This text-based course is a written transcript of the event, “Parenting a Child with Selective Mutism: Turning Struggles into Successes”, presented by Joleen Fernald, M.A., CCC-SLP, PhD (c).
>> Joleen Fernald: First I would like to share a few disclosures and biases that may impact the way that I present today. I am both a parent of a child with selective mutism (SM) as well as a treating professional. The perspective that I bring shares both sides of the table and I hope that I will be able to answer any questions from clinicians that may have additional questions or thoughts about parenting a child with SM as well as treating children with SM. I will bring research into my presentation as much as I can. However, research is significantly lacking in the area of SM, so some of what I share is actually based on the more than 90 children that I have seen who have selective mutism over the past 5 years with the SM clinic. My experience is my experience, so just because I have had a certain experience does not necessarily mean that you will have the same experience or same outcome from a strategy that I might present to you. I also wanted to share that I am a DIR® Floortime™ provider and training leader. I am going to share a little bit about that model, but my disclosure is really that I actually work for the Interdisciplinary Council on Developmental and Learning Disorders (ICDL), and I am their coordinator of continuing education, marketing, and publications. As I share the DIR Floortime model, know that I do also work for ICDL.
I am not going to share about the prevalence of selective mutism, etc. I think that you can find that information in some other presentations. I am going to making the assumption that many of you have some understanding and awareness of what selective mutism is. The purpose of this presentation is to share with you some of those challenges that parents and some clinicians experience, as well as how we as professionals can help support those parents in having those children and families on your case load.
DIR Floortime Model: What is it?
The DIR Floortime model is a “framework that helps clinicians, parents, and educators conduct comprehensive assessments and develop an intervention program so that it is tailored more to the unique challenges and strength of children with autism spectrum disorders and other developmental challenges” (www.icdl.com). I think many people think that DIR Floortime is more of a model for children on the autism spectrum, but Drs. Greenspan and Wieder, who really formalized the model - their concept is much greater than children who have autism, but that it broadens out to children with other developmental disabilities as well as neurodevelopmental.
I want to share with you what the ‘D’, the ‘I,’ and the ‘R’ actually stand for. ‘D’ stands for functional, emotional, developmental levels, and you may see that in any order. Some people say developmental, emotional, functional levels. I call them FEDLs. ‘I’ stands for individual differences. ‘R’ stands for relationship base.
D (Developmental)
The ‘D’ looks at children’s milestones rather than thinking about development from the perspective of how young a child started to talk or when they first took their steps and so on. The ‘D’ looks at a child’s social/emotional development and what skills they need to master to have a healthy emotional state. That is what we are looking at for those FEDLs.
I (Individual Differences)
‘I’ stands for individual differences. This is the area that we are really going to focus on today. Individual differences are those things that truly make a child unique, and we as adults have these same individual differences as well. This is really based on how a child takes in information, how they regulate the information, how they respond to their sensory input, how they understand different sensations, such as sound and touch, as well as their praxis - that planning and sequencing of actions and ideas as well. Taking all of those pieces into consideration is going to really help us support our children with selective mutism.
Examples of Individual Differences. Different examples of individual differences for our children with SM include visual spatial processing. Many of our children with SM have visual spatial challenges. Many children have sensory processing difficulties, motor planning as well as other biomedical issues such as allergies. Some children have gastrointestinal issues. Keep that in mind as well for our children with anxiety, and then other speech and language issues, including receptive and expressive challenges.
Below is a general FEDL form. It is included in your handout and you can use this when you are observing children.
