Testimonies

When I was 14 years old, I decided to be a special education teacher. I was reading a book called One Child by Tory Hayden. It was a true story about a very loving teacher and her work with a young child who was diagnosed with selective mutism. It was called elective mutism at the time. I was filled with certainty that this would be a perfect career for me. And indeed, I became an elementary and special education teacher. I truly loved my job and considered it a calling. During those years, I worked with three children diagnosed with this complex condition.

In the academic year of 2004 to 2005, I was teaching fourth grade in Malden, Massachusetts. It was during that year that I developed and implemented a program to treat selective mutism for a child in my class. Selective mutism is a severe anxiety disorder in which a person is unable to speak in certain situations, such as school. The reasons that some children develop this condition are not well understood. In a small number of cases, it is due to trauma. Most of the time is a coping mechanism to deal with anxiety. Some children are perfectionists and therefore more anxious in the school setting. My student, Becky was beginning fourth grade without ever speaking in school. She had not spoken in a school setting since nursery school. In third grade, Becky was given a buddy, another student who would speak on her behalf. Her third-grade teacher had decided that no one should speak to Becky in order that she would not feel uncomfortable. She had also been given anxiety medication. She received speech therapy each week, however she had never spoken to the speech therapist.

Although Becky was completely silent in school, she spoke often to her immediate family at home. In fact, she was very talkative and outgoing. Her parents described her as a happy child who enjoyed playing with her sister, riding horses, and singing Disney songs. She did not, however, speak to her grandparents, or other members of her extended family. In school, however her affect was stiff and rigid. She looked uncomfortable communicating in any way and hesitated to make eye contact.

Right away, I was determined to help Becky speak. I knew that selective mutism, if left untreated, would only get worse over time. Children typically become lonely and isolated and often suffer severe anxiety and depression. And of course, it impacts their social life and academic performance. However, this would be quite a challenge. Unlike the author of the book One Child who taught a small group of children, I was a regular education teacher at the time. I had a class of 26 children without any teacher aides assigned to me. I also had to embark on research. I had to familiarize myself with the current best practices and determine which approach would be feasible in the classroom setting.

In the meantime, the school year was beginning. I knew enough about selective mutism to put a few strategies immediately into practice. Immediately, I began speaking to Becky as I would any other child. I asked her questions, greeted her, etc. I encourage the other children to do the same, regardless of if she answered or not. Sometimes Becky would smile and nod or shake her head, or Lucy might speak on her behalf. Or she would write her answer in a little notebook.

 I met with Becky’s parents and asked them to allow Becky to come in early before school several days a week. We also decided that Becky should not be taking the medication recommended by her previous teachers. It was making her lethargic and there was no evidence in the literature that medication could significantly treat this condition, although it is used sometimes in combination with other therapies.

Working with Becky before school gave me the opportunity to intervene in a one-to-one setting. I wanted to give Becky a voice and a place in our class. I would ask her to help with seasonal decorations, sharpening pencils, putting paper and other materials out for the other children to access. I would speak to Becky quite a bit and encourage her to respond even nonverbally.  Very quickly, Becky’s body language changed. Even though she wasn’t talking, she would look me in the eye, and move about in a more confident and relaxed manner. She nodded her head and pointed or gestured with ease. She also began making little noises with her tongue and loud breathing sounds as she helped me. Sometimes I had other children join us. She was much more relaxed in a small group setting. One day during class, I felt someone tapping my back with their finger. I turned around and it was Becky. She was holding the artwork from a recent class display that had to be returned to the children. She was smiling looking at me expectantly. “Thank you for reminding me” I said. “Would you like to pass these out to the class?” She smiled and nodded.

In the meantime, I was researching suitable programs to treat selective mutism. In November a colleague gave me The Selective Mutism Resource Guide by Maggie Johnson and Alison Wintgens.At the time more progress was being made in Great Britain on treating this complex disorder. The book presented a program based on desensitization. Because selective mutism is much more of an anxiety disorder than an actual speech impediment, similar principles to people suffering from phobias can be applied. For example, a person who fears mice may start by simply looking at a picture of a mouse until they are not afraid. It uses behavior modification and the basic principles of task analysis which I have learned and studied as a special education teacher. This guide laid out the principles and techniques needed to reverse the condition. After reading this, I was more confident that I could individualize a specific program for Becky.

All the research on selective mutism indicates that if left untreated, the mutism and the compounding social emotional effects will worsen over time. It was not going to be enough to simply provide a comfortable environment for Becky. Nor was it going to be enough to be a kind and supporting teacher. A specific intervention is needed in these cases. It can be a lengthy process for some children to speak. Some children are only marginally successful, and others may take several years to speak successfully after a program is started. The most success has been reported on younger children between the ages of five and seven.

And so, the interventionist must set forth an expectation for the child to speak. This must be done gradually and incrementally. If expectations are too high, the child will experience anxiety and potentially regress. I had to be very careful to set appropriate goals that Becky could achieve without anxiety. For me to do this, I needed time with Becky and someone she was already speaking with several times a week. After meeting with Becky’s parents, I met with Becky alone. I explained to her how important it was to be able to speak in class and in other situations. I told her that I wanted to help her be able to speak comfortably to me, the children in class, and eventually everyone else. I asked her if she would be willing to try to work with me. I explained that there would be goals for each day of the program. I told her that I would discuss each goal ahead of time and if she wasn’t comfortable, we would try something else. I told her we would be meeting three days a week before school to begin with. I asked her if she would be willing to try and she nodded.

Becky’s very first goal was simple. It was to play a game with her mother that required speaking in the classroom with me, the teacher, outside the closed classroom door. Since Becky was already speaking to her mother at home, the only change was speaking to her mother in a different setting. I set up a game of Trivial Pursuit and instructed that the questions be read out loud. I said timer for 10 minutes and asked them to play for that amount of time taking turns and speaking out loud. I explained the goal to Becky and she agreed to try. I closed the classroom door and stood outside a few feet away. Her first goal was successful, she was able to speak to her mother and take turns playing the game.

Within a few days, I was able to move my chair closer to the classroom door and then open the door. At that point I could hear Becky’s voice as she played different games and activities with her mother in the classroom. Each day I put a star next to the goal that she achieved. It was a slow process, but Becky was making incremental progress each day. The most difficult goal for Becky to achieve was allowing me to move my chair into the classroom as she played the game with her mom. It took three or four weeks to achieve this goal but eventually she was comfortable with the fact that I could hear her voice. After that progress was much quicker.

Eventually, I was able to sit at the same table as Becky and her mother. At this point, we played games called “counting circles” and “talking circles.” We took turns counting. When it was Becky’s turn, she was able to say out loud the number three. It was the first time she spoke where I was directly facing her. We repeated a similar process with days of the week, months of the year, seasons, etc. Then we were able to move on to more conversational speech. I created a game which I called 20 questions. They were lists of questions that we could ask and answer to one another. They included questions such as what’s your favorite color? What’s your favorite movie? What’s your favorite song? How many brothers and sisters do you have? And so forth. I made the questions easy to answer with short one- or two-word answers. Becky, her mother and I would take turns asking and answering questions. At first, Becky would avoid eye contact and whisper. But gradually by repeating the goal with the expectation that she would speak in a full voice; Becky was able to talk with more confidence and ease.

Eventually, we were able to progress to more informal speech without the need for prewritten questions.

Then, at last, it was time to involve the other children in the classroom. I set up counting circles and talking circles. I started with her closest friends. One by one, we would count out loud, recite days of the week, and then play 20 questions. It usually took only a few minutes for Becky to speak to each new child. The children in my class were very excited. They could not wait until it was their turn for Becky to talk to them. Often, I would include groups of children that Becky was already speaking to in the along with a child that she wasn’t.

There was also a small group of children that met informally to eat lunch with Becky in my classroom.  There were five girls that Becky was very friendly with. I  called it “talking lunches.” In this small group setting, Becky truly blossomed. She would talk loudly, dance, laugh, giggle and joke. It was a joy to be a part of. On their own, the children named this group “the secret ninja club” because we met privately in my classroom and the children were aware that Becky was speaking uninhibitedly only to them. I was made the secret ninja club president. I would periodically find little notes on my desk addressed to me and what activities the group could do at lunchtime to help Becky, as well as little stories about the other children’s lives.

One of my students, Tammy, was one of the last to join the talking circles. I had instructed the children not to overreact when she spoke to them and remain casual. I had also cautioned them to follow the 20 questions game or other simple questions first. Tammy was never one to follow such specific instructions, although she was quite endearing in her own way. When presented with the opportunity to ask Becky a question, she asked “so, how come it took you this long to finally speak to us?” Becky surprised me by answering right away “I don’t know.” Then Tammy asked, “Will you be my friend?” Becky nodded and replied “yes.”

Gradually, the talking circles included teachers, the principal, and students from other classrooms. I would often arrive at school in the morning to be greeted by groups of children sitting outside my classroom waiting for the talking circles to begin. Most days there was a talking circle before or after school. Talking lunches continued.

My next important goal was to have Becky speak in front of the entire classroom. It was then the middle of May and Becky was speaking to every child in the room in a small group setting. However, she was still reluctant to speak in front of the entire class. She would not even ask me to use the bathroom. I decided to play a multiplication game with half of the class. The rest of the class would sit quietly doing a math worksheet. While the other children stood in a circle. I recited a multiplication problem and tossed the ball to a student, who then verbally answered, and threw the ball to another student. When a student tossed the ball at Becky after stating “7×3” she was able to answer “21.” The children were finding it difficult to hold back their excitement because it was the first time she spoke in front of the entire class. The next day I played the same game with the other half of the class including Becky. The third day, I played the game with the entire class and Becky was able to answer out loud.

 

After this, I set a goal that Becky would answer a specific question that I asked of her. I told her ahead of time when this would take place and what the question would be. So, during science, when I called upon Becky in front of the class and asked her what an invertebrate was, she was able to answer out loud that it was an animal without a backbone. The children could not hold back their excitement. A few children started clapping, and then the entire class. Becky smiled and seemed generally pleased with herself. Since she didn’t seem embarrassed, I took a moment to congratulate her in front of the class.

I spent a few days asking Becky prepared questions. Then I was able to move on to asking her a question that I hadn’t reviewed with her ahead of time. I tried to ask questions that I was confident she would know the answers to. She did very well with this and answered in a full voice in front of the whole class much to the delight of the other students.

One day in early June I was writing on the board something for the children to copy when I heard loud talking and laughing. I turned around to reprimand the child only to discover that it was Becky and her friend Lucy talking out loud and laughing. I paused, not sure how to respond in this case. The other children were looking at me, fascinated by this predicament. What progress!

Becky ended her year in fourth grade with great success. On the last day of school, she was part of a play performed for the entire class and some guests. My vice principal was very supportive and allowed me to pick Becky’s fifth grade teacher who would continue with the program. I was also fortunate to be teaching summer school for first graders Becky was my helper during summer school and so had the opportunity to talk to little children and keep up the progress that she had made. During fifth grade, I helped the teacher implement the program and set goals. I kept in touch continually with Becky and her parents.

Eventually Becky went on to junior high and even signed up for the drama club. She went on to college and is now a dental hygienist. No one would know today of the difficulties that she overcame. She is an outgoing young lady who speaks to everyone and is independent and confident. It was one of my greatest accomplishments as a teacher. I have an enormous amount of admiration for Becky. Each day she was in my class she took small steps to overcome her greatest fears. And to all the other children who were so eager to help her and so filled with compassion and kindness, I look back with gratitude. They were also a huge part of her success.

Lisa M. Gilbert

Beginning January 15, 2024, Atlantic Severe Needs Associates welcomes new clients seeking private consultations regarding our objective of assisting Special Needs children and adults in identifying and mitigating issues of Cerebral Palsy and other neurological and learning problems. Lead by Lisa M. Gilbert, Executive Director, who was herself a Cerebral Palsy victim and 20 year  public school special  education teacher in two suburban Boston school systems. Ms Gilbert, with a Bachelor’s Degree from Salve Regina College and a Master’s Degree from Boston College, will head up our non profit organization. She will also retain other nationwide personnel experienced in their field of special and health education. This will be to insure the finest quality of consultation being offered to our clients. Applicants for these future positions should send their resumes to [email protected]

Ms Gilbert’s objectives for Atlantic Severe Needs Associates is to help parents of special needs children  have the best meaningful life that God wants for them and to give as much potential employment or self business opportunities to a growing adult Cerebral Palsy population.