SELECTIVE MUTISM INFORMATION & RESEARCH ASSOCIATION
Registered Charity No. 1022673
PARENT AUTHORED ADVICE
Transferring Speech to the Classroom and Working towards Generalisation within the School Environment
This document contains lots of ideas and suggestions on how to plan and deliver an intervention which promotes generalisation within the school environment. This includes: Transferring speech from the withdrawal room to the classroom, generalisation within the classroom, answering the register and working on initiation and assertiveness. The document contains an example plan of an intervention which could be helpful to anyone who is looking to implement a small steps programme, and put their plan to paper – including formal sliding in. This document could be particularly useful to Keyworkers as well as parents.
This document is published by SMIRA and is written by a dedicated parent, known to SMIRA, from their own experiences, in the hope that it will be useful to others.
Disclaimer: The opinions expressed here are not necessarily the views of SMIRA.
When planning an intervention we often refer to “Sliding In” or Stimulus fading. We speak of eliciting speech in a private “safe base”, usually in a quiet room, shielded from interruptions. But what happens after sliding in has taken place successfully in the “safe base”? The Selective Mutism Resource Manual (SMRM) recommends that after a rapport has been built and speech has been elicited with a keyworker they should then proceed to start the generalisation phase. This simply means connecting speech with a larger range of people and in a larger range of locations until children can speak in any setting and to any person. Now as you can imagine, this can take a very long time dependant on the child’s anxiety levels. But you may find that whilst you work on certain objectives other objectives will just fall into place, i.e. will be accomplished naturally as the child’s confidence increases.
So how can you transfer speech from the withdrawal room to the classroom? In this document we will look at suggestions and examples of how this can be achieved for young children (under 9 approximately). Remember that every child is different so what works for one child may not work for another. It is down to you, alongside the rest of the team around the child, to use the knowledge about the individual to decide what may work in the unique situation before you.
PREPARATION
- Ensure that the child is speaking to the classroom-based key worker confidently (not whispering) before you attempt to generalise the speech to the classroom. It is recommended in the Selective Mutism Resource Manual that the keyworker be a classroom based keyworker for this stage because it will be beneficial to the child to have that person with them on a regular basis to help generalise the speech around the classroom and school, and be available for reassurance and support throughout the day as the child needs it. This makes a lot of sense, and people would be wise to follow this sound advice. But unfortunately in some cases this may not be possible or there may be reasons why this won’t work in certain individual situations. In these instances, although not ideal, a member of school staff not based in the child’s classroom but who sees the child as much as possible could take on the role.
- In exceptional circumstances some parents have successfully taken on the role of keyworker. When parents take on the role, so long as anxiety levels are not too high, and their child can already speak to them in an area of the school building, then parents do have the option of following a plan such as the below without prior formal sliding in as outlined in the Selective Mutism Resource Manual. If going straight to this method it helps if the child is able to speak to a few classmates outside of school to make early steps in the plan more manageable. As always it will depend on the child and the situation.
HOW PARENTS CAN HELP WITH PREPARATION
- It is advisable for parents to have lots of playdates at home to help the child build friendships in preparation for this stage. If the child is already speaking to classmates outside of school it should be a lot easier to transfer speech to the school environment.
- Parents can also help their child with de-sensitisation in preparation for this stage. This usually consists of making voice recordings or videos of the child speaking at home, and then working towards the child feeling comfortable enough listening to/watching it in the classroom with their permission. The child could for example, when ready, use a talking photo album to share their news.
- Parents could try to give their child as many opportunities to speak to them around the school before and after school starts. For example, one mother used to stay in the playground with her child and her big sister until all the parents and children had gone, giving the child the opportunity to practice speaking in an environment that she wouldn’t normally feel able to. Another parent worked on trying to keep her child in conversation on the journey to school. Eventually her child could speak closer and closer to the school gates, then through the gates and into the playground, and eventually she was able to speak to her mother in the corridor, toilets and cloakroom if these places were quiet in the mornings before she entered the classroom. Another parent spent time with her daughter in the classroom before and after school, and in the holidays doing pre-practiced activities from home.
PLANNING
- Make an intervention session plan with the assistance of all individuals who are committed to helping the child. By now there should be a team of people, all working together to plan and deliver the intervention, review progress and share information. In the team there should be the parent/s, school staff and any professional who is involved. Regular meetings should be taking place.
- The plan should break the process down into small, manageable steps which increasingly require more speech within more anxiety provoking situations. By making the difference in difficulty between each step small enough, the child should be able to carry on speaking and accomplish the goal. You may find that with each step the child takes, the anxiety that is felt raises a little, which may be evident with a decrease in volume or frequency of speech for a short period of time. But because the step is little, it is achievable.
