By asking forced-choice questions and waiting patiently for verbal responses, we can often encourage a child with Selective Mutism (SM) to respond to questions from therapists, teachers, friends and community persons. However, how do we even begin to approach initiation goals? For many kids with SM these tasks are significantly harder. Whether it is offering a storekeeper a greeting, asking to use the restroom, inviting a friend to play a game, offering a compliment or asking a teacher for help, the communication can pose a much greater challenge. How do parents and professionals know when the time is right to introduce initiation tasks and what strategies to use?
Some signs your child may be ready to tackle this big step in his/her journey to overcome SM include; having great success with response tasks across several settings; using sentence-length answers when responding to questions; demonstrating confident interactions with several key communication partners. One way to feel more confident of his/her readiness is to ask for the child’s assistance in rating how hard a specific verbalization goal may be on a 1-5 scale (professionals call this a Subjective Units of Distress Scale or SUDS).
Working with the child to create a verbal script is one great way to start. Many children with SM will report that they “don’t know what to say.” Moreover, because many kids miss social skill practice opportunities due to SM or experience such high anxiety in public settings that they cannot focus on the social skills that are being modeled around them, this may be completely true. Creating verbal scripts can help the child feel more confident that they are doing it “right.” For example, a teacher who sees that the child is having trouble opening a lunch item may prompt, “If you need help, you could say, ‘Can you help me open this?'” and wait patiently for them to follow the script. When playing a board game with a neighbor, the parent may create a rule that all players must end their turn by telling the next player, “its your turn.” At first, the child may need another full prompt (e.g., “Remember to say ‘It’s your turn'”), a partial prompt (e.g., “Remember the new rule”), or even a nonverbal prompt (e.g., the neighbor waiting patiently to start their turn until they have been directed to do so).
However, ideally, adults will want to reduce their assistance over time so the child can complete the task with more independence. In a public practice, the therapist may ask the child, “Do you know what you want to say or would you like some examples?” to make sure the child has a script prepared. If not, they can offer several choices and give the child a minute to think about how he/she wants to say it. The child can construct his/her own sentence and is not reliant on the adult to create the script.
Another suggestion is to build momentum. One can start a brave practice with several response-oriented goals to build up bravery and confidence before introducing one final initiation goal. In practice, this may look like the child ordering a drink and meal items by responding to the employee’s questions before approaching the counter to ask for extra napkins. The fact that the child will be done with the practice as soon as he/she has met the initiation goal should also provide incentive for that child to accomplish this new goal. Offering double points toward an identified reward may also pique the child’s motivation.
It’s important to always have a Plan B. If the child reports that a given initiation goal (such as offering a compliment to a store employee) is too hard or finds himself/herself “frozen” when preparing for the practice, you can still work with the child to scaffold up to that important initiation goal. For instance, the parent could get the person’s attention and offer an initial com-pliment (e.g., “I like your shirt”) and the child could offer their compliment next (e.g., “I like your shirt too!”). In this way, the child still gets practice with the goal and will be more willing to try offering a compliment independently in the future. Each step, no matter how small, gets you closer to the end goal and promotes further success!
Katelyn Reed, MS, LLP
Board of Directors
Selective Mutism Association