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6/8/2009 1:19:05 PM
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 Mari67 Posts 10
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I hope I can find someone who can relate to my son's issues. Hi my son is 6 and has a combination of issues. He has an expressive/receptive language delay for his age. At home he expresses his wants, needs, is assertive, plays with brother, etc. and functions fine with everything but as soon as he gets to school, he's very quiet, won't talk the the other kids/teachers only whispers to them sometimes. He's a little angel in school everybody loves him including the kids and always answer things for him.
This is affecting his learning and he'll be repeating kindergarten and transferred to new school which I'm very upset about. He needs the one on one instruction due to his shyness and not communicating to others, it's hard for them to know what he knows and no one can figure him out. I wasn't prepared for his IEP and was very emotional after they told me all the negatives about him. The psychologist only did a one sided evaluation report, only including his school behavior and transfer to a new school in an autistic class. His psycholgist at Miami Children's didn't find him to be autistic but his behavior -not talking, staring into space, shyness make them think that. He just needs someone to direct him on what to do. I don't know what to do. I'm very frustrated and feel horrible moving my son to another school again. Can anyone help me or give me some advice. thank you this is a wonderful site Mari 67
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6/8/2009 1:37:10 PM
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 yrodriguez Posts 16
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Hi,
I am so sorry that you are having such difficulty. First, I believe you are a great mom for looking for answers. I do not want to tray you in the wrong direction. Each child is different and responds different to the school environment. If you feel in your heart that the placement is incorrect; I would start there. Call our office phone at 305-271-9797 and ask to speak to an Education and Support Specialist. We can review that IEP and discuss your options. If your child has Selective Mutism; perhaps someone reading this will reach out to you about their personal experience.
Take Care,
I hope I can find someone who can relate to my son's issues. Hi my son is 6 and has a combination of issues. He has an expressive/receptive language delay for his age. At home he expresses his wants, needs, is assertive, plays with brother, etc. and functions fine with everything but as soon as he gets to school, he's very quiet, won't talk the the other kids/teachers only whispers to them sometimes. He's a little angel in school everybody loves him including the kids and always answer things for him.
This is affecting his learning and he'll be repeating kindergarten and transferred to new school which I'm very upset about. He needs the one on one instruction due to his shyness and not communicating to others, it's hard for them to know what he knows and no one can figure him out. I wasn't prepared for his IEP and was very emotional after they told me all the negatives about him. The psychologist only did a one sided evaluation report, only including his school behavior and transfer to a new school in an autistic class. His psycholgist at Miami Children's didn't find him to be autistic but his behavior -not talking, staring into space, shyness make them think that. He just needs someone to direct him on what to do. I don't know what to do. I'm very frustrated and feel horrible moving my son to another school again. Can anyone help me or give me some advice. thank you this is a wonderful site Mari 67
-- Yamilet R
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6/8/2009 1:55:30 PM
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 Mari67 Posts 10
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THANK YOU I WILL DO THAT. yrodriguez wrote:
Hi,
I am so sorry that you are having such difficulty. First, I believe you are a great mom for looking for answers. I do not want to tray you in the wrong direction. Each child is different and responds different to the school environment. If you feel in your heart that the placement is incorrect; I would start there. Call our office phone at 305-271-9797 and ask to speak to an Education and Support Specialist. We can review that IEP and discuss your options. If your child has Selective Mutism; perhaps someone reading this will reach out to you about their personal experience.
Take Care,
I hope I can find someone who can relate to my son's issues. Hi my son is 6 and has a combination of issues. He has an expressive/receptive language delay for his age. At home he expresses his wants, needs, is assertive, plays with brother, etc. and functions fine with everything but as soon as he gets to school, he's very quiet, won't talk the the other kids/teachers only whispers to them sometimes. He's a little angel in school everybody loves him including the kids and always answer things for him.
