Using the ‘sliding-in’ method to treat Selective Mutism: a case study look

Bismillah al Rahman al Rahim

One day, a parent spoke to me anxiously:

‘My child chatters like a monkey when she’s at home, I can’t keep her quiet! But she is just so shy – she doesn’t even speak to my friends if they come over. And the SEN teacher told me that she does not speak at all in class or even in the playground. What is going on?! This isn’t normal is it? I try and get her to at least say ‘Asalaamo alekum’ and shake hands with my friends, it looks so rude when she is just silent!’

I went in to observe her daughter in the classroom, and indeed she was silent throughout the lesson. I later watched a video of her at home, confidently demonstrating and instructing her little sister in how to make Playdough Ice-cream with her new Ice-cream maker, on Youtube.

That laughing confident girl is so different from the timid little girl I saw in her classroom, unwilling to even be noticed by her teacher in case she was asked a question, or pressed to say something.

This little girl has Selective Mutism, and she is one of a number of children I have seen here recently in the UAE with this condition.

Common treatments & approaches

It is not strictly a speech and language problem, because most of the children who have it are perfectly capable communicators in the place(s) they regard as ‘safe’, (usually home). In my experience, this is a condition more common to girls. Usually, it is treated by Psychologists who are able to use various psychological approaches to help the child. Sometimes, in children with a high degree of anxiety, a medicine might be prescribed (I personally would avoid this if at all possible, and pursue other methods of treatment, making this a less preferable option).

In UK Speech and Language Therapists have increasingly become involved with treating such children. I have personally seen a number of children through to full ease in communicating there, using techniques based upon de-sensitization, and building confidence, helping with general communication as the child begins to talk more freely. Often, but not always, a child with Selective Mutismalso has a speech and / or language difficulty that needs to be treated.

A glimpse at another child ....

One 3 year old child I worked with was referred to me by his Mother, after his nursery teacher told her that he would not talk in school at all. The mother was aware he had a problem, because he would just ‘freeze up’ when any adult or child came into their house, or when he was out with her and someone spoke to him. He only spoke around his immediate family.

The ‘sliding-in’ method

There is a method I used in this instance, called the ‘Sliding-in’ method. It worked for him, and we were able to use this to help build his confidence in school, working with one key person till he could talk freely with her, then with one or two other children, and gradually with most people in his nursery.

​1. I started to build bridges with this little fellow, by visiting his home, and waiting at quite a distance away from him until he was happily chatting and playing with his Dad.

2. Then I would gradually come into the room until he was comfortable with me being there while he continued to chat to his father.

3. I began to slowly join in his games in an indirect way, until he then felt easy enough to talk with me about the game.

In this particular case, when this little boy started to talk, I noticed that his speech was very unclear, and this can be so for some children with Selective Mutism.

He responded well to therapy, and though his speech difficulty was significant, he made steady progress thanks to the support of actively interested and proactive parents and a course of speech therapy.

By the time he started in FS2, his speech was mostly clear, and he was able to talk freely with most people he knew, though was still very nervous about talking to new adults.

Gratitude & impact

When I see a young child overcome their communication problem like this, I am always grateful to be a part of their success and be able to help in such cases! What an honour.

I hope you found this case study look interesting – leave me a comment below to share your own experiences of Selective Mutism. Have you ever tried the sliding in technique?

Warmly,

Margi

(MRCSLT & HCPC, UK Reg.)

Highly Specialist Speech & Language Therapist

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