- It helps to draw up the plan around the three variable factors – People, Location and Activity. As a rule, never change the location and person variables in the same step. In the early phases don’t change the activity in the same step either – just one variable at a time, but as confidence grows you can usually be a little more flexible with this variable. This type of plan is otherwise known as a ‘conversational ladder’, a form of stimulus fading like sliding in. A much more in depth explanation of how to create a ‘conversational ladder’ can be found in the book ‘Helping your child with Selective Mutism’ by Angela E. McHolm et al.
- When considering activities begin with activities which the child feels confident doing, feels at ease with, and which the child finds fun. Think about what the child is good at. The activities chosen should increasingly encourage more speech. Take into account the speaking demands of the activity. They should work up from low speaking demands, to medium speaking demands, to high speaking demands. Please refer to the SMRM for an extensive list of activities.
- You could give the child a choice of activities to complete each session making sure that the activities on offer motivate the child and encourage speech at the right level.
- For some children concentrating on activities that they have pre-practiced at home and they are very competent with helps to reduce their anxiety due to feeling confident that they can complete the activity efficiently and without worry of doing something wrong.
- When thinking about location the first step may be to practice speaking with just the key worker and the child in a few locations around the school such as the playground or the hall when there is no one else around. This will help the child learn that it is not just within the withdrawal room that they can speak.
- The first session in the classroom should be when it is empty such as at lunchtime. When moving onto sessions during class-time, start off in a quieter part of the classroom with a little privacy, e.g. In the reading corner. Towards the bottom of your list you may have areas in the classroom which are more open. You will also need to think about the positioning of the child within each step. E.g. It is a lot easier for the child to speak in a small group when facing away from the rest of the class.
- When considering the person variable, the first should be the keyworker whom the child is currently speaking to. The SMRM suggests that you should next introduce significant classroom-based adults before any children. But, if the child finds speaking to children a lot easier to accomplish than speaking to adults (such as the teacher) then in some cases children are introduced first. Remember you are making a personalised plan. You need to make decisions based on the knowledge you have of the child as an individual.
- Before introducing any new children in the generalisation stage you should find out from the child whom they would like to join the sessions first. They may already have spoken to a few select children in the withdrawal room when sliding in or on playdates outside of school. If so the child may like to introduce these children first in the order s/he chooses.
- Generally at this stage of the intervention there should be no need for sliding people in from outside of the room. New people can be gradually introduced from the beginning of the session and be included in the activity from the start. Occasionally there may be children who feel their anxiety rise so much in a full classroom situation that they find themselves unable to speak. In these cases it may be helpful for the parent/s to join in with the sessions temporarily until the child feels more comfortable. If this strategy does not work or is not possible/suitable then you may find cause to slide in from outside of the room. This will mean inserting intermittent steps and holding extra sessions in the withdrawal room and/or in the empty classroom.
The plan below is a real life plan that was used successfully with a 5 year old girl. The plan was made with the intention of being flexible. If she found a step too hard then an intermittent step could be added. If she found steps very easy then step/s could be omitted. The aim is to go at the child’s pace.
EXAMPLE PLAN
The stages below are broken down into Step, Person, Location and Activity (to see these in a table form, please download the PDF of this document).
1. Keyworker alone with N
Quiet corner of the hall (classroom entrance leads off hall). Each session move the table closer to the classroom door.
a) Board game from home that has low speaking demands.
b) Play game with medium speaking demands.
c) Read. Then play game with medium speaking demands.
2. Keyworker alone with N
In empty classroom at lunchtime.
a) Board game with low speaking demands.
b) Read. Then game with medium speaking demands.
c) Read. Then ask simple questions. Then game with medium – high speaking demands.
3. Keyworker alone with N during class
In back corner of classroom on the carpet, behind the storage units. N cannot see the rest of the class.
a) Play game with low – medium speaking demands.
b) Key worker then reads N story. Keyworker asks simple questions. Keyworker reads story then asks simple questions. Then N reads (when ready).
c) N reads. Then board game with medium speaking demands.
4. Keyworker, N and best friend E
In back corner of classroom on the carpet, behind the storage units.
N reads to keyworker only. Then E joins them for a game with low-medium speaking demands.
5. Keyworker, N and other best friend G
In back corner of classroom on the carpet, behind the storage units.
N reads to keyworker only. Then G joins them for a game with medium speaking demands.
