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Navigating Selective Mutism during COVID-19

Individual, Parent and School-Based Telehealth Support For Selective Mutism

I offer telehealth sessions to educate and coach parents and teachers in using evidence-based strategies for increasing speech and social interaction in children with selective mutism. I also offer individual telehealth sessions for children to build speech and expand their social circle to a variety of adults and peers through bravery-based activities and games. With patience and creativity, we can continue to make progress on your child's social and speech-related goals


Virtual Therapy Playgroups at Brighter Outlook Cognitive Behavioral Therapy 

Brighter Outlook offers dyadic and small group teletherapy for children with SM. Goals include increasing verbal and nonverbal communication with adults and peers in a fun and supportive setting. Small, focused playgroups start with warm up time with parents, followed by direct interaction and games with group leader, and facilitation of connections between each child. Groups will meet for 45 minutes one to two times per week. Please contact Brighter Outlook for more information.


Guidelines for Virtual Playdates:

Below I have put together a variety of ideas for telehealth playdates. Some of these ideas you may be able to implement on your own, and others with therapeutic support. 


1) Set up video calls with preferred peers, relatives, teachers, and others in your child's network. Consider someone who is willing to have regularly scheduled calls to allow for repetition and building momentum over time.


2) Engage in parallel play on the video calls at first to warm up. That is, each parent plays with their child separately, using play therapy skills (praise, reflection and description) and asking forced choice questions to get their child's frequency of speech up. There is no cross talking yet. If you are integrating an adult relative, have that person use play therapy skills while observing your play with your child. For more on CDI skills, see: http://mint.fiu.edu/wp-content/uploads/2014/05/SM-Handouts-Packet.pdf


3) Consider starting with audio only so the child cannot visually observe the other party. Or have them sit with their back towards the video screen. These initial adjustments may help reduce anxiety and make it easier for the child to speak. Increase challenge over time to include video and have them face the screen.


4) Consider the location of the camera. Start with the camera at a farther distance and slowly move the camera closer to the location parent and child are seated.  


5) Once both children have warmed up, consider a joint game that requires each child to verbally respond with short one-word answers. Give each child easier tasks to start. For example, if playing 20 questions, each child can answer yes or no and parents can guess the object or animal.  Also consider games that require movement and nonverbal responding for an easier start. See below for ideas!


5) Don't forget prizes and rewards after the session for their brave practice! 


Games that can be adapted for video exposure work:


Spot It 

Hold the two cards close to the video screen so both parties can see.


Guess Who

This is easy to play if each child has the game in their home. Children take turns asking the questions.


20 Questions or Hedbanz

There is an app you can install on your phone for Hedbanz to make it more fun.


Would you Rather? 

It's easy to download great questions for kids off the internet. Here is an example: https://conversationstartersworld.com/would-you-rather-questions-for-kids/


Bingo Zingo

Each party works to complete their game board. Children can push each container at the same time to display the new tokens.

 

Show n Tell 

Children can show toys and items of interest from around the house, favorite games, stuffed animals, or introduce family pets. Parents can ask forced choice questions of each child about those items. Or for more advanced kids, they can ask questions of each other.


Board Games 

One side has the board game and moves the pieces. The other party calls out the numbers or states their choices in the game.


Hangman

One child writes the letters and draws the hangman. The other child states the letters.


Hot n Cold 

One child hides something in the room. The second child directs the camera where to move (e.g, forward two steps, backward three steps, etc). The child that has hidden the object states whether they are hot, cold, warm, freezing, or burning hot, depending on how close the child guessing is to the object.

 

I Spy

One child decides on an object in the room (I spy something that is the color brown). The other child guesses objects in the room.


Mad Libs

One child is in charge of writing and asks for a noun, adjective, etc. The other child provides the answers.


5 Second Rule

One child has two come up with three ideas from a specific category (You don't need to limit the time to 5 seconds)


Surveys

Have children create a survey with a list of options (example: favorite superhero, color, season, holiday, princess, ice cream flavor, etc.) and ask the other child which of the options she likes best.


TellTale

With this deck of cards, one child can make up a story using the sequence of cards to share with another child


Magic Jinn Animal Guessing Game 

This can be ordered on Amazon. Magic Jinn guesses your animal based on the hints you provide.


Make Up a Card Game

You can show the child a card and they can guess if the next will be higher or lower. They get the card if they are correct. If they guess wrong, the therapist or other person playing gets the card.


Puppet Play

Child can answer forced-choice questions asked by a puppet (played by relative or therapist). As a higher-level challenge, have the child speak while being the puppet in a skit or other dialogue.

  

Nonverbal games to increase social connection and warm up:


Charades/ Guesstures

One child acts out what is on the card and the other child guesses.


Simon Says 

One child verbalizes during this game or a parent can lead the game for both children.


Yoga Poses

Use picture yoga cards to have both kids do yoga poses together.


Outdoor Activity

Watch each other's play. Chalk on sidewalk, bubbles, riding bike, etc.


Dance Party

Screen youtube clips first.  There are a variety of engaging dance tutorials for kids online. 


Facebook Messenger Video

Facebook messenger video is engaging and visually fun for kids. They can video with each other while pressing special effects that turn their faces into anything from a dragon to an angel or astronaut.


Play an instrument or do a craft together



Ideas for older youth or kids needing more advanced challenge


Presentations

Have them share with each other a DIY tutorial they created (e.g., a craft, cooking, dance move, or other activity).  Also can record video projects and have dyads share via email. Or have them present on an academic topic they are learning about through online schooling.


Skits

Create and present a short skit or monologue from a play.


Debate skills

Grandparent or other adult asks child questions about specific topic they have researched.