This is affecting his learning and he'll be repeating kindergarten and transferred to new school which I'm very upset about. He needs the one on one instruction due to his shyness and not communicating to others, it's hard for them to know what he knows and no one can figure him out. I wasn't prepared for his IEP and was very emotional after they told me all the negatives about him. The psychologist only did a one sided evaluation report, only including his school behavior and transfer to a new school in an autistic class. His psycholgist at Miami Children's didn't find him to be autistic but his behavior -not talking, staring into space, shyness make them think that. He just needs someone to direct him on what to do. I don't know what to do. I'm very frustrated and feel horrible moving my son to another school again. Can anyone help me or give me some advice. thank you this is a wonderful site Mari 67

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6/9/2009 7:07:48 PM
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 srancano Posts 1
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Hi,
It is really difficult to deal with school issues. I have a 10 year old daughter with high functioning autism. From what I understand there is a big difference between autism and selective mutism. I have a few questions for you. Have you consulted with a speech therapist about your sons selective mutism? Have you had a private evaluation or consultation with a psychologist that can help you rule out the diagnosis of autism? The school is not qualified to give you a diagnosis of autism. Their evaluations are only used to see if your child is eligible to receive special eduation services. Also, do you feel the current school you are in are willing to help your son. You can ask for help from the region or district to send specialist to come observe your son and give recommendations on how to help him. I hope this helps.
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6/11/2009 10:19:35 PM
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 miamirn Posts 40
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Hi,
I agree with srancano. My grandson is 7 years old. He has high functioning Autism PDD-NOS. He has an expressive/receptive language disorder, related to his Autism. He is doing very well. He has problems talking to children and adults in certain circumstances. It even happens with his Mom, Dad and me. It would appear as if it is Seclective Mutism, but it is his Autism. It was only a couple of years ago he was speaking like he had a stroke, in jargon and appeared mute most of the time. He improved both on his own and with the help of his family and a little therapy. (wish we could have afforded more). A speech therapist evaluated his language problems, and a thorough psycho-education test evaluated his problems both psychological and educational. The evaluation also included a ADOS and ADIR evaluation. There were interviews and questionaires as well as ongoing observations during the entire process in to make a diagnosis of Autism (The ADOS and ADIR are considered the Gold Standard in testing for Autism). In other words there are specific tests that can diagnose Autism that are used in conjuction with a general psychoeducational evaluation to diagnose Autism. There are other tests that are used to diagnose Selective Mutism. A medical doctor depends on these evaluations to make their diagnosis(s), they don't pull it out of a hat.They need these evaluations in order to make psychologic and psychiatric diagnoses.IQ An evaluation by a psychiatrist may, necessary. Especially if there is a suspicion of Selective Mutism.
The Public School System does IQ tests ,pscyoeducational evaluations, interviews and does a very good job at screening for problems, but they do not diagnose children.They also do screening evaluations for Speech/language, occupational and physical problems relating to these therapies with a particular focus on educational function. The purpose of all school testing is to evaluate how a child is functioning in the school setting academically and behaviorally and what services, within the school system would benefit the student in order for the child to excell with the learning process. Their focus is narrow, but effective. If your child has Selective Mutism, their screening process may come up with an indication that it may be this diagnosis and recommend further testing done outside the school system by a trained professionals. Teachers sometimes have good intuition, of what kind of problem their student may have and recommend that the school screen for a diagnosis, but it is only a screening.The evaluations are not in depth tests. The testing shows that certain types of programs, classes and services in the school system will benefit their students. This may be where they came to the conclusion that your child would be best served in a class with Autistic children. Autism has a classical symptom of children having difficulty understanding and or expressing themselves. The placement may be a good one, even though the label of Autism may not be appropriate. My son, who is 25 now, was in several types of programs. He has Bipolar and ADHD. When he was 20, a diagnosis of Asperger's Disorder was made. He was inEH- Emotionally Handicapped,SED- Severely Emotionally Distrurbed,LD GIfted- Gifted Learning Disabled,VE- Variable Exceptionality,BG- Behavioral Gifted. Pick the one you like the best. lol. Now it makes me laugh to see me writing all these programs. He was still the same child in all the different programs. I had him placed in SED, because it was the finest program in the school system at the time. Was he severely emotionally disturbed? No! SED was a label. Yes some of the students were severe, but the program afforded him the best educational and behavioral approach there was. It was an excellent program. Ideally. He should have been in an "ADD/BP/GIFTED" Attention Deficit, Bipolar, Giifted Program. Laugh out Loud!
