What is Selective Mutism?
Selective Mutism is an anxiety-based mental health condition which usually commences in early childhood. Those with Selective Mutism speak fluently in some situations but do not speak in other situations. For example, they may be able to speak freely and confidently at home but find it difficult to speak in school. The child is not choosing when and when not to speak, the nature of the anxiety-based condition, means that the young person physically cannot speak, due to their anxiety. There is set diagnostic criteria for Selective Mutism, and this is usually diagnosed by a Speech and Language Therapist, or Clinical Psychologist.
Selective Mutism most often starts in early childhood, between age 2 and 4. It's often first noticed when the child starts to interact with people outside their family, such as when they begin nursery or school.
Some children do not meet the criteria for a diagnosis of Selective Mutism, however, they may find speaking confidently in some situations difficult.
If your child has been referred into this pathway, the first appointment will be a telephone consultation with one of our Speech and Language Therapists. This is so that we can talk to you about your concerns without your child present.
Following the initial telephone call, we will decide on the next steps. This usually includes a nursery or school visit to observe how your child communicates in this setting. We usually speak to educational staff to gather their views on their communication and learning and agree on the most appropriate therapy plan.
Therapy to develop confident speaking is guided by the Speech and Language Therapist, however, it is typically carried out in school with the young person, parents and educational staff. We also provide training to ensure a communication friendly environment in school and help parents to support their child in the community.
We work in clinics across Blackpool, Fylde and Wyre, along with seeing children and young people in their nursery or school.
If your child is worried or anxious about coming to an appointment with our team, you might find it helpful to read the ‘story’ on this page with them a few times before you come to see us: What happens at an appointment? :: Blackpool Teaching Hospitals.
Reasonable adjustments
Reasonable adjustments are changes we can make to help everyone use our service more easily, that also includes adjustments for the parent or carer.
You might not know which reasonable adjustments will help you/your child until you visit us. You can tell us what support your child may need at any time and change it if needed. We know that some days you/your child may need more help than other days. We will do our best to make changes that help you/your child.
Sometimes, we may not be able to make every change, but we will try to find other ways to support you.
This Reasonable Adjustments menu has been designed to support you with discussing what adjustments you/your child may need and what we can offer.
We can provide information, answer any questions you may have, and help you get ready for your child’s appointment.
To prepare for your appointment you can also:
- Request an ‘easy read’ appointment letter with date, time, and location of your appointment which includes visual supports.
- We may be able to facilitate a visit to the clinic before the appointment to familiarise your child with the environment.
- Let us know if your child needs a quiet waiting area.
- Bring your health passport to your appointment if you have one.
- If you child is being seen by the Social Communication team you can see a photo of the person who will be seeing your child in ‘meet the team’: Social Communication :: Blackpool Teaching Hospitals
Adjustments you may need:
Let us know if you/your child requires any supports to communicate during the appointment.
This can include: an interpreter for you/your child including BSL interpreter; communication boards/visuals, pen and paper, makaton.
Let us know if you/your child has specific needs which may mean adjustments to the offered provisions, some of our supports are delivered virtually, in small groups face-to-face, one-to-one in clinic settings or at home.
Appointments can range between 30 minutes to one hour. We understand that can be a long time to sit in one place.
Please let us know if you/your child needs a movement break or a break in the appointment (you are welcome to step out of the room for short time).
Please bring any sensory or fidget toys or objects that will help you/your child.
Let us know how we can support your child’s sensory differences.
You/your child are welcome to bring any supports from home that you find useful e.g. ear defenders, headphones or ear plugs, weighted blanket, fidget toys.
Sensory breaks – please let us know if you/your child would benefit from a break to regulate.
Touch and distance – please let us know if you/your child needs extra space, some of the rooms we use can be small.
Where possible we may be able to accommodate or adapt how we use written and visual resources.
This includes the use of large print font or use of coloured paper (limited option of colours).
You are welcome to bring your own overlays or equipment to support visual or learning needs.
Let us know if you or your child has a visual impairment. If you use ‘read aloud’ or text to speech software please advise how we can make information accessible for you.
If you require written information in braille format, please let us know before the appointment.
We will be talking to you and interacting with your child during our sessions. If you or your child needs support communicating, let us know.
Processing time - we will give you and your child extra time to think, let us know if you need longer.
Slow down - share with us if you find slower paced interactions beneficial, let us know if you need us to slow down, pause, repeat, or rephrase something.
Decision making - you can have time to make decisions after the appointment and contact us know when you are ready, please let us know if you want to go away and think through options.
Use of Augmentative and Alternative Communication (AAC) - please bring any AAC system (paper-based) or voice output that your child uses to communicate to the appointment.
Written supports - we can write things down for you as we go through the appointment.
Other - if you have other requests, please let us know.
