Hello, I have a 10 year old daughter who was diagnosed with SM when she was 3 1/2. She has NEVER talked at school and never spoke in therapy. I am having a very difficult time finding a doctor who knows anything about SM. There is a therapist at her school who worked with her for the last 6 months last year and will do so again this year, but she didn’t have any real progress. Every year my daughter says she will speak at school and every year she doesn’t. She is a straight A student except for her reading because the teachers can’t test her in that. I don’t know much about the different meds, but from reading some of your letters and some letters from other parents of SM children my daughter sounds like a good candidate for medication. Could you give me some advice on the different meds and some of the short term and long term side effects? My husband and I are getting frustrated, our daughter seems to be perfectly happy not speaking at school but I am worried. She has learned to cope with it and has a lot of friends who accept her for who she is.


From reading your letter, I believe your daughter is the perfect candidate for medication. At this point you have gone through many years of trying to help your child; therapy was not successful…you really have no other option at this time. SO, talk to your family Dr. or pediatrician and tell him or her you are ready to try medication. You have nothing to lose, and everything to gain! Honestly, the majority of children do respond to medication, so it is worth a try. If your Dr. tells you he is against medication, then pursue other DR’s in the area, call them first and ask them about their experience with SM AND prescribing Prozac to children. Many DR’s do not ‘recommend’ these drugs to children for the simple reason they are just not comfortable prescribing it!

So, if your Dr. is of no help, and either will not prescribe it himself/herself and is reluctant to recommend a psychiatrist, then call your area children’s hospital and ask for the various child psychiatrists that they recommend. Call them all up and speak to them before choosing one.

Please read over the many questions proceeding yours, I have talked about medication so many times……The types used in SM, the pros and cons…if you have any further questions, that I have not already answered I will be happy to answer them.

Prozac, Paxil and Zoloft are the most common medications used for SM children. They ‘replace the missing seratonin in their brains’ and help them to function in social situations. Preliminary studies indicate these drugs are safe in children, but because Prozac (the oldest of the bunch) has only been around since 1988, no one truly knows the long term effects.

You mentioned that your child will tell you that she ‘is gonna talk next year’…This is very, very common for SM kids. They really do WANT to talk…they just cannot. It is like they have stage fright, and the words will not come out, no matter how hard they try. By replacing seratonin, most children will improve, and their social phobia will lessen.

Dr. Elisa Shipon-Blum