When all is said and done. It is up to us, as parents, to make sure our children are diagnosed and placed in the best school program we can find. Is a challenging, arduous, stressful? Yes, but it is ultimately a very rewarding experience. I know I couldn't have done it without a lot of work, research and help from others; family friends, aquaintences, professionals. For my son, the adventure continues. It is never really done. And now it is my turn for my grandson.(It is hereditary in my family). This time I have experience. I am a lot more confident and hopeful. I know things do get better, in time. Life does get easier. The children do have fruitful lives.
Today, I do laugh at the school system, the health care system, myself and all those that are mine.
Please stay strong and do ask for help frequently and don't forget to find the humor in life.
miamirn/Elona
PS.Recently, my grandson attended a Social Skills group for nine weeks sponsered by CARD. There has been a noticable, mild improvement. I am so pleased. He has learned to be a little more comfortable with expressing himself; he has also learned that it is an expected social norm. All the other children improved in some way in the group. It was an inspiring experience. The children learned from the psychologists and each other. The parents and I were directly involved, the last 4 sessions with the children, using the skills we observed and learned from the psychologists.There was a one way mirror and closed circuit TV's.
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6/15/2009 5:24:26 PM
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 farigarcia Posts 1
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Hi. I agree with all the above replies and think your best course of action is to find out what you're really dealing with. A strong and accurate psycho-educational evaluation would be your best bet. It will guide you as to the best therapies and placement for your son. There's reference on another post (from Claudia) as to getting this eval done with Nova and they charge according to family income since these evaluations are very expensive. I totally understand that it's very frustrating for people to label just by "looking" at your son and not doing an accurate assesment. I'm sure your son knows so much more than what the tests reflect. Very frustrating for us parents. The testing part for me is the most frustrating. I have a 10 year old son with autism and there's so much more that he knows that he can't express because of his language limitations - arrgghh. Find a good, patient evaluator.
Once you have an accurate evaluation, you can think about where your son is best placed. It could be his current private school if they're willing to work with you which does happen. It could be another private school which offers smaller class size or it could be in the public school system or homeschooled. A lot of choices (to an extent) but first, please get him properly diagnosed so you can make an educated decision that works for your child and your family.
Please do contact our office and see what further help you can get. Good luck and stay strong.
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6/16/2009 1:58:12 AM
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 findhervoice Posts 7
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Hi Mari 67,
First, you are not alone because your son sounds alot like my daughter, except she is only 4 1/2. For the past two years she hasn't verbalized to her teachers in school or to any adults when in social settings. Basically she communicates all nonverbally, gestures, hides to speak, (so she can't be seen), whispers in my ear or through other students. In the past she has physically displayed a blank stare or stiff body posture, look downs and becomes mute... According to a few psychologists, Her condition is called "Selective Mutism" and without proper intervention she will not just grow out of it! This condition seems to fall through the cracks and overlooked as being Shy! But my child is definitely not SHY,,,,, she functions very normally when in her comfort zone. (home) Unfortunately There has been a whole lot of learned behaviors and avoidance tactics that she has mastered in order not to use her voice. And... when we (myself) or other students in her class speak for her, then it re-inforces her NOT to speak. So...we have alot to UNDO and still trying to find the best equation to do this. I have had a difficult time finding a qualified professional who has experience with Selective Mutism. There are many who treat anxiety, but this is way more specialized and complex. Now it's my job to find the correct environment to help her relax and excel. (It's a slow process, I know. And I understand the frustration!)
In addition to this condition, my daughter has had 5 seperate Seizure-like episodes during a sleeping state, where she props herself up while coughing, smacking lips (like chewing) & reflux gagging which is followed by vomiting. Her Eyes are open so she appears awake, although completely unresponsive, eyes deviated in a zoned out appearance, body limp but hands rigid. This lasts for about 15 minutes, then she falls fast asleep, then has no recollection when she awakes. All episodes where more or less the same. After some EEG's and a Brain MRI that presented itself clear, they said it was just benign PARASOMNIAS and are very common in young children which they grow out of around age 5 and not related to her SM. But, I have my concerns if it was truly a seizure vs. parasomnia, and more importantly is it somehow connected to her SM and the anxiety she has...(she also grinds her teeth excessively). Any one experienced anything like this in conjunction with your SM or Autistic kids?
