Setting up the Environment
A key aspect of any intervention programme for SM is supporting those in the individual’s environment to build social comfort.
This can take the form of:
Training/information sessions on what SM is and how to support the individual – for home, school, social activities. I have found the video from the SMIRA website “Silent Children – approaches to Selective Mutism” DVD http://smira.org.uk/index.php/resources/smira-publications/12-dvd particularly useful for engaging an audience.
Elimination of maintaining factors – these are factors that maintain the mutism. These can range from forcing a child to speak to the opposite – not providing enough communication opportunities so that the individual has no reason or motivation to speak. The School Environment Checklists for anxious/reluctant communicators is really helpful for identifying these factors and making plans to eliminate them- this was previously found on the SMIRA website in the downloads section http://www.smira.org.uk/index.php/downloads/smira-leaflets
Supporting those in the individuals environment to implement social skills, desensitisation, cognitive and behavioural intervention programmes. If an individual receives one hour of direct therapy per week from a clinician they will receive one hour of therapy a week. If a clinician uses that hour to up skill those in the individual’s environment; that individual will be receiving therapy whenever they are in contact with the people who have been trained to implement it.
The Selective Mutism Resource Manual (Johnson and Wintgens, 2002) has a wealth of information, strategies, handouts that can be used to support education of those in the individual’s environment. I often give handouts from here to schools and families to support up skilling e.g. Handouts 2, 3 and 4