44:27 | for him. Make sure that this is all documented so that he will qualify for gifted for the rest of his schooling life |
| harrison | 21:44:58 | ok# |
| smgexpert | 21:45:02 | this is important, and you can read more about it in our website (e library), and you can also go to other sites that discuss this a lot, such as CHADD.org (this is for ADHD< but there are many resource about IEP). |
| smgexpert | 21:45:16 | He may make friends in that gifted class that are more like him |
| smgexpert | 21:45:27 | Did you sign your son's IEP? A document? |
| smgexpert | 21:45:54 | You can go to our website after this, and look at the information on the elibrary, and print it out, read it, and go to school and ask for a meeting with all the teachers. |
| harrison | 21:45:57 | Two of the children in that class he is talking to. Another one is on his baseball team.# |
| smgexpert | 21:46:23 | Parents are the best advocates for their kids. Once you know about it, you can teach others. |
| smgexpert | 21:46:29 | How is the preschool teacher doing? |
| djdeets | 21:46:40 | Should I use the phrase " use your words" to encourage speaking to other children ?# |
| smgexpert | 21:46:41 | I wish that the parents of that child would be here on tonight as well. |
| harrison | 21:46:42 | I only signed his 504 plan. and the gifted class documents# |
| djdeets | 21:47:11 | I suggested that they chat --I dont know what happened ?? I wish they were on too ..... |
| smgexpert | 21:48:03 | I would do more of "using humor, acting, doing silly things", and having some time alone with the child, you, and another child. The other day, I just suggested for a KG teacher to have lunch with the child with SM, and with another child They started getting silly making up and doing mimic of funny things. Suddenly, the child was talking to the teacher, and to the other child. |
| djdeets | 21:48:32 | She is very different at home but in large family settings she withdraws just like in school . |
| smgexpert | 21:48:47 | Situations that do not focus the child "using her own words", especially with a preschooler, can work really well: using humor, unpredictable things, being silly, and, for both of you (also Harrison):making mistakes. |
| djdeets | 21:48:59 | She does "loosen" up when I act silly. |
| smgexpert | 21:49:08 | This is why you need to start slowly and with smaller groups of people and children. |
| harrison | 21:49:21 | My son's kindergarden teacher did that, and he was able to whisper to all the children. But was not able to talk in front of the class# |
| smgexpert | 21:49:53 | You see, when teachers and parents show that making mistakes is just part of life, and when they laugh about it, you are making and giving a model that this is just how life is. As a matter of fact, in my office the word "PERFECT" is not allowed. |
| smgexpert | 21:50:23 | Well,here again, one step at a time, and never stopping, Makes sense? |
| djdeets | 21:50:24 | Right now her aunt in the classroom teacher, her cousin is in the class ( she talks to him but only him ) but I AM WORRIED ABOUT NEXT YEAR WHEN SHE MAY NOT FEEL COMFORTABLE WITHOUT HER AUNT AS THE TEACHER ???# |
| smgexpert | 21:50:50 | Are you her aunt? |
| djdeets | 21:51:04 | And I am also concerned with regression over the summer . |
| harrison | 21:51:04 | Both of my children and my husband are perfectionist# |
| harrison | 21:51:11 | she's beside me# |
| smgexpert | 21:51:11 | Now: you are anxious... what are we going to do (using humor) |
| smgexpert | 21:51:23 | THis is actually the topic of this chat: next year. |
| djdeets | 21:51:27 | No I am not her aunt --just a concerned special ed teacher . |
| smgexpert | 21:51:40 | I recommend to expose the child to the next year's teacher before this end of the year. Can you do that? |
| djdeets | 21:52:33 | yes --I know that is the topic --She knows the teacher for next year . I just dont know if she realizes that will be her teacher for the 4 yr old program. |
| smgexpert | 21:52:52 | THe apple does not fall far from the tree. Anxiety is probably 80% genetic. So, we work with parents and with children. This is why it is so important to work together with parents, because parents become afraid that their kids cannot handle "facing their fear", and they do not go with "program". So, we, psychologists and mental health workers, work with parents as well. |
