Thursday, 27 September 2007

A big step forward

Things have been on the up since the summer holidays, as H is now happy to be heard speaking, if only in English. He also used a Swedish word in front of someone he believed could not speak it (Danish is a bit different). Then he’s begun to whisper words in both English and Swedish into my ear for me to pass the message on to anyone outside the close family (mainly at nursery). The Health visitor 4 year check was a tad frustrating as I had forgotten to pre warn her about his ‘problem’ and she seemed a bit confused if he could understand language as he wouldn’t speak, or thought it was due to initial shyness. I had to be firm to say I’d talk to her afterwards (out of H’s earshot) as I know he’s v aware. Anyhow, now she has got the psychologist to ring me, and I have an appointment next week, without H. I don’t know how helpful it’ll be. We saw her for S’s behavioural probs when he was 5, and it all I can remember taking away from it was to hold him tight if he got too excited !
Despite my exhaustion due to the change of schedule of Ramadhan I felt I should write something today about H. I'd been neglecting to include this situation in my du'as until fairly recently. I feel I sometimes forget to ask for khair in this life concentrating more on akhirah, forgiveness etc. I forget that Allah wants us to ask things of Him, including this present world.
It was truly a significant improvement, and I have had to contain my joy from my boy as I do not want it to make him take a step back. Even when I swore S to secrecy , S said why wouldn’t it actually make him continue to talk if you praise him? but no, I’ve read and seen for myself that highlighting the fact he’s talked makes them more self-aware and thus reduces speaking.
Today was the 2nd home visit we’ve had from his nursery teacher and 2 friends. The first time they came he would whisper what he wanted to say to them via my ear and I told them what he’d said. Today it started well as he eagerly shouted ‘Hej!’ (Hello) down the intercom when they rang the doorbell. His teacher couldn’t believe it was him. It must be so strange to have known someone for a while and never heard them speak. Then they played the Duplo board game that involves doing simple maths, which H loves. (The other day he was asking for most of the car journey home from dropping off his brothers, various sums, getting harder and harder. This was quite a strain for my fasting brain, and I did consider just saying random answers as he wouldn’t know anyway? But I gave them my best shot!).
Firstly he would give the answer with his fingers, and then moved on to saying the first sound of the number (in Swedish). The I wandered off to get on with some housework. I paused for a second to think, this would be nice, having a nanny for the children so I could actually finish stuff, without being interrupted every 2 minutes to answer some interesting, but brain stretching question. Anyway back to the game and H. By the time they’d finished and I’d set off dishwasher and washing machine (small things like that do satisfy me) H had obviously being stretching his teacher’s mathematical ability and was now able to tell me the answer to a sum like 11 plus 8, in Swedish, in front of his teacher!! She then continued to ask him various questions involving numbers as answers (I was thinking isn’t he going to buckle under the pressure) and he , as clear as a bell, said the Swedish number including the infamous sound(in Sweden anyway ) in the word for seven (sju) (the sj sound is meant to be hard to say and some end up saying ‘sh’ but its more like ‘kh- wh’. Them he decided to show her his DVDs and named the characters, and then went on to say a sentence in Swedish which I can’t for the life of me remember what it was (I was still in shock). I could see his friend had cottoned on that now H was able to talk and his friend then tried to interact more and talk to him. The special needs teacher had said that may be the children would make a big fuss when he finally spoke, but the reaction the boy had seemed natural and didn’t cause h to notice I think.
But he didn’t want to go back with them to nursery and so this showed how his speaking is a clear barometer of his stress levels. He didn’t want to talk to his teacher or friends on the way down. I really needed to sleep and did feel guilty forcing him to go (although he’s usually happy while he’s there and when I pick him up)
Then later when I picked him up, whilst I was helping him get ready to go home , in the presence of several other kids, parents and one teacher in the changing room he said to one girl in his class ‘glass’ which means ice cream. (His reward (or bribe, I’m guilty as charged) for letting me have a sleep, although it was mostly, unbeknown to him, for being so brave and speaking to his teacher and friends).
To top it all, on the way back from picking M from English class H decided to, v loudly, say a Swedish swear-word in combination with a slightly more innocent English rude word, just for the sake of it, in front of our neighbours teenage daughter. I then felt compelled to say ‘Don’t say that they understand that word!’