6. Keyworker, N and other best friend H
In back corner of classroom on the carpet, behind the storage units.
N and H read to keyworker taking it in turns to read a page. They then play a game with medium speaking demands.
7. Keyworker, N, H and G
In back corner of classroom on the carpet, behind the storage units
N and H read to key worker taking in in turns to read a page. Then, G joins them all for a game with medium speaking demands.
8. Keyworker, N, H and G
Middle of carpet away from the storage units. N facing away from the rest of the class.
N and H read to key worker taking it in turns to read a page. Then G joins them all for a game with medium speaking demands.
9. Keyworker, N,H,G and E
Middle of carpet. N facing away from the rest of the class.
N and G read to key worker taking it in turns to read a page. Then, H and E join them all for a game with medium – high speaking demands.
10. Keyworker, N,H,G and E
Middle of carpet. N facing side on to the rest of the class.
N and E read to key worker taking it in turns to read a page. Then, H and G join them all for a game with medium – high speaking demands.
11. Keyworker, two best friends (E, G or H) plus one other child from the class. Repeat as necessary, each time introducing a different classmate of N’s choosing
Middle of carpet.
N facing side on to the rest of the class.
N and any friend read to key worker taking it in turns to read a page. Then classmates join them all for a game with medium speaking demands working up to high speaking demands.
12. Keyworker, N and one best friend (E, G or H) plus 2 (working up to 3) other classmates. Repeat as necessary using different children
Gradually as the sessions repeat N should be facing the rest of the class.
N and any friend read to key worker taking it in turns to read a page. Then classmates join them all for a game with medium (working up to high) speaking demands.
13. Keyworker, N, two best friends and two other classmates of N’s choosing. Repeat using different children
Sitting at table in central part of classroom.
N and friend of N’s choosing read to keyworker. Then other friends join in with a game with medium speaking demands working up to high speaking demands.
14. N, and three friends of her choosing. Key worker slides out and watches discreetly from afar
Sitting at table in central part of the classroom.
Any game of N’s choice with at least medium speaking demands.
15. Keyworker, N, and three friends of N’s choosing. Teacher sits or nearby in sight and hearing distance not paying them any attention
Sitting at table in central part of the classroom.
Any game of N’s choice with at least medium speaking demands.
16. Keyworker, N, and three friends of N’s choosing. Teacher sits at table listening to a child read not paying them too much attention
Sitting at table in central part of the classroom.
N and one friend read to Keyworker taking it in turns to read a page. Then any game of N’s choice with at least medium speaking demands.
17. Key worker, N, two friends of N’s choosing and teacher. Repeat as necessary.
Sitting at table in central part of classroom. Keyworker sits next to N and Teacher sits next to friend. When repeated N sits next to teacher.
N and one friend read to teacher and Keyworker taking it in turns to read a page. Then second friend joins them to play game with medium speaking demands. When repeated ask simple questions about the story.
18. Keyworker, teacher, N and one friend of N’s choice.
Sitting at table in central part of classroom. N sits next to teacher and friend sits next to keyworker.
N reads her book to the teacher and friend reads her book to the keyworker.
19. Teacher and N
Sitting at table in central part of classroom
N reads her book to the teacher. Keyworker close by.
Rule: Only move onto the next step when the current one has been completed successfully. i.e. The child was able to speak in an audible voice.
- The above is just one example of a personalised plan. Every child is different. Some may need more steps, others may need less. E.g. Many children may benefit from more sessions in the empty classroom than this child had, introducing children and significant adults when the room is quiet first.
- As you can see, in the first few steps the activities change in quick succession but the location changes more gradually. This is to build up the child’s confidence with the keyworker outside of the withdrawal room.
- Reading played a big part in this child’s intervention. This is because this child loved to read and was an area of strength for her. The praise she got for reading motivated her and so for this individual it worked very well. It was found to be a very useful tool to help her ‘warm up’ before the main activity. If you are working with a child who finds reading difficult or does not enjoy it, obviously it would not be a good activity to choose. Always choose an activity which the child loves to do.
- In this example the child’s three best friends featured heavily in the intervention. This is because she felt comforted to have them there and she spoke fluently to them outside of school. Having her best friends in the sessions also acted as a motivator for her.
- It was decided in this case to slide in friends before the teacher or other teaching staff because it was easier for the child to accomplish and it is what the child wanted. The idea was to very gradually work up from less anxiety provoking to more anxiety provoking situations.
