Selective Mutism

dashofreality

Hello, I have never posted here but thought this would be the best place to ask for advice. My DD is just about to turn 4. She was born at 35 weeks and has always run a bit behind on milestones but generally is on target. She has been evaluated twice - once around 15 months, prompted by our pedi for no speech, and once just before 3 prompted by me based on lagging gross motor skills and sensory sensitivity. She did not qualify for services either time.

My concern now is her selective mutism. It has been very noticeable for about the last year and half. She speaks fine (and quite loudly) at home and with family. She will not speak to strangers, even other kids. She also does not speak in preschool/daycare. She has been in daycare since she was 12 weeks old. She is happy at preschool, excited to go, will smile and nod to the teacher, tell me about her day, but she does not speak.

We are military and unfortunately we have had a lot of change the last two years. We have had a few daycares, 2 moves, and currently my DH is deployed and will be returning soon. I haven't addressed the SM because she has had so much change, but since she has been at the same school for 2 months without a single word, I think I probably should address it.

Any advice? She will have her 4 yo well check soon, I am thinking that I will bring it up then. In the past my pedi has been a bit dismissive though, and the military system isn't fantastic for behavioral health. Writing this all out is solidifying my feelings that there is a concern. I appreciate any stories, resources, things to look for etc.

Junebug060609

No information on SM, but we are a military family as well. Does she see a developmental pedi? Is she in EFMP or ECHO?

dashofreality

@junebug060609 No she does not see a dev pedi and she is not EFMP or ECHO.

 

Honestly, my concerns have been brushed off by my pedi. I did contact EI and she had an eval. She is receptive and will answer questions by nodding or pointing so she did not qualify. At the time I wasn't as concerned with SM, more gross motor and sensory.  Things are starting to pile up and I think I need to start pushing more. Her eating is becoming worse, she has never been affectionate, and the SM. I have downplayed this because the two times I have gotten evals they kinda act like I'm a bit crazy and she is fine.

dashofreality

-auntie- said:

Has she ever seen a developmental pedi and been formally evaluated for an ASD.

While it's possible for a girl to have global delays around speech and gross motor skills, along with SPD and SM, it's also what you might see in a gril with ASD, especially one who would be considered "high functioning".

Does she have any restricted or strong interests? Do you hear her sometimes repeat dialog from another source? Does he speech sometimes seem scripted or formal? Does she tend to interact more/better with adults than same aged peers? Do her teachers have any concerns?

Thanks @-auntie- No she has never been evaluated for ASD. No restricted/strong interests. She will often bring up something that she overheard days later, in an appropriate context, but not much repeating/scripted/formal. Definitely better with adults. In her dance class she doesn't talk but hangs around the teacher. The only kids she talks to/plays with are her brother and her 2 cousins. Teachers are concerned that she never talks, but she is so 'easy' and seems happy that I feel like they overlook a lot.

Besides the SM, she seems to just touch on some of the red flags but nothing has been enough to warrant further eval. She is very sensitive to smell, and is very limited in what she will eat, but she eats enough. She shows some possible stim behavior, but it is only when she is going to sleep/tired. She won't talk but she will follow directions from a stranger, doesn't hide and is ok with eye contact. She did recently start giving me an occasional kiss and hug, but she has always been uncomfortable with affection. She loves imaginative play and now has an imaginary sister.

I have had some concerns for awhile, but everyone in my family thinks I am overreacting and she is fine. So far 1 dev pedi, 1 EI eval, and 1 neurologist (for absent seizures) have also said she is fine.

Sorry for the novel, it is nice to be able to state my concerns without someone telling me I am overreacting.

dashofreality

@bubba2b I'm sorry about your DS' dx. I think pushing is in order....but denial is so much easier.

Keeptruckin

Just chiming in with my experience. I too was the mom who asked for Evals and was offered quick screenings that didn't pick up any red flags. It seems like you really know in your gut something is off but no one wants to listen. Ask for a full ASD evaluation. When I would look up the criteria online I couldn't check off yes to a lot of the red flags, but that was probably my mommy goggles. But I would look at my daughters behaviour and say, yes she has autism, that is what this is. My daughter never had any SM that lasted longer than a day, but she still has certain situations and people she will literally not say a word. Good luck!

kcisthebombdotcom

Welcome!! My daughter is very similar. I'm not sure if she had selective mutism but she definitely has some anxiety of speaking. It took her nine months to start speaking to her EI therapist and she just started speaking in school this month that ironically she's been in for nine months. She's always been incredibly excited to go to school and is all smiles all the time there. She is on the autism spectrum with sensory issues. She's attracted to much younger children and teaching them to do things and I bet it's because there isn't that expectation to speAk.

dashofreality

Thank you all so much!! Auntie the detailed information is very helpful. I really appreciate all the information and your stories.

I will definitely bring this up with her pedi and seek additional evals. It is difficult to see how she is a completely different person outside of our home. I owe it to her to see if there is anything that will help her be able to be herself outside of her comfort zone, even if it means heading down a slightly scary path.