Transcript

Introduction

Hello my name is Hannah Murphy and I am a Speech Therapist with the NHS. Today I am talking to you as primary school teachers about effective communication to children with Selective Mutism in a mainstream primary school.

The aims of the presentation are to understand just how important communication is for the client. This will help you to focus on their needs and view how it is from their position. I will inform you of common barriers that these children may face that can impact on their development. I will identify how these barriers can be overcome and therefore increase their verbal and non-verbal communication skills.

Selective Mutism is not a medical condition, but rather a psychological one. It occurs when a child is perfectly able of speaking and understanding language, but is unable to speak in certain settings because they are afraid of the social interactions that go along with speaking to others. It is commonly mistaken for shyness when a child begins school, and can make you as their teachers with a full class impatient at times, but you have to understand that it is probably just as frustrating for them as it is for you.

These children are not mute 100% of the time. They may be a perfectly normal child at home who loves chatting to their family members; it is just certain situations they aren’t comfortable in where they cannot speak. Selective Mutism sometimes happens because of a traumatic event in a child’s life.  An example of this is if a young child refused to make the “-th” sound because they had bitten their tongue when they were younger, and were terrified it would happen again.

Each child is different and responds to various methods differently, but all these methods involve communication.

To be able to understand what it is like being a child with selective mutism, I would like you all to do a quick activity. The aim is to line yourselves up in order of age: Oldest on the left and youngest on the right. You are not allowed to make any forms of speech. You will have 2 minutes to do this.

Activity

By doing that activity, it should have enlightened you on not only how it feels for the child to be impaired in that way, but also how it is for others surrounding them by not knowing what they are thinking.

Importance of effective communication with primary school children

Any communication you are able to give will be extremely helpful for the child.

This impairment is a form of phobia, so the more opportunities they are given to help overcome it, the more chance there is they will start to speak.

Communication from fellow classmates will make the child feel they are not an outsider, which gives them psychological security. The child needs self esteem and to feel comfortable in the classroom to build up the confidence to speak.

It is difficult to lead a normal child’s life as it is, so letting them know you understand through communication is very important to the child. They will not feel alone.

Some selectively mute children think they will not be heard or others will not listen to them, which is why they choose not to speak. Talking to them shows you are interested in them.

These children are able to communicate without even using any words at all. An example of this is using portrayed emotions such as frowning when they disapprove, or nodding when they agree.

Effective communication “requires competent performance of both verbal and non-verbal skills”. Just because the child does not speak that does not mean to say they do not want verbal communication. It is frustrating for them anyway so with both speakers lacking verbal communication, it is almost impossible to get the correct message across. Verbal communication may involve humour to make the child feel at ease. The more comfortable they are, the more likely they are to talk. Non-verbal communication allows speakers to add emotion and meaning to what they are saying. For example, if you asked the student to shut the door, a smile and briefly pointing to the door you are referring to makes the action relaxed, whereas arms crossed and a tensed face makes the child think they are in trouble for not already having shut the door.

If the child does speak, never attempt to interrupt them or correct something they have said that is incorrect until they have finished speaking. It may inhibit further speech.

If there is a conversation between you and another child and the selectively mute child is in close proximity, attempt to involve the child in what you are saying and engage them.

Effective communication means you are not just assuming what the child is saying and can actually take the time to find out their thoughts and needs.

Most children have very short attention spans which mean that when they are concentrating you need to use this time as effectively as possible.

You and the child need to understand each other and create a bond in order for the best possible change to be made. The empathy shown will make sure that you know how the child feels.

What barriers they commonly face

The first barrier all selectively mute children will face at some point is bullying. This may be verbal, physical or psychological. Other children may not understand why they are different and target them as the odd one out.

Another barrier to reduce their development is when the selectively mute child feels forced or pressured to speak. This can promote negative feelings for the child. It may be pressure from either you as their teachers or other classmates.

The environment may be a barrier to speaking. For example, if they are surrounded by others in a noisy setting, they are less comfortable to speak. If there is too large an audience, the child may feel worried that they will make an error.

A final barrier selectively mute children face is the concerns of what the reaction of speech will be. There can be a negative reaction which will not help with self esteem issues. Although you may think a positive reaction is encouraging for the child, they may be uncomfortable with the attention they are recieveing and become embarrassed and less likely to talk.