ANSWERING THE REGISTER
Whereas some SM children find it fairly easy to answer the register due to low speaking demands and same repetitious response, others find it extremely difficult. For some the pressure, expectancy to speak, and the feeling of ‘all eyes on them’ is too much. It is a good idea to put a support strategy in place from day one before anxiety takes a hold. This may help to prevent the child from experiencing negative feelings around participating. Make a plan. Below are a few ideas on how you could help the child work towards being able to answer the register.
- Practice answering the register through role play at home or in another environment where the child feels at ease to.
- As a start to help promote participation encourage non-verbal participation. The child could simply raise their hand, make a gesture, use a musical instrument or make noises such as animal sounds. These suggestions would be most effective as whole class approach to prevent the child from standing out too much. The class could nod one day, another day wave their hand, click their fingers, clap, wink and so forth.
- As an initial strategy it may be possible to set up a register system on an interactive white board in which children simply have to touch their name causing it to change colour.
- Use a voice recording (when ready). This will help with desensitisation.
- Use a puppet. Some children find it much easier to speak in role. You might find that the child can speak using a puppet, maybe holding in front of their face and putting on a different voice. You can use this ability to help build up the child’s confidence. This process can be broken down into steps: Step 1. Child answers register with full sized puppet. Step 2. Child answers register with finger puppet. Step 3. Child answers the register with face drawn on finger. Step 4. If child keeps finger to his/her mouth work on moving the finger away. You can use your imagination with this step, e.g. draw snake on finger, as the child answers “yes” – hold the “s” and the snake wriggles away. Step 5. No face on finger.
- Answering the register in pairs (whole class approach). It won’t matter with this approach if the child is unable to answer as the other child will be answering anyway which removes the pressure from the anxious child. When the child is ready they can take the next step of beginning to join in with the classmate. The next step would be for the child to answer alone.
- Answering the register with parent or keyworker. This again needs to be broken down into small manageable steps. The following is an example of this idea which was used successfully with a five year old girl. This suggested method should only be attempted with a child who is able to speak at least a little in the classroom, but who struggles with the register. It is likely to be too difficult for a child who has not yet spoken in the classroom, or who does so infrequently… Step 1. Child sits on parent’s knee and whispers “yes” to the register. Step 2. Child says “yes” to the register in quiet voice. Step 3. Child says “Good Morning” in answer to the register. Step 4. Child says “Good Morning Mrs X” in answer to the register (now same as the other children). Step 5. Parent starts to slide out. Child sits in front of parent. Parent gradually moves away each day. Step 6. Parent waits outside of classroom. Step 7. Parent no longer needed. The way in which this method breaks down what the child says when answering the register, i.e. Yes – Good Morning – Good Morning Mrs X, can also be adopted into other methods too, such as with the ‘answering in pairs’ and ‘puppet’ ideas.
- Teachers need to ensure that when calling out the register they give the child ample chance to answer verbally. It is right that teachers should not place pressure on children with SM to speak, but it is also unhelpful to expect that they will not. For example, a quick wave to the child then promptly moving onto the next child does not give the child the opportunity to make small steps when they are ready and does not encourage progress. It is a good idea to count to 5 or 6 before moving on thus giving the child the time they may need to find their voice if they are ready.
With each of these suggestions it is very important that the child is in agreement with the method chosen. Also, where methods are split into steps, as always it is important that the child be confident with the current step before moving onto the next one.
PROMOTING GENERALISATION
- After the child has successfully transferred speech to the classroom you may find that for a time the child’s speech – especially spontaneous speech is limited to the planned small group/one to one sessions they participate in. The child may also be quite reliant on the keyworkers presence. Listed below are a few ideas that may help to generalise speech within the classroom.
- Giving permission: Sometimes simply saying to some children that it’s alright for them to speak/ask for help/say they don’t understand etc… can help to unhitch them from their dependence on the organised sessions and their keyworker.
- Practice lesson activities outside the classroom in a small group then later in the classroom in a small group.
- When asking the class questions give the child time to think and process what to say. Many children with SM take longer to answer questions than may be deemed typical. Try counting to between 5 and 10 to give them the opportunity to gather their thoughts and courage. If the child does not respond tell them you will get back to them and ask that they write the answer down while they are waiting. The child can then read the answer back to the teacher which will make it easier for them thanks to the visual cue. This can be done as a whole class approach.
- Allow the child to sit with a child/children they speak to in the sessions when completing group or paired work.
- When the child is sat with children in class that they are verbal with in the sessions the teacher could speak to the child about the activity being undertaken.
- Use ‘alternative choice’ questions – questions with a choice of two answers. It is a lot easier for children to reply by repeating a word than to have to think about an answer, retrieve the words they are looking for, and then proceed to voice them.
- If the child is a confident reader encourage paired reading.
- Invite the child to participate in whole class circle time. This could be the sharing of news or show and tell. Encourage the child to bring things in that they are passionate about or special work they have done at home such as artwork, a poem, or a story. The child may like to show special toys from home or photos. If the child would like to share things with the class they may be more likely to speak about these interests, achievements or cherished belongings because they motivate them, even if quietly and only to the keyworker at first. This can then be built on. Also, by allowing the child to keep some special belongings in school for a while after being shown to the class, and letting them show or play with the objects with their friends during unstructured parts of the day, you may find this helps the child to speak to the other children without adult input and may help encourage initiation. – Encourage and assist the child to start a lunchtime club regarding their special interest. Using their passion to engage the child with other pupils will help self-esteem to grow as they share their interest and knowledge with peers.
- Giving the child responsibilities, e.g. to issue out library/classroom books.
- Scripted role play or acting out a favourite story can help some children. First practicing in small groups with privacy, then working up to performing to the class.
- If the child has a hobby or talent promote it by allowing them to share it with others if they would like. This may help to boost self-esteem and may encourage conversation.
Some children find unstructured play out in the playground at break times difficult. It would be beneficial to the child if the keyworker (or other appropriate adult whom the child can speak to), could try and find time to facilitate some organised activities which require some speech at play time. For example, Duck Duck Goose, What’s the time Mr Wolf or Red Letter. - When the child is ready think about introducing new adult conversational partners such as dinner ladies, office staff, and very importantly his/her teacher and teaching assistant/s for the next year group they will transfer to. Plan all the little steps following the guidance above.
Hold small group activities in a variety of locations (working up the ladder in small steps), including the next classroom that will be entered in the following transition. Good transition planning is very beneficial.
PROMOTING INITIATION AND ASSERTIVENESS
Initiation can be very tricky for children who are working through their Selective Mutism. Children often reach the stage where they can answer questions very well but find it extremely difficult to ask questions or report an incident, and generally find the more assertive functions of speech a big challenge. Some of the above ideas which help with the generalisation stage can be helpful with this but there is more you can do…
- Play the ‘Yes’, ‘No’ or ‘I don’t know’ game. This could include a list of statements or questions, some of which are very silly or of which the child would never know the answer to, such as “What did the Queen have for dinner last night?”
- Give the child errands or messages to deliver, e.g. “I have a note from Mrs X for you”. Or “Can Mrs X have the stapler please”. It may be an idea to ensure that the person who is being asked or told something is aware of the question to be asked/message to be given beforehand to prevent any misunderstandings, or the child being asked to repeat which may make the interaction stressful for the child. In the build up to this non-verbal errands should be completed first.
- Play games that include asking questions such as Guess who, Happy Families, Who am I. The Favourites Game is a good game that entails opinion sharing as well as answering and asking questions. In a small group children take it in turns to ask the group “What is your favourite…? Every child then shares their favourite toy, drink, flavour of ice-cream etc…
- Fact finding and reporting back without a prompt.
- Being responsible for time keeping and giving an adult a reminder at the end of the session
- Play games/complete activities which gives the child practice at correcting the speaker. For example, make deliberate mistakes when playing a matching or naming game.
- Encourage children to say when they don’t understand, or need clarification or help through a whole class approach.
- Some of these suggestions can be found in the Selective Mutism Resource Manual. Please see Appendix 5 for further details and for many more ideas of activities that can help with progressing through the generalisation phase.
© Saggers 2013
Appendix
References
M. Johnson and A. Wintgens. 2001. The Selective Mutism Resource Manual. Speechmark Publishing Ltd.
A.E. McHolm, C. E. Cunningham and M.K. Vanier. 2005. Helping Your Child with Selective Mutism. New Harbinger Publications inc.
Glossary
- SM – Selective Mutism
- Formal Sliding In: A formally planned intervention with the use of stimulus fading such as is outlined in the Selective Mutism Resource Manual.
- Generalisation – Connecting speech with a larger range of people and in a larger range of locations until children can speak in any setting and to any person.
- Keyworker – Adult actively leading the intervention.
- Withdrawal Room – A private room situated in the school.
Bibliography
M. Johnson and A. Wintgens. 2001. The Selective Mutism Resource Manual. Speechmark Publishing Ltd.
A.E. McHolm, C. E. Cunningham and M.K. Vanier. 2005. Helping Your Child with Selective Mutism. New Harbinger Publications inc.