Ruth Perednik - The Selective Mutism Treatment Guide: Manuals for Parents Teachers and Therapists. Second Edition: Still Waters Run Deep

The Selective Mutism
Treatment Guide:

Manuals for Parents, Teachers, and
Therapists. Second Edition

still waters run deep

Ruth Perednik

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The Selective Mutism Treatment Guide Manuals for Parents, Teachers, and Therapists Still Waters Run Deep. Copyright 2011 by Ruth Perednik. All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the publisher.

ISBN: 9659178328
ISBN-13: 9789659178322
Second edition published 2016
First edition published 2011

Library of Congress Cataloging-in-Publication data.
Perednik Ruth
The Selective Mutism Treatment Guide:
For Parents, Teachers, and Therapists Still Waters Run Deep

Jerusalem

For Mum
my compass, always

Contents

Chapter 1

Introduction

How to Use This Book

Ronais a five year old china-doll pretty redhead. She looks fragile, and her behavior the first day I see her, on a fresh winter morning, exudes vulnerability. She stands stationary and silent in the midst of a swirl of activity and noise in her bustling, effervescent preschool class. Every child (and there are many) seems to be talking or laughing or shouting or complaining, and most are in motion. Rona is still.

Rona has never spoken in kindergarten. She had been attending a private small playgroup prior to this year and had been fairly relaxed, participating in most activities, while never speaking to children or staff. But on entering this kindergarten with forty children, two bubbly, larger-than-life teachers, and all the consequent commotion, she shut down and froze. She speaks to no one and participates in nothing.

Donis a small and delicate, blond, blue-eyed, beautiful five-year-old. He has never spoken to a soul outside the confines of his immediate family. He is silent in kindergarten, which he grudgingly attends daily. He engages in all of the formal demands of the kindergarten, displaying his exceptional intelligence in his pictures, puzzles, and work sheets. Not a word escapes his lips, which remain tightly sealed. He shows little facial expression; most of the time, it is as though a grim and inert mask covers his face. He is liked by his peers and will play with them when invited to do so, without uttering a sound. He seems to be constricting his presence in an attempt at invisibility. At home he is a totally different child: chattering and singing, making exquisite use of language, demanding his rightful place among his siblings, and scolding his two cats; laughing, smiling, grimacing, and frowning.

Leslieis a fourteen-year-old, tall, slim, gracious brunette who tends to look at people using peripheral vision, giving her a shy and cautious air. Leslie has never spoken in any educational framework. No one in her kindergarten recalls her having uttered a word. As a young child, she was silent and introverted, seldom played with other children, and kept to herself most of the time. She was compliant, participating in kindergarten activities to the minimal level acceptable, without ever speaking. This pattern continued in elementary school, during which she diligently completed schoolwork and excelled academically but kept to herself and remained absolutely silent throughout. Her only source of peer interaction was her best (and only) friend, Jamie, with whom she would chat on the phone and occasionally invite to her house after school. Now Leslie is embarking on her high school career, no change visible on the horizon. At home she speaks comfortably with members of her immediate family, both in English and in French, but falls silent when friends of her parents or strangers come home. She retreats into her shell and, whenever possible, into her room, shutting the door firmly behind her.

Leslies parents are desperatethey can see their beloved only daughter leading a lonely life with little social interaction and feel that the future portends possible deterioration into agoraphobia, depression, or at best, isolation.

Rona, Don and Leslie suffer from selective mutism. Well meet them again in later chapters and learn how they overcame their difficulties, and moved from silence to speech.

Before you is an innovative, tried and tested approach to the treatment of selective mutism (SM)the consistent failure to speak in certain settings or to specific people despite having the ability to understand and use language. It is based on twenty years of clinical experience treating hundreds of children with SM, and on current, widely accepted ways of understanding and treating this condition. It views parents, school staff, and therapists as having the potential to successfully implement this treatment and free their child of selective mutism. Children with SM usually respond well to the appropriate treatment and break free of their silent shackles in a relatively short-term intervention program. Whats more, most of them become regular, normative children once they overcome selective mutism.

This book gives a general overview of what selective mutism is, how it presents in classrooms and kindergartens, and how it affects the child and his or her family. It describes the causes of selective mutism and includes sections on anxiety, social anxiety, shyness, inhibition, and introversion, which are sometimes part of SM. We consider a variety of difficulties that can appear together and be intertwined with SM. We consider language issues along with how bilingualism and immigration can be elements of the root cause of SM. We will look into methods of assessment and diagnosis. But the brunt of this book is how to help children with SM. We see three potential therapeutic agents of change: parents, teachers, and therapists. Ideally, when these three agents work together to promote growth, a powerful force for change is put in motion. To this end we have written three sections for these designated groups: parents, school staff, and therapists, each of whom have treatment manuals written specifically for them.

Each manual includes an overview of how to understand and treat SM, as well as insights, strategies, and tools specific to each one. Parents and teachers are vital, active partners and are each guided to engage in activities aimed at helping the child to speak freely. For therapists, a clear, step-by-step guide will enable implementation of an effective treatment plan. We describe methods of treating younger children, along with a chapter on cognitive-behavioral techniques to treat older children and teenagers.

This treatment plan may be carried out by a therapist, a family member, a teacher, or any other person who is sufficiently warm, skilled, understanding, and committed to the well-being of the child with SM. Many concerned and caring parents have implemented this program without a therapist, and teachers too will find much that they can do to help the child in school without the full-scale program. However, when the resources and the inclination are there to implement the complete program with parents, teachers, and therapist working togethercooperating, communicating, and fine-tuning one anothers interventionsthe result is a potent push toward overcoming SM.