| Lmkoll | 21:53:12 | We have about 10 minutes left. |
| harrison | 21:53:20 | I found it helped alot having playdates outside the school and I kept up the friendships even after the school year was over# |
| djdeets | 21:54:07 | I have suggested for the parents to have playdates but it is difficult for them and work schedules. |
| harrison | 21:54:26 | And having another child from the previous year in the same class helped# |
| smgexpert | 21:54:32 | This helps. FOr the summer, make sure your kids are involved with other children who will be with them at school as well. And, the week before they start school, start with the routine, and maybe they can meet their teacher. For your son, it may help to find out if he will be with the same gifted teacher in math> it's important to find someone |
| smgexpert | 21:54:46 | that they can relate to and feel comfortable that will be there next year. |
| smgexpert | 21:55:03 | Also, knowing that one of their best friends will be in the same class would help. this is hard to ask in public schools |
| harrison | 21:55:16 | Even weekend playdate for an hour or so would help her.# |
| smgexpert | 21:55:17 | but it could be part of the IEP or 504 |
| smgexpert | 21:55:43 | Yes, everything helps in exposing your child in various places, situations, activities and people. |
| harrison | 21:55:54 | Yes I do have that in the 504 plan.# |
| djdeets | 21:56:13 | How can I encourage my student to get her needs met . ( not letting other children take the toy she was using , requesting to use the bathroom , asking for supplies etc.) |
| smgexpert | 21:56:33 | I have written a couple of articles in my website on prevention and planning for summer and for next year. Please, go to www.verajoffe.com for more information. You can also email me with questions, if you wish.INcluding on Cognitive Behavior Therapy (I explain that also) |
| djdeets | 21:57:15 | cognitive behavior is on website??? # |
| smgexpert | 21:57:15 | One step at a time: choose one first step for her to advocate for herself then take another one. Start from the easier to the harder one. the most functional to the harder one. |
| harrison | 21:57:34 | Yes. My son will let other people go in front of him or other children will take advantage of him because he will not speak up# |
| smgexpert | 21:57:40 | I am very happy that we had a chance to talk tonight. |
| harrison | 21:58:51 | thank-you |
| Lmkoll | 21:58:51 | DJDeets, you may also be interested in the book the Ideal Classroom Setting for the SM Child. It can be found on line in our bookstore and has a lot of additional helpful ideas for teachers. Here is the link: harrison 21:58:56 Thank you for all the info# |
| Lmkoll | 21:58:57 | Thank you, Dr. Joffe, for being our “expert” this evening. I am sure some of the attendees would like to know more about end of the year planning. |
| smgexpert | 21:58:58 | Harrison This is more reason to help him more intensively with being assertive, even with his"eyes". CHildren with SM and with Social Anxiety often get bullied, and he is still 7 and I recommend a very structured, and a lot of intense play dates, frequent ones, and to offer to help him when he has kids at home: on how to become more assertive. We use language for that |
| djdeets | 21:59:53 | Thank you for all your advice . I am going to the website now :) |
| Lmkoll | 21:59:56 | Here is the link DJDeets:http://www.selectivemutism.org/resources/bookstore-member/the-ideal-classroom-setting-for-the-selectively-mute-child |
| smgexpert | 22:00:01 | If you have further questions you are welcome to email us. Please, make sure you attend other chats, and we will put them in the website in the next two weeks. |
| smgexpert | 22:00:20 | Thank you all. |
| harrison | 22:00:45 | We have that book and we give a copy to the teachers every year# |
| smgexpert | 22:00:53 | Do you have any closing comments? Was this helpful? Such a short time. I learned a lot from all of you Thank you, Vera Joffe, Ph.D. (www.verajoffe.com) |
| harrison | 22:02:06 | It was very helpful. You gave me further insight in his anxiety of making mistakes. Thank-you# |
| Lmkoll | 22:02:16 | Thank you SMG members for being part of our community. We welcome your feedback and questions. Please contact us if you need anything further. Our next chat will be posted within approximately two weeks. |