How to overcome them

To overcome bullying, firstly you need to be vigilant against teasing. Remember that the child cannot tell you if they have been called names so you need to be wary that it may happen at any time. If the bullying is getting out of hand, it may be an option to discuss the disorder with the class. Make the other children accept that they don’t talk in certain situations, but that doesn’t mean they don’t understand. They should talk to the child the same way they treat other children, as they are just as interesting and an important member of the class. To make everyone feel equal, you could have a class discussion where people share experiences of times they felt shy and didn’t want to talk. Curiosity from other classmates is only natural, but if they make comments such as “Why don’t they speak?” you need to deal with it in the correct way before it is uncontrollable. Give the impression you aren’t concerned and let that individual know that children are often shy. Make it clear that the child can speak at home and it will be nice when they can speak in school. After this, return to the topic you were previously on to avoid further questions.

To overcome the pressure to speak, you must allow the child to explore their communication in whatever way they initially feel comfortable using non-verbal communication. Eye contact shows that you are interested in someone; however prolonged eye contact may be taken as offense as it can seem aggressive. Facial expressions are ways of conveying emotion, and they can let your student know you are showing approval. Gestures are used to emphasise the speech and make you as the speaker seem involved.  Another technique is called stimulus fading. This involves the child sitting in an empty room with a parent who they feel comfortable talking around, and gradually increase the contact with others whilst using the parent as a safe base. For example, when the child is talking to the parent, have an adult walk past the room but not into it. This could develop into an adult stopping outside the room, and then being in a corner of the room until the child is comfortable with others. Make sure that there are plenty of opportunities for activities that don’t involve speaking. The child should never be in the position where they fall behind on class learning just because of their impairment. When speaking to a Speech Therapist who specialises with selectively mute children, she explained that the most common fault with teachers is that they treat the child differently. She suggested never pushing them too hard or making them do less. You could make comments such as “I wonder if...”, “I expect...” or “It looks as though...” These could provoke responses but do not necessarily require one. Ensure the comments about lack of speech in front of the child are encouraging, and stress that the difficulty won’t last forever.

[I showed the audience a table of what you want to say and what you should say]

So for the first sentence, what could be said instead to encourage the child rather than patronise them? Take answers from audience. The second choice singles them out as an outsider. How could you talk about the same topic but let them know it won’t last forever? Take answers. The third example pressures the child. What could you say instead? Take answers. How else could you explain to the children why Sarah isn’t going to read? Take answers.

To make the environment not seem like a problem, it is useful to keep the spotlight off them  so that any attempts at communication made will go unnoticed and this encourages further speech. Try not to make the register an issue. You can accept a smile, a nod or even a raised hand. To make the register enjoyable for the whole class, make it into a game that doesn’t involve speech but another form of contact with others. Choose a helper, and when you read out a person’s name in the register, the helper has to go around and shake hands with the child. It becomes fun for the children when you speed up the register and makes it a challenge to move around the class as quickly as possible! This allows selectively mute children to participate without anxiety.

To overcome the reaction of speech, you need to handle the situation accordingly. At the first utterance, you should be pleased but do not dwell on the occurrence. Continue along the similar lines of the conversation to try and evoke similar responses. In the classroom setting, it is easier said than done to control the other classmates’ responses. There is likely to be an immediate shout of “They spoke, Miss!” or applause. You can modify the response by saying “There’s no need to make a fuss – we always knew they could speak.” Praise should be used but in the right circumstance. You should use it to acknowledge success such as “Look what you did!” rather than previous praise such as “Come on, you can do it!” or an empty praise such as “Good girl.” Only use this praise for communication such as nodding or shaking the head, but not the speech itself as drawing attention to it may inhibit further conversation and cause embarrassment.

General

You should liaise with the child’s parents on what specific things make the child feel more anxious. There should be a record that you can use to identify factors such as communication, participation, social relationships and self esteem. I will pass around some copies of an example now. On a severe case of Selective Mutism, there may be a need to confer with the school’s SENCO or arrange a meeting with a speech therapist or educational psychologist. Trained staff will be able to provide further support needed.