Thinking Aloud
This is taken from a chapter I wrote in a book called ‘Selective Mutism in our own Words’ by Carl Sutton and Claire Forrester. It is an account of my time working with a girl who has selective mutism, during her time in primary education. Her name has been changed for ethical reasons. Working with Chloë has been one of the most rewarding, frustrating and emotional experiences of my teaching career. It was certainly the longest! I had encountered children with selective mutism before, when teaching in Secondary Schools; however, they were the ones who had managed to use the transition from Primary to Secondary to find their voice. Therefore, the selective mutism was no longer evident by the time I was teaching them. Allow me to introduce myself. I am Hélène Cohen; ‘Miss’, or Mrs Cohen to thousands of children, many of whom are now adults. I have been teaching for over 30 years, initially in the secondary sector, but more recently at a small, independent primary school. Working with all aspects of Learning Support has been my main interest, although I am also a teacher of English, leading the subject in the school referenced in this account. That’s probably all you need to know about me. So, back to Chloë. I shall be calling her this, having asked her to choose her name for the purpose of this account. That epitomises our relationship – everything up front, no tricks, no lies. She is the focus, after all. I first met Chloë soon after I started at her school. She was in the reception class, and her teacher expressed a concern about a little girl who wouldn’t speak in school. She would happily, indeed noisily, talk at home, but only around a very select few people. Not knowing where to start with this, I went on a course. I decided that three of us should go: her current class teacher, the one who would most likely teach her the following year and me. Thus I met Maggie. Maggie Johnson was running the course and it was she who opened my eyes to the fundamental nature of selective mutism: anxiety. This was a revelation to me, as Chloë could be seen playing happily with friends, especially when she thought we weren’t looking! Whilst appearing extremely shy, she always seemed happy in school. Initially, I worked with Chloë from a distance, offering support to her teachers, as they attempted the various steps as laid out in Maggie’s book. All was going well, slowly but well. Chloë started to record her reading at home to be played back to her teacher, she would quietly talk with a select few of her closest friends in school – definite progress. Then changes happened in her home life, and the little talk there was became less. I was also aware that Chloë would be moving up to KS2, across the road and with a very different regime, so the transition needed managing. There would be more teachers, most of whom would be new to her, and more movement around the school on a day-to-day basis. Added to this, Chloë was evidently an intelligent girl. I decided to work with her on a weekly basis, to build a relationship, so that she would have continuity when transferring to KS2. I always took her out with another child, to help her to feel more secure. This is when I saw, first hand, the full extent of the anxiety behind selective mutism. We used to play games that would develop her logical thinking skills. This would require Chloë to make choices, which is where the anxiety showed. Whilst whichever friend was joining her that week (there were 3 who would take turns) would happily select a response, placing a tile in the square of her choice; Chloë would sit, anxiously tearing at a tissue, reluctant to commit to her choice unless 100% certain. She would work away at the tissue, gradually shredding it, and select her response by holding this tissue and tile in both hands and slowly move her whole body gently forward until she touched the square where she needed to place her tile. Her face looked anxious, her shoulders tense - I find it hard to describe in words just how closed in and full of anxiety the movement would be. During this time I needed to do an assessment of her receptive vocabulary, as it was hard to place her academically due to her anxiety about getting an answer wrong. Using a picture based assessment, where I would say a word and Chloë would need to select one of 4 pictures that best fitted the word, her score was average, a standardised score of 102 where 100 is exactly average. For this assessment, Chloë only answered when absolutely certain of the answer and did this showing immense anxiety. My experience and intuition meant that I felt that this was not a reflection of her true ability. This is a concern for those who display selective mutism. The underlying anxiety means that a test situation will often not reflect true potential, so such a child could easily be placed in a set at school at a level below her ability, which will further undermine self-esteem. This can easily become a downward spiral, as self-esteem is essential to successful learning as well as to breaking the silence of selective mutism. To be continued next week…
As I worked with Chloë, I gradually gained her trust. The aforementioned honesty when working with Chloë was essential for this. I always outlined what we were doing, talked openly with her about her voice, and appealed to her innate sense of fun. This was helped by the introduction of home visits during the holidays. In her own environment, while she still didn’t speak in front of me, her sense of mischief started to shine through. We tried the various sliding in techniques as outlined in Maggie’s programme, but Chloë was not yet ready for this. Being sensitive, she picked up on how much her mother wanted her to succeed in speaking outside of the home and that in itself added to her own pressure and anxiety – all resulting from the mutual love between her and her mother. So instead, I drank coffee with Chloë’s mother and we would chat, so that Chloë could become more comfortable around me. There were small steps of progress surrounding the transition, the first being Chloë’s ‘accidental word’ in school. Here are the notes of the incident: “Today, at lunch, R saw Chloë being a bit silly and she was crawling on the floor, so he asked her if she was OK and she said, “Yes, fine.” Then quickly put her hand to her mouth, as if realising that she had said it out loud. R then asked her to fetch him a glass of water, which she did – albeit slowly. He then continued to eat his lunch quietly, without trying to make any conversation. C will inform Chloë’s mum of this incident. Hopefully Chloë will be able to reflect favourably on this.” This utterance was denied by Chloë, and still is to this day, although assurances were given that this didn’t mean that she would now be pressured to speak in school. Having established earlier than usual who would be Chloë’s teachers in Year 3, I ensured that all of the KS2 teachers and TAs underwent some basic selective mutism training with Maggie Johnson, so that none would put undue pressure on her and all would have some understanding of how communication would work. In Year 3 we also started on a range of activities with a small group of Chloë’s friends, all of which took away the pressure of making choices; things such as blowing bubbles and playing silly games. It was also agreed that I should be in the pool with Chloë for swimming lessons, supporting her and another child, to help them to become comfortable in the water. All of this seemed to help Chloë develop confidence around me and this was first seen when I redid the receptive vocabulary assessment. This time, albeit reluctantly, Chloë agreed to have a go even when unsure. This had a tremendous impact on her standardised score, which went up by 15 standardised points, a score much more in line with my understanding of her natural abilities. This in turn was a super boost to her self esteem and marked the start of her real cheekiness when working with me – it turns out that Chloë cheats, not to win, but to ensure that I lose! The transition to Year 3 was positive. I was able to monitor her progress more closely, being based in the KS2 part of the school. Chloë’s confidence gradually grew and she would sometimes ‘forget’ where she was and was even seen running, when she thought no one was watching. This confidence was noticeable in several ways. In Year 3, Chloë’s movements became bigger: from the closed in, anxious movements, tearing (or as we referred to it, killing) a tissue, she would now make ‘body sounds’, tapping, stamping, pinging a ruler on the table, and would even reach across to write on the class white board. Her silent, puppet-operating performance of ‘Head, Shoulders, Knees and Toes’ to her entire class was extremely entertaining and she even played the piano in assembly as everyone was filing in. Added to this, she started to record herself making the body sounds, and allowed me to play these to a select few members of staff. She also, through the dedicated work of an exceptionally patient teacher, started to join in with PE and Games for the first time. Every step of progress, for example with throwing and catching a netball, would then be shown to me so that she could build on this, and not deny her achievements. Her mother would then ensure that she rehearsed these skills at home, away from prying eyes. Notice how casually I threw in that Chloë played the piano in assembly. This was huge! It also involved tears – not hers. Her mother had, as agreed with Chloë, waited outside. I was in the hall. I managed to hold it together the whole time I was in Chloë’s presence, then quietly slipped out after her performance. The full force of the emotion and the enormity of what Chloë had achieved then hit me as I cried with her mother, quietly, outside the assembly hall. This epitomises the intensity of working with someone who has selective mutism. The emotional investment is high, but the rewards are higher. To be continued next week…
