My son is 7 and in first grade. He is taking 7.5 mg of Lexapro and does play therapy 2x/week but has not yet spoken to his therapist. He only whispers to one boy in school and doesn’t participate in gym, recess, library, etc. He is extremely gifted and is reading at the sixth grade level and has been doing multiplication and division since he was 4. We are trying to determine the best teacher for him for second grade. Our school cluster groups the gifted children. There is a really sweet, caring, kind teacher who everyone says would be perfect for my son. However, the gifted cluster would be with a different teacher, one who pushes harder academically. My concern is that my son has always viewed himself as being quite different from his peers. In your opinion, is it better for a gifted SM child to be with a caring, nurturing teacher or with his intellectual peers? How much does it add to his anxiety to not be placed with intellectual peers? Also, the friend that he does speak to will not be placed with him next year as he needs a different type of teacher.

What do you think of Lexapro? We will probably increase the dose or switch meds at the next appt. since we haven’t seen much progress. I would really appreciate your opinion. Thank you.


I am glad you are actively seeking treatment. However, you mentioned your son is in play therapy. The question I ask is: What is the therapist doing to help your son progress communicatively? Play therapy is fine assuming your therapist is helping your son progress from nonverbal–> verbal communication and understanding your son’s anxiety in various settings. i.e, when he is in school, can he respond comfortably via pointing/nodding to his teacher one on one? In a group? With a few children? Can he initiate his needs nonverbally? i.e, Can he go up to his teacher and indicate his need without feeling anxious? How is he transferring speaking from one person to another? Can he give his order in a restaurant, can he make a phone call or answer a call? IF you are not sure of these answers of how your therapist is progressing your son, you need to talk with him/her. She should be informing the school with you as to how to help your son in school. Working in an office setting playing games to feel relaxed is fine assuming the goal is to progress outside, in the real world. Your therapist, teachers, and you need to work together to help your son. It can’t be done independently.

In other words, what is classic for SM is that a child’s anxiety changes from one setting to the next and from person to person. I your son is speaking or not speaking to your therapist is not a measure of progress. What is, is how he is improving communicatively out of the office.

The teacher can make or break a school year in terms of communication comfort. Having a teacher who understands SM and that there will be times of more and less anxiety, and how to help your son feel less anxious as well as to be able to read your son’s body language is important. Understanding that his inability to communicate one day is a reflection of anxiety and not defiance or control is important as well.

In terms of teacher selection and gifted placement is whether or not your son wants this. Many children feel confident and safe with their academics and stifling them academically does not help them…some need that stimulation and want it. Other children are not so interested and would rather be with their friends and are not that motivated. There are many ways between now and then to build comfort with peers who would be in his gifted class. This relates to what I was saying earlier. Work needs to be done via IEP or 504 Plan or without any plan, but with accommodations to help your son build social comfort and progress communicatively with other children. Again, this is crucial.

Also understanding that some SM children, despite giftedness, may still have difficulty finishing, completing assignments in class, may need extra time for testing..will hesitate and have trouble ‘thinking’ in class. If this is the case with your son, then pushing him ahead into a more challenging curriculum may not be in his best interest. If he has no trouble in class and flows through his work as he does at home, then you may have your answer to school placement next year assuming you can build rapport with other children who will be in his class.

Dr. Elisa Shipon-Blum