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SLP Corner: Individualized Education Plans or Section 504 Plans for children Diagnosed with a Childhood Anxiety Disorder and Selective Mutism

By: Joleen Fernald, PhD, CCC-SLP

  • Least Restrictive Environment
  • Allow nonverbal communication (pointing, head nods, shakes, thumbs up or down, facial expressions etc.)
  • Prior preparation or alternatives for presentations
  • Video/Audio taping
  • Verbal intermediary
  • Small group work
  • Testing accommodations…For example, taping reading fluency lessons at home via video or audiotape is appropriate, assuming a gradual weaning to “verbalization” is taking place. Consider this sequence of steps:
  • Allow the child to tape her lessons at home.
  • Next, encourage her to tape in a classroom with her parent present.
  • Encourage her to tape part of a lesson on tape, then whisper the lesson to the parent (or teacher)within the class setting.
  • Next, have her whisper the entire school lesson in the classroom with only the teacher present.
  • Increase to another student (a preferred friend), plus the teacher.
  • Increase all to verbalization.
    Each individual step is often a huge leap because the child feels that “the words just won’t come out” even
    through she desperately wants to speak to her peers. Even the slightest successes from the child—including
    looking at the teacher, or coming to the speech room—should be calmly but fully praised the adult.
  • Related services (emotional support, speech and language therapy, occupational therapy etc.)
  • Do not single out the child
  • Have a classroom routine / structured setting
  • Have a “safe” place in the room
  • Do not expect her to talk
  • Don’t comment if the child does talk
  • Seat child in close proximity to a “buddy” or friend
  • Don’t have child be the first to accomplish a demonstration
  • Phrase questions requiring single word responses
  • Do not pressure child for eye contact
  • Give advanced notice of changes in routine, field trips, outside speakers
  • To help with initiating peer interactions use language such as “___ needs someone to help with a puzzle, why don’t we join her”
  • Weekly communication from the teacher
  • Don’t call out the child’s name or draw unnecessary attention to the child. If you are happy with something the child is doing, say something generic like “I love how kids are putting away their toys”
  • Be aware of child’s sensitivity to loud noises or being overwhelmed by lots of chaos
  • Use words to explain how you feel, not just facial expressions and body language
  • Be concrete – child often has difficulty understanding abstract language
  • Quarterly meetings with all related service providers and teacher
  • Minimize direct questioning
  • Arrange appropriate seating
  • Provide the child with word prediction software to encourage her written responses can be heard by all
  • Provide one-to-one time with the teacher (or speech/language pathologist, or psychologist) to play a simple, familiar board game or computer game. The relaxed atmosphere will allow the SM child to “open up.” Then,
    when the child is comfortable enough to speak in this situation, add one close friend in the room with the SM child and adult. Next, increase the peers to two in the same room with the SM child and adult, etc.

Featured Author and Organizations: Joleen Fernald, PdD, CCC-SLP
Joleen Fernald, CCC-SLP has a PhD in infant mental health and developmental disabilities with the Interdisciplinary Council on Developmental and Learning Disorders founded by Dr. Stanley Greenspan.  She has a special interest in the social emotional development of young children. As a speech-language pathologist, Joleen works with children with a variety of communication disorders. She has partnered with Easter Seals NH to begin an assessment and treatment clinic specifically for selective mutism, a social communication anxiety disorder and is the immediate past Chair of the Selective Mutism Group, a non-profit organization specializing in the advocacy of Selective Mutism awareness. Joleen enjoys public speaking and has presented nationally on the topics of childhood apraxia of speech and selective mutism. To learn more about Selective Mutism visit the SMG website at To learn more about Joleen and her work, please visit her website at: Joleen

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