Selective Mutism


This week, I was very lucky to be able to attend Selective Mutism training at City University, delivered by Anita McKiernan. The training covered the definition, assessment and treatment of this complex condition, using the Selective Mutism Resource Manual, a fantastic resource for working with this group of children. It was a fascinating day, which left me feeling motivated and excited to get cracking.

Selective Mutism is an anxiety disorder; a severe phobia of speaking in certain situations. Often, nursery or school are included in the places on which children fear speaking. When children with this condition feel there is an expectation for them to speak, the fight or flight response is triggered and their cortisol and adrenaline levels shoot up. This can persist throughout the school day, leaving the child feeling terrified and exhausted. This is often followed by distress and meltdowns once they get home. It is clear to see how this condition can have serious impacts on a child, and can lead to wider mental health difficulties if unresolved. This is not the same as shyness; these children can be very confident and extroverted in other situations.


Treatment for these children requires careful planning and well co-ordinated collaboration between child, family and education staff. Much of my work with late talkers focuses on reducing pressure and anxiety, and making communication calm and fun; these are also core values in Selective Mutism treatment. I am thoroughly looking forward to working to empower these wonderful children and their families. 

World Book Day - Thursday 3rd March - reading is for EVERYONE

book day

This Thursday is World Book Day. Children the world over will don marvellous (often lovingly home-crafted) costumes to dress as their favourite book characters. It's all about getting children in to books and reading. However, it's not all about children with literacy skills. Books are brilliant for all ages and abilities. If your child is preliterate, choose books with pictures that clearly explain the story. Take time to explore the pictures together, even if it means you end up going completely off topic from the printed words. Follow your child's lead with this - see which aspects of books and reading they enjoy and go with the flow.

For children with learning difficulties, bringing in some objects or props can help them to engage more with the story. Bag Books provide set of props which turn stories in to multi-sensory experiences, with objects, sounds, textures and smells which relate to the story (I particularly love "Gran's Visit", which includes a classic lavender perfume and a piece of tweed fabric to represent Gran! You can also easily make sensory stories yourself - just take a book you love and try to think of 1-2 items per page that will add extra sensory information. 

Sometimes children prefer non-fiction books on their own topics of interest. This is common in children' with autism spectrum conditions. As always, my advice is to follow their lead and get on board with their interests. Share these books just as you would with a traditional story book.

If you want to work on story-telling and narrative skills, try using your child's topics of interest as inspiration for writing their very own story. Encourage your child to think about who they want in their story, where they want it to be set and when they want it to happen. This is usually a great start to generating a simple story. So that your child doesn't have to worry about spelling, writing or typing, they can dictate the story to you, then you can write it out. This lets them focus fully on the details of their story. To turn it in to a 'book', you can use Powerpoint to put a few sentences on each slide, add a few relevant Google images, and print. 

Now then...all that's left for me to do is plan my book day costume. I should probably go for something sophisticated and grown up like Wuthering Heights or Pride and Prejudice, but my friends wouldn't let me get away without admitting that my favourite book is actually Bridget Jones' how does one go about dressing as a diary?

Osmo fun!

Happy New Year! I'm now settled back in Banbury and am working full time, having finished my research role at the Royal College of Speech and Language Therapists. I will of course miss it, but I'm very excited to be able to focus all of my energy on my clinical work again. I still have availability to take on a few more children, so please do spread the word!

So, this Christmas was definitely a gadget-based one. My mum got a drone, my fella got a 3D pen and an egg-on-a-stick machine (I know...don't ask) and I got a brilliant little thing called Osmo (thanks Dave!). At this point I should make clear, I'm not in any way linked with Osmo or being paid to say nice things about it, I just want to let you all know how awesome it is. Osmo is a wonderfully simple system which opens up a new way of using the iPad. It consists of a small stand and a clip on mirror, which sits over the iPad's front-facing camera. This allows the iPad to "see" what is happening on the desk in front of it. 

There are a range of apps and accessories. Words is a hangman-style game, in which players race to put the right letter tiles in front of the iPad to complete the words. Numbers involves using number tiles to complete maths challenges. Tangrams uses the classic wooden puzzle pieces and the iPad "watches" you make shapes and tells you when you've got them right. Our favourite app so far though is Masterpiece. It essentially allows you to trace pictures via the iPad. The image you want to work from is displayed on the screen, and your paper, pen and hand are projected on to the iPad screen by the Osmo mirror. As someone who usually can't draw for toffee, I'm really enjoying not having to worry about size, shape or perspective and just focus on style and shading. The best thing about it though is the time-lapse videos it creates, showing your work-of-art come to life.

My mind is racing with ideas for how I can use Osmo in my therapy sessions. I love the way it combines the iPad's technology with tactile, "real-life" objects. I often use drawing and colouring in my sessions, so Masterpiece will really add something. The Word app apparently allows you to add your own words, which will be great for speech sound therapy. I'd love to hear from other SLTs, teachers and families who have tried Osmo.

Latest News

Oxfordshire calling...

I'm excited to say that I'm heading back to Oxfordshire. After a wonderful year in South-West London, my partner David and I have decided to move back to Banbury, North Oxfordshire. We're really looking forward to being closer to family and friends. I also can't wait to start working with some of the nurseries, schools and other settings that I have worked with in the past. We will be moving over the Summer and I will be taking on new clients from August. I will miss the families and schools I have worked with in London over the last year and would like to thank them all for making me feel so welcome.

Stammering therapy in Hampshire

In other news, a very good friend of mine has recently stepped in to the wonderful world of independent speech and language therapy. Abi and I met at university and have remained firm friends ever since. Abi specialises in dysfluency - what she doesn't know about stammering isn't worth knowing! She delivers highly individualised therapy for children and adolescents with stammers. She covers the Portsmouth and South Hampshire area.

If you would like to know more about mine or Abi's work, please get in touch!

New Beginnings!

Tomorrow, I will be starting my new role at the Royal College of Speech and Language Therapists - Research and Development Officer. Don't panic, I'm still available for private assessments and therapy, as it's a part-time role. I can't wait to get started! It's all about evidence-based practice, helping therapists to access and use research more effectively, and helping researchers to focus on the most useful stuff for the profession. 

I feel very strongly about ensuring that the therapy approaches I use are supported by sound research evidence. I want to be sure that the families I work with are getting a reliable, effective service. Luckily, this is typically the view-point of my speech therapy friends and colleagues too, and is recognised across the profession as best-practice. However, unfortunately that's not always the case. The recent news of this trade protection case in America is a sad example of how parents' trust of 'professionals' can be so easily abused.  Parents mustn't be afraid to ask therapists what the evidence is for the approaches they are using with their child. It can be a bit confusing, as there are lots of things which haven't been researched very much yet, so we do often have to rely on our own clinical knowledge and experience. However, plenty of therapy approaches do indeed have research to support (or sometimes disprove) their effectiveness. 'What Works?' is a great resource from The Communication Trust which gives summaries of the evidence behind a range of speech and language therapy approaches. An interesting read on some of the more controversial approaches with a lack of evidence can be found over at Caroline Bowen's excellent website

I'm so excited to start my new role and hope that I am able to leave a useful drop or two in the vast ocean that is evidence-based speech and language therapy. For now though, Antiques Roadshow and an early's been a while since I've had an early Monday morning start! 

Following your child's lead

Following you child's lead is such an simple strategy, but it is surprisingly underused. If a child sees that an adult is interested in the same thing as them, they are more likely to let that adult in to their play. Once an adult has been let in, they are in a much better position to encourage and support the child with their language development. This can be used with children of any age and ability, from new babies to teenagers. 

The easiest way to do it is to simply stop, sit back, and see what your child opts to do when adult input is at a minimum. Look to see if they choose a particular activity. Depending on your child's age and stage, this could be anything from cooing, babbling, crawling, clapping or jumping, to playing with dolls, playing with cars, dancing, or racing in the garden. Show your child that you are interested and see if you can find a way to join in. It's as simple as that! Once your child has let you in to their activity, you can gradually start to adapt the activity to work on turn-taking, attention and listening skills, new vocabulary, and many more communication skills. Make sure you don't change the activity too much though - your child needs to stay in charge most of the time to keep them interested and motivated.

This brilliant video by Phoebe Caldwell demonstrates Intensive Interaction, an approach which has following the child's lead at its core. Phoebe is a specialist in Intensive Interaction. In this video, she uses it with Ricky, a young man with autism.