Coping with Selective Mutism: The Architecture of Fluid Communication

Although selective mutism may not typically rank among the most frequent issues encountered by speech language therapists, I think it must be the area I get the most questions about from teachers. As I've reflected on why this may be so, I realize that it’s just the kind of condition that a therapist would do better to work through people in the child’s life and daily communicative contexts in order to make real impact, vs. following a 1:1 intervention model.

Notwithstanding, I have had some direct experience managing the challenges that accompany selective mutism, affecting participation, interaction and measuring student progress. I wanted to take some time here to share my perspective on this area and some strategies that I have found helpful.

The UDL Framework: removing barriers

The foundation upon which I have constructed these strategies is Universal Design for Learning or UDL. UDL is a framework that in many ways levels the playing field for individuals who may have typically been at a disadvantage.

UDL has its roots in Universal Design, as in the field of architecture, in which the design and composition of an environment focuses on making it accessible, understandable and usable to the greatest extent possible by all people regardless of age, size, ability or disability. In other words, design that helps everyone get their needs met. A common example of Universal Design is the choice to use ramps over stairs, since a ramp will allow those who use wheelchairs, strollers, skateboards and bikes to access as well as people walking or running.

When I have needed to troubleshoot how best to help a student with selective mutism, I kept in mind the three core guidelines of UDL, which are explained very comprehensively on the cast.org website (https://udlguidelines.cast.org/). That is, in my planning of lessons and activities, I incorporate

Multiple means of engagement: offering choices, e.g. of what to do and how to go about the learning process. We want to incorporate learner’s interests and keep them motivated. In Early Years, this can look like choices of what to ‘play’, since young children learn primarily through play-based activities.
Multiple means of representation: offering options in how information is communicated to learners, and in how they will eventually make meaning. So information is conveyed not only via text and images but also graphics, spoken words, physical objects, movement and space, etc.
Multiple means of action & expression: this refers to how the learner communicates with others in the classroom, and again the key concepts are options and choice. We don’t lock into only verbal responses but also allow the learner to express themself via other means, such as writing, pictograms, nonverbal communication and assistive technologies.

What does this technical jargon actually mean for our work with students with selective mutism??

Basically, in the mainstream school setting, the teachers and peers are likely expecting that the student expresses him- or herself using spoken words. And the student with selective mutism is very likely choosing other, nonverbal ways to communicate.

I recommend that rather than fixating on the fact that the student isn’t talking (i.e. a deficit model– essentially focusing on the lack of speech), we honor all attempts to communicate, that is, all the various forms of nonverbal communication.

Common nonverbal communication in the classroom:

pointing

gestures

nodding or shaking the head

eye gaze

eye contact

body proximity

facial expression

drawing

writing

Interpret interpret interpret

When we apply UDL in the classroom, we interpret nonverbal communication as strongly as if the student were speaking. Furthermore, since students with selective mutism often retreat from even nonverbal interaction with adults, treat any form of nonverbal communication as a big message, and interpret-- in other words, say what you think the child wants to say.

Furthermore, even when the nonverbal cues are not exactly communicative, make them so, as a basis for interaction that doesn’t have to rely on the child telling you a story, answering direct questions, or other verbal skills. This is called interpreting, and it’s a technique language therapists use with a wide variety of clients.

For example, if at playtime she runs outside eagerly, happy and smiling, towards the climbing frame, you can comment, “Let's run quickly to the climbing frame! Go go go! We love to climb!” Or if he comes to school with a tired or grumpy face, you can say, "I am so tired on a Monday morning!" Or when they arrive proudly wearing new shoes, comment "Those shoes are so cool!"

Comment rather than ask test questions

In these cases, I also definitely avoid asking any form of a test question. Test questions are the types of questions adults often ask children when we want them to demonstrate information that is already known to the adult asking the question. Likewise, the child knows that the adult knows the answer. When adults ask test questions, they essentially ask children to give a verbal performance. Examples of test questions, when coming from adults who know the child well are:

What is your name?

How old are you?

What color is this?

What is this? (referring to an object that everyone knows exactly what it is)

Test questions not only put pressure on children to speak and essentially offer very little value to creating building an interaction through sincere communication. That is, unless the adult has truly forgotten the answer to the question, in which case, it wouldn't be a test question.

Removing Barriers

When wanting to connect with a student with selective mutism, and keeping UDL in mind, we remove barriers to participation. In other words, we ensure that talking is not the only option for participation.

For example, I make sure the communicative environment, that is, the classroom, is filled with supports that will enable them to communicate even more. Often, for young children who are not yet able to read, write or type out messages, the best way is via pictures, pictograms and photos. Twinkl has some really nice Word Mats that can serve as picture vocabulary for specific areas of the class, or topics being discussed. With visual supports for language used throughout the classroom environment, young students can learn to point to get their message across. Also as mentioned before, if the student uses a visual to communicate, model what they want to say as if they were saying it.

When we offer multiple means of expression, the message sent to the student is essentially,

“I understand you, even though you are not speaking.

You are still an important member of this class.

You don’t want to talk, that’s fine.

But you are still expected to participate, and I will find ways for you to participate like all the other students, even if it doesn’t involve speaking.”

With older children, response cards can be used as a whole-class approach, in a way that doesn’t single out the student with selective mutism. This is not only empowering but it also reminds the student that in no way does a refusal to speak enable them to avoid participating or interacting. No excuses!

Of course keeping in line with the UDL guidelines, we want to ensure that pictures and text are not our only option offered for participation. We can also offer options for participating via making noise (that isn’t speech), for example in music class or drama. Musical instruments, sound effects, beat boxing, body percussion… the ideas reach as far as your creativity.

But when will the student talk?

These strategies are only a first step. But any progress or strategy changes beyond the first steps will depend highly on how the student responds to the initial approach taken. And since all students are unique as are all teachers, and as is the dynamic of each and every classroom, recommending next steps or giving a prognosis for when the student might talk is simply not feasible.

I will say that, in my experience, when we respond to all students' attempts to communicate, they feel heard. They feel empowered. When they become empowered to communicate, their motivation to refine their communicative messages increases. And for the majority of humans, speech is still the most efficient way to communicate with others in the mainstream classroom environment.

So while I can offer no exact prognosis for speech, I would still encourage educators to keep removing barrier to communication, to keep building that inclusive learning environment that fosters fluid communication of all kinds. Remember, the most powerful tool you have is your own connection with the student. So keep that connection strong and the student will continue to build on skills that lead to speech.