Wednesday, 29 August 2007

H managed to join in a bit with the Al fatihah recitation playgroup yesterday. I was really pleased as I didn't think he's want to participate. I'm hoping the fact he's becoming one of the older ones in his group as in nursery, he'll feel more confident, inshaAllah.
Have got a meeting today to discuss his hours at nursery. we feel he should stay for snack time in the afternoon as he enjoys it and asks to go. As he is now 4 and we get 15 hours a week for free there are always the bureaucratic hurdles to overcome with this. Also his special needs teacher is going to ask the psychologist to observe him. Funny we have a Psychologist coming for his restricted interaction and for S it was for his unrestricted (i.e. misbehaving!) Good job we have M in the middle or I'd be worrying I was the worst parent in the world!!

Sunday, 22 July 2007

I think I'm relaxing about this...

The trip to the UK proved interesting. H didn't talk to anyone (except once to my Mum and I think it was by accident, him thinking she was me), BUT he non-verbally communicated quite a bit with friends and family, none of whom he'd seen since he was 1 and 3/4, so unlikely he'd remember them (i.e they were strangers).
He was happy to talk in English to me or hub or siblings in front of people, and he must have realised they'd be understanding him. This has been the prob at nursery that he'd regressed to not even speaking English in front of anyone (including children) there. Maybe the overall stress levels were down as everything was in his first language?
Other points of note, he'll talk to his Uncle in Pakistan, on the phone, who he's not seen since he was a few weeks old so is completely unknown to him and still talks to his grandmother there on the phone too. This seems strange as the phone is usually more stressful for anyone (I remember people who stammer find this particularly hard) and he does use the odd Urdu word which is his 3rd language really (only a smattering though). I can understand his willingness to talk to her as she's lived with us for several months at a time, on and off since he was born, but his Uncle? and men did seem to cause a greater anxiety stranger reaction when he was a baby.
Also the other day, something I didn't personally witness, but my Swedish friend and my kids reported that he was sitting with the friends young daughter in Biryani's cot, looking at books together, and he was telling her the names of some of the pictures in Swedish (plus according to M I think, rude Swedish words ?!).
Now I'm inclined to the 'less is more' attitude in terms of intervention, and pray Allah through the course time increases his inner calm in difficult situations to let the words come out.Ameen.

Saturday, 2 June 2007

A practical example of H's fear of speaking.

We were int he park and H was on one of the swings. With 3 other kids to attend of course I couldn't keep my eye out for him all the time. The 2 elder brothers were playing Kubb with me on the other team with a Danish boy who comes sometimes to our park. Another family were also around the swings. Next thing the mother near the swings tells me i should perhaps check my child (H) on the swing. He was very upset, in silent tears, because I hadn't come to push him on the swings. He hadn't had courage to even make a loud noise to attract my attention, let alone call my name. Later on that night before bed he was quite upset just thinking about it. We talked through what would have been a better thing to do to get my attention (call my name) but he wasn't sure if he could do it if people were there.
Today we were in the park and we practised him saying my name, louder and louder as I moved further away from the swings. Of course later on when some people came he got quieter but did manage to say 'push me' quietly. Don't know if I'd have heard it my attention was elsewhere.

Wednesday, 16 May 2007

Some more snippets of info I'm trying to make sense of

I've taken out the snippets I feel useful at the moment. Articles often seem more geared towards school-age kids. The emphasis on a 'team' of professionals and a more structured approach also has me slightly concerned. All that's happening now with H. is quite haphazard. But then are we making an issue out of something that may have gone unnoticed if he'd been at home instead of nursery from an early age and then gained his confidence before being thrown into the 'real' world? Allah knows best and it' something else to feel guilty about. However can imagine if had kept him at home and he'd been mute in school / later on, the lack of nursery attendance would've been blamed, no-win situation.
Here's parts of an artlicle by Robert Schum:
SLP = Speech and language therapist.
'The SLP can also use techniques to help reduce the general anxiety of the child with selective mutism through direct intervention and collaboration with the classroom teacher. Routine and structure often help an anxious child. Clearly understanding activities and having a predictable schedule reduce the unknown. If a schedule is changed or a new activity occurs, a preview of this change can be helpful. Anxious children sometimes appear to be "slow to warm up." They might not jump right into a new activity, but first prefer to observe other children doing an activity until they are sure that they understand what to do. Once they engage in the activity, they may require some adult assistance at first, and then have the adult fade the assistance as the child becomes more confident in the skills. For example, in a kickball game, the child might want to first observe other students play, later start playing with adult assistance, and then independently join in.
In working with children who are mute, I usually use terms such as "shy" and "nervous" to describe feelings when they are reluctant to speak, and "brave" when they extend themselves in therapy or in the classroom. Most of my patients understand these terms, and I find them helpful to use with teachers and parents. UmSuhayb comment: Have read shouldn't use term 'shy' with the child?
Because children with selective mutism often show other anxiety symptoms, another treatment goal in the schools is to promote more spontaneity in behavior. In individual therapy, I often use various media to help the child be more spontaneous and less constricted in actions. For example, we draw with markers, cut paper, use modeling compounds, and get messy with finger paints. The approach is to reduce the child’s self-consciousness and inhibition. These media also afford the child opportunities to communicate in a nonverbal fashion. The SLP should know that the duration of mute symptoms is highly variable. I have had young patients show improvement in symptoms in several months, with no more than 12 sessions of therapy. I have had other patients whose symptoms have persisted for several years. I recommend that in consulting with teachers and parents, we caution them that it may take some time until the child is comfortable speaking spontaneously at school and in other social settings.

