presented by Gail J. Richard
Selective mutism occurs when an individual is capable of speaking and is verbal in at least one setting, but refuses to talk in public situations. Onset during preschool years usually masks an underlying communication problem that may be missed or classified as a psychiatric problem. This course will explain the presumed etiology and major characteristics of the disorder, and then address the role of the speech-language pathologist in assessment. General treatment options will be explained, with expansion in one particular treatment program for preschool and school-aged children. Prognosis for resolution of the disorder is enhanced with early identification and intervention.
Gail J Richard, Ph.D., CCC-SLP, worked in the public schools in Iowa for four years before joining the faculty at Eastern Illinois University, where she has been for 35 years. She was Chair of the Department of Communication Disorders & Sciences for 14 of those years, teaching undergraduate and graduate courses, and supervising in the Speech-Language-Hearing Clinic. She is currently a professor emeritus and Director of the Autism Center and Students with Autism Transitional Education Program (STEP) at Eastern Illinois University. Dr. Richard specialized in childhood developmental language disorders, with expertise in autism, auditory and language processing, syndrome disorders, selective mutism, language-learning disabilities, and executive functions. She has numerous clinical publications, including The Language Processing Test, Differential Screening Test for Processing Disorders, The Source for Processing Disorders, The Source for Selective Mutism, The Source for Development of Executive Functions, The Source for Syndromes, The Source for ADD/ADHD, The Source for Autism, several clinical materials, book chapters, and articles. She has given over 500 presentations in her professional career and enjoys sharing her practical clinical knowledge with practitioners. Dr. Richard has been very engaged with professional organizations, including the Illinois Speech-Language-Hearing Association (ISHA) and the American Speech-Language-Hearing Association (ASHA). She served in many roles, with the highlight being President of ASHA in 2017. She is a Fellow of ASHA and received Honors from ISHA, as well as numerous college teaching and service awards. Her other activities included Faculty Athletics Representative for EIU and service on the NCAA Management Council, which resulted in her induction to the EIU Athletics Hall of Fame!
An early form of selective mutism was identified in 1877, but it wasn’t included in the Diagnostic and Statistical Manual of Mental Disorders until the fourth edition, published in 1994. This chapter will discuss the evolving definition of selective mutism, presumed causes of the disorder supported in the research, and major characteristics in the disorder profile.
Evaluating a child who is refusing to talk can be a bit intimidating and challenging, but can be managed in a professional manner that results in qualifying a child for services. This chapter will present informal and formal procedures that can be conducted in a variety of settings. The child’s level of engagement (verbal and/or nonverbal) will influence the extent of assessment procedures that will be possible.
Treatment strategies are varied, based on the professional discipline involved in coordinating the therapy and presumed etiology. This chapter will provide an overview of the major treatment approaches and then focus on the common component in almost all of them: decreasing the individual’s anxiety through gradual and controlled exposure to speaking situations.
This chapter covers a communication desensitization treatment program that has four phases: nonverbal, ghost/whisper, motor/voice, and generalization.