Tips for Teachers & Strategies for Staff: Addressing SM in School

If a child is receiving recurring therapy for selective mutism, that therapy likely only occurs for 1 hour per week, which pales in comparison to the 30-35 hours they spend at school with teachers and staff. However, teachers are tasked with attending to the demands of entire classes of up to 25-30 students, so it can be difficult to figure out how to address the needs of one kid — especially if that kid completes their work and poses no disruption to general instruction. At the same time, we know that selective mutism can have negative impacts on educational, behavioral, social and emotional functioning, so it is important for teachers and staff to have the tools to support those students in school. This article provides helpful steps for incorporating the most commonly used behavioral intervention found in SM treatment studies — contingency management systems — into the school setting.

1. Determine who is on your team
   
   An important member of your team will be the key worker. This individual takes the lead in managing school interventions and coordinates communication across everyone involved in speaking exposures. Notably, this person cannot be the primary classroom teacher. The teacher is able to facilitate exposures within the daily schedule and curriculum, incorporating speaking demands into instruction without interrupting the flow of learning. The key worker needs the flexibility to conduct pull-out and push-in exposures across multiple school settings (e.g., running “errands” to the office to practice speech with new adults or prompt pre-planned questions during small group activities). Potential key workers are school psychologists, social workers, paraeducators, or even preferred adults like office administrators and school leadership.
   
   If the child is receiving private treatment for SM, that clinician is also on your team! External providers are valuable sources of information regarding structuring an SM treatment plan and addressing potential roadblocks. Regular communication between the key worker and external supports ensures consistency in interventions across settings, which will boost progress. 
   
   

2. Set Goals
   
   Initial goals should be dependent on baseline speech; for example, if a student is only comfortably responding in private to one teacher, their first goal could be responding to a different adult that has not prompted speech before (which reduces the chance of failure due to contamination). A smaller goal could be responding to their teacher with one person within earshot; a bigger goal could be answering a rehearsed question in a small group. However, asking a question in front of the whole class is way too big of a jump from current speech to be a reasonable goal.
   
   There are many possible directions to go when considering goals — responding to new adults or peers, responding in new environments, increasing sentence length, raising speech volume, initiating with new adults or peers, initiating in new environments, presenting in front of a group, and more. There is no one right path to increasing speech, so school expectations, curriculum standards, and student interest can provide good starting points. Following the SMART goal framework — specific, measurable, achievable, relevant, and time-based — is another helpful guideline for developing effective goals. Setting a goal like “during math, Ella will verbally respond to 2 forced-choice questions” provides far clearer expectations than “Ella will speak in front of peers,” which reduces anxiety and increases goal completion.
   
   

3. Determine Reinforcement
   
   The most successful contingency management systems incorporate frequent small reinforcements and intermittent larger rewards. The smaller reinforcements should be things students can earn daily in order to track progress, like brave points and stickers, accompanied by brief descriptive praise. Bigger rewards can be redeemed upon earning a predetermined number of those smaller reinforcers. In elementary school this can look like earning a sticker for every forced choice question answered during the day, and earning a small toy for getting 10 stickers, whereas in high school it might look like getting a tally mark for every initiation during a small group activity and earning 30 minutes of screen time at home for 5 tally marks. Providing this external motivation can help students build bravery and confidence in their own speech, which eventually supports their intrinsic motivation to speak freely.
   
   

4. Put Your Plan in Motion!
   
   Now that you have target behaviors and positive reinforcers, it’s time to get started! For more guidance on how to use reinforcement systems at school with kids with selective mutism, check out this webinar sponsored by the Selective Mutism Association and hosted by two of our clinicians: Taylor Hicks-Hoste, PhD, LP, NCSP & Katelyn Reed, MS, LLP. If you are looking for additional support for students who may have selective mutism, feel free to refer families to Thriving Minds to discuss our services — we’re more than happy to help!