Selective mutism is not a speech and language disorder, but does that mean the Speech Language Pathologist (SLP) does not play a role in assessment and treatment? Not exactly. Approximately 20-30%* of children with selective mutism also have a speech or expressive/receptive language disorder. Additional children may have a social/pragmatic disorder or may stutter.
The anxiety of having speech or language differences could compound with general anxiety and perpetuate selective mutism. In addition, it is difficult to get services in the public-school setting to help with selective mutism. So, what can the SLP do? It depends on the environment.
In the school system, SLPs are limited to legal standards of qualifying students for an Individual Education Program (IEP). The suspected disability has to impact learning or social outcomes in a significant way. With selective mutism, the selected disability is Anxiety which would qualify for Other Health Impairment (OHI) some districts may qualify as Emotional Disturbance (ED) on an IEP. This would mean that they qualify for services under special education. Even if a student does not qualify for a speech and language disorder, if the team decides that there is an area of difficulty (e.g., speaking) that the speech and language therapist can assist with, you can still ask for SLP services. There are also 504 plans which can provide supports outside of special education but DO NOT provide related services (Occupational Therapy, Speech Therapy, Specialized Academic Instruction.) The difficulty that the SLP faces in the school environment, is that they have a finite amount of time that they can assess a student. Treatment may also be difficult if the student is not yet verbal at school. A goal could be to build rapport with the speech language pathologist to make it possible to further assess (if they qualify without a speech-language impairment.)
In a private practice, there are no hoops to jump through. An SLP is able to fade into counseling sessions and (hopefully) become an adult that the individual with SM is verbal with. We can take as much time as needed and do a full assessment in all areas of communication. At that time, if there is a speech and language disorder, the SLP works closely with the therapist to set goals for functional communication and what has worked for the child in becoming verbal in the private practice environment. There is much more flexibility with time and a different comfort level as the private practice office is typically viewed as a comfortable space. At that point we can work on speech, language, social, or fluency skills.
There is a significant difference between private practice and the school setting as it related to the diagnosis and treatment of speech and language disorders for all children, especially children with anxiety disorders. We hope to be able to help you with your child’s speech and language needs here at Pinnacle Counseling and Testing Center. We hope to meet your and your child soon!
*https://selectivemutismcenter.org/whatisselectivemutism/