We will be starting Therapy soon with The Insititute for Children and Family Health, formerly CPC. I've heard that ABA = "Applied Behavior Anaylisis", although mainly used for Autistic children, works wonders with Selectively Mute. It's a different reason why they don't verbalize, but this technique apparently works the same for therapy. We have done many hours of play therapy where after about 5 sessions, behind closed doors, I can hear my daughers voice, but she doesn't look them in the eyes when she speaks. The true problem exists not behind closed doors, one on one, but in school or social settings. Now we are considering Small Group SpeechTherapy,(Traditional ST has not worked in the past), Social Skills Building Classes, and summer camp. We also reopened her case with FDLRS, even though they denied her special needs services last year. After some thorough tests (all nonverbal) her evaluation showed her fairly intelligent. But,all they could offer her was an Emotionally Disturbed Classroom. Of course I disagreed, as did they...but that's just it...there's no place for this problem! It's overlooked as just being shy.
I'm glad to see that you are reaching out as I am and maybe we can help eachother in some way. I have read the other posts offering some sound advice. (Thank YOU!) I too am getting her a re-evaluation, considering her age. I also believe a Social Skills Building group (as long as it's small) with qualified therapists can make a big impact. I found one which may be forming at the Pinecrest Community Center. Not sure where you are located, but I'm happy to provide the details if it may help you.
My question to you or anyone reading this? Does this condition (Selective Mutism) qualify my daughter with "special needs" and if so, how do I prepare an IEP if FDLRS denies her services? Also, if there is any type of support group out there for SM, please include me.
Thanks! findhervoice
Mari67 wrote:
I hope I can find someone who can relate to my son's issues. Hi my son is 6 and has a combination of issues. He has an expressive/receptive language delay for his age. At home he expresses his wants, needs, is assertive, plays with brother, etc. and functions fine with everything but as soon as he gets to school, he's very quiet, won't talk the the other kids/teachers only whispers to them sometimes. He's a little angel in school everybody loves him including the kids and always answer things for him.
This is affecting his learning and he'll be repeating kindergarten and transferred to new school which I'm very upset about. He needs the one on one instruction due to his shyness and not communicating to others, it's hard for them to know what he knows and no one can figure him out. I wasn't prepared for his IEP and was very emotional after they told me all the negatives about him. The psychologist only did a one sided evaluation report, only including his school behavior and transfer to a new school in an autistic class. His psycholgist at Miami Children's didn't find him to be autistic but his behavior -not talking, staring into space, shyness make them think that. He just needs someone to direct him on what to do. I don't know what to do. I'm very frustrated and feel horrible moving my son to another school again. Can anyone help me or give me some advice. thank you this is a wonderful site Mari 67
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6/16/2009 8:20:06 AM
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 findhervoice Posts 7
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Hi miamirn,
Can you provide more info on the Social Skills group which your Grandson attended for nine weeks sponsered by CARD?
It's so great to see a Grandma advocating so well for her grandson!
Your post was very informative regarding SM vs. Autism....(some food for thought)
Thanks! findhervoice
miamirn wrote:
Hi,
I agree with srancano. My grandson is 7 years old. He has high functioning Autism PDD-NOS. He has an expressive/receptive language disorder, related to his Autism. He is doing very well. He has problems talking to children and adults in certain circumstances. It even happens with his Mom, Dad and me. It would appear as if it is Seclective Mutism, but it is his Autism. It was only a couple of years ago he was speaking like he had a stroke, in jargon and appeared mute most of the time. He improved both on his own and with the help of his family and a little therapy. (wish we could have afforded more). A speech therapist evaluated his language problems, and a thorough psycho-education test evaluated his problems both psychological and educational. The evaluation also included a ADOS and ADIR evaluation. There were interviews and questionaires as well as ongoing observations during the entire process in to make a diagnosis of Autism (The ADOS and ADIR are considered the Gold Standard in testing for Autism). In other words there are specific tests that can diagnose Autism that are used in conjuction with a general psychoeducational evaluation to diagnose Autism. There are other tests that are used to diagnose Selective Mutism. A medical doctor depends on these evaluations to make their diagnosis(s), they don't pull it out of a hat.They need these evaluations in order to make psychologic and psychiatric diagnoses.IQ An evaluation by a psychiatrist may, necessary. Especially if there is a suspicion of Selective Mutism.
The Public School System does IQ tests ,pscyoeducational evaluations, interviews and does a very good job at screening for problems, but they do not diagnose children.They also do screening evaluations for Speech/language, occupational and physical problems relating to these therapies with a particular focus on educational function. The purpose of all school testing is to evaluate how a child is functioning in the school setting academically and behaviorally and what services, within the school system would benefit the student in order for the child to excell with the learning process. Their focus is narrow, but effective. If your child has Selective Mutism, their screening process may come up with an indication that it may be this diagnosis and recommend further testing done outside the school system by a trained professionals. Teachers sometimes have good intuition, of what kind of problem their student may have and recommend that the school screen for a diagnosis, but it is only a screening.The evaluations are not in depth tests. The testing shows that certain types of programs, classes and services in the school system will benefit their students. This may be where they came to the conclusion that your child would be best served in a class with Autistic children. Autism has a classical symptom of children having difficulty understanding and or expressing themselves. The placement may be a good one, even though the label of Autism may not be appropriate. My son, who is 25 now, was in several types of programs. He has Bipolar and ADHD. When he was 20, a diagnosis of Asperger's Disorder was made. He was inEH- Emotionally Handicapped,SED- Severely Emotionally Distrurbed,LD GIfted- Gifted Learning Disabled,VE- Variable Exceptionality,BG- Behavioral Gifted. Pick the one you like the best. lol. Now it makes me laugh to see me writing all these programs. He was still the same child in all the different programs. I had him placed in SED, because it was the finest program in the school system at the time. Was he severely emotionally disturbed? No! SED was a label. Yes some of the students were severe, but the program afforded him the best educational and behavioral approach there was. It was an excellent program. Ideally. He should have been in an "ADD/BP/GIFTED" Attention Deficit, Bipolar, Giifted Program. Laugh out Loud!
When all is said and done. It is up to us, as parents, to make sure our children are diagnosed and placed in the best school program we can find. Is a challenging, arduous, stressful? Yes, but it is ultimately a very rewarding experience. I know I couldn't have done it without a lot of work, research and help from others; family friends, aquaintences, professionals. For my son, the adventure continues. It is never really done. And now it is my turn for my grandson.(It is hereditary in my family). This time I have experience. I am a lot more confident and hopeful. I know things do get better, in time. Life does get easier. The children do have fruitful lives.
Today, I do laugh at the school system, the health care system, myself and all those that are mine.
Please stay strong and do ask for help frequently and don't forget to find the humor in life.
miamirn/Elona
PS.Recently, my grandson attended a Social Skills group for nine weeks sponsered by CARD. There has been a noticable, mild improvement. I am so pleased. He has learned to be a little more comfortable with expressing himself; he has also learned that it is an expected social norm. All the other children improved in some way in the group. It was an inspiring experience. The children learned from the psychologists and each other. The parents and I were directly involved, the last 4 sessions with the children, using the skills we observed and learned from the psychologists.There was a one way mirror and closed circuit TV's.
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6/16/2009 10:45:08 AM
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 Mari67 Posts 10
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Hi, you can find alot of information on Selective Mutism on the internet. Go to www.Selective Mutism Center.org. I know it's better to work on her issues early. You still have alot of time to work with her and help her quicker since still so young. I know how hard it is to see your child struggle. This web site will have alot of tips on helping her. Good luck. Mari 67
findhervoice wrote:
Hi Mari 67, First, you are not alone because your son sounds alot like my daughter, except she is only 4 1/2. For the past two years she hasn't verbalized to her teachers in school or to any adults when in social settings. Basically she communicates all nonverbally, gestures, hides to speak, (so she can't be seen), whispers in my ear or through other students. In the past she has physically displayed a blank stare or stiff body posture, look downs and becomes mute... According to a few psychologists, Her condition is called "Selective Mutism" and without proper intervention she will not just grow out of it! This condition seems to fall through the cracks and overlooked as being Shy! But my child is definitely not SHY,,,,, she functions very normally when in her comfort zone. (home) Unfortunately There has been a whole lot of learned behaviors and avoidance tactics that she has mastered in order not to use her voice. And... when we (myself) or other students in her class speak for her, then it re-inforces her NOT to speak. So...we have alot to UNDO and still trying to find the best equation to do this. I have had a difficult time finding a qualified professional who has experience with Selective Mutism. There are many who treat anxiety, but this is way more specialized and complex. Now it's my job to find the correct environment to help her relax and excel. (It's a slow process, I know. And I understand the frustration!) In addition to this condition, my daughter has had 5 seperate Seizure-like episodes during a sleeping state, where she props herself up while coughing, smacking lips (like chewing) & reflux gagging which is followed by vomiting. Her Eyes are open so she appears awake, although completely unresponsive, eyes deviated in a zoned out appearance, body limp but hands rigid. This lasts for about 15 minutes, then she falls fast asleep, then has no recollection when she awakes. All episodes where more or less the same. After some EEG's and a Brain MRI that presented itself clear, they said it was just benign PARASOMNIAS and are very common in young children which they grow out of around age 5 and not related to her SM. But, I have my concerns if it was truly a seizure vs. parasomnia, and more importantly is it somehow connected to her SM and the anxiety she has...(she also grinds her teeth excessively). Any one experienced anything like this in conjunction with your SM or Autistic kids? We will be starting Therapy soon with The Insititute for Children and Family Health, formerly CPC. I've heard that ABA = "Applied Behavior Anaylisis", although mainly used for Autistic children, works wonders with Selectively Mute. It's a different reason why they don't verbalize, but this technique apparently works the same for therapy. We have done many hours of play therapy where after about 5 sessions, behind closed doors, I can hear my daughers voice, but she doesn't look them in the eyes when she speaks. The true problem exists not behind closed doors, one on one, but in school or social settings. Now we are considering Small Group SpeechTherapy,(Traditional ST has not worked in the past), Social Skills Building Classes, and summer camp. We also reopened her case with FDLRS, even though they denied her special needs services last year. After some thorough tests (all nonverbal) her evaluation showed her fairly intelligent. But,all they could offer her was an Emotionally Disturbed Classroom. Of course I disagreed, as did they...but that's just it...there's no place for this problem! It's overlooked as just being shy. I'm glad to see that you are reaching out as I am and maybe we can help eachother in some way. I have read the other posts offering some sound advice. (Thank YOU!) I too am getting her a re-evaluation, considering her age. I also believe a Social Skills Building group (as long as it's small) with qualified therapists can make a big impact. I found one which may be forming at the Pinecrest Community Center. Not sure where you are located, but I'm happy to provide the details if it may help you. My question to you or anyone reading this? Does this condition (Selective Mutism) qualify my daughter with "special needs" and if so, how do I prepare an IEP if FDLRS denies her services? Also, if there is any type of support group out there for SM, please include me. Thanks! findhervoice Mari67 wrote: I hope I can find someone who can relate to my son's issues. Hi my son is 6 and has a combination of issues. He has an expressive/receptive language delay for his age. At home he expresses his wants, needs, is assertive, plays with brother, etc. and functions fine with everything but as soon as he gets to school, he's very quiet, won't talk the the other kids/teachers only whispers to them sometimes. He's a little angel in school everybody loves him including the kids and always answer things for him.
This is affecting his learning and he'll be repeating kindergarten and transferred to new school which I'm very upset about. He needs the one on one instruction due to his shyness and not communicating to others, it's hard for them to know what he knows and no one can figure him out. I wasn't prepared for his IEP and was very emotional after they told me all the negatives about him. The psychologist only did a one sided evaluation report, only including his school behavior and transfer to a new school in an autistic class. His psycholgist at Miami Children's didn't find him to be autistic but his behavior -not talking, staring into space, shyness make them think that. He just needs someone to direct him on what to do. I don't know what to do. I'm very frustrated and feel horrible moving my son to another school again. Can anyone help me or give me some advice. thank you this is a wonderful site Mari 67
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6/16/2009 11:21:46 AM
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 Guest
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Yes, I am familiar with the website, they have some valuable info. And yes, you are right, she is young, which is to our advantage. Thanks for your feedback. findhervoice
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6/16/2009 12:50:28 PM
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 miamirn Posts 40
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findhervoice wrote:
Hi Mari 67, First, you are not alone because your son sounds alot like my daughter, except she is only 4 1/2. For the past two years she hasn't verbalized to her teachers in school or to any adults when in social settings. Basically she communicates all nonverbally, gestures, hides to speak, (so she can't be seen), whispers in my ear or through