In this context, it is important to remember that the mutism is only one specific symptom of the social anxiety. Many times we can note improvement in other, nonverbal symptoms of anxiety. If we focus only on the mutism, we can become discouraged by the slow progress in the improvement of that symptom. However, if we take a broader view of the anxiety, we can often identify encouraging progress over a wider array of behaviors. The SLP can be of great help in counseling patience with other members of the team, including parents and teachers.

This integrated approach to therapy promises the best opportunity for the child’s success.
Additional references can be found in The ASHA Leader Online at
Robert Schum is a clinical psychologist and associate professor in the Department of Pediatrics at the Medical College of Wisconsin. His specialty is the assessment and treatment of children with communication disorders. Contact him by email at '

Also have advised nursery to try activities involving blowing,using mouth but not actually speech, eg bubbles, pingpong balls with straws.
Plus his preference for playing with younger children (less of a threat ?)

Need to advise re anxiety reduction (pictorial timetable, letting him know who he'll be with, relaxing activities, dough, baking, painting..)

Thursday, 10 May 2007

Must start getting serious

about helping my son, H, 3 1/2 years old. However the stuff so far I've read seems to indicate the more the problem is highlighted the worse it becomes and doing any sort of 'therapy' intrinsically highlights a problem?. I'm a qualified Speech and language therapist and I'm feeling overwhelmed.
Here's some stuff I got off the net to start with:

Identifying a child with SM
Children with Selective Mutism:
Find it difficult to make eye contact when they are anxious. They may turn their heads away and ignore you. One might assume they are being unfriendly, but they are fearful and just do not know how to respond.
Look blank or expressionless when anxious. In nursery or school they will be feeling fearful most of the time, which is why it is hard for them to smile, laugh or show true feelings, even when they have a wicked sense of humour.
Move stiffly or awkwardly when anxious, or if they think they are being watched.
Find it difficult to answer the register or say hello, goodbye or thank you. This can seem rude or hurtful but is not intentional.
Can be slow to respond to a question.
Worry more than other people.
Can be very sensitive to noise, touch or crowds.
Can be intelligent, perceptive and inquisitive.
Suggested strategies
If the child does not answer the register verbally, allow them to acknowledge their presence in other ways, such as a smile, a nod, a look or raising a hand. A teacher in an infants class encouraged all children at registration to make an animal noise instead of responding verbally, and this proved successful.
Encourage self-expression through creative, imaginative and artistic activities.
Sometimes sit the child at the front of the group for a story, to encourage attention and involvement.
In discussion and circle times, give the child the opportunity to speak and be patient when awaiting a response.
If the child is socially isolated, link them with other quiet, shy children, singly or in small groups. Play games involving interaction between pairs or the group, such as rolling a ball, pulling on quoits, rowing boats, ring games and rhymes.
Try non-verbal activities which require expelling air and using the mouth, for example blowing out candles, blowing bubbles, blowing ping pong balls with a straw.
Make noises for toy vehicles and animals in play situations or as sound effects for a story.
Introduce play with puppets, because the child may 'speak' through the puppet, especially from behind a screen. Masks may be helpful.
Encourage participation in noisy games and rhymes with predictable language such as 'What's the time, Mr Wolf?'
Use activities that focus on the senses to develop the child's self-awareness
This article was written by Alice Sluckin, Chair of the Selective Mutism Information and Research Association (SMIRA) and a former senior psychiatric social worker, for Nursery World, 17 February 2005. The Selective Mutism Information and Research Association can be contacted at 13 Humberstone Drive, Leicester LE5 0RE. Telephone: 0116 212 7411 (Tues, Wed & Fri, 4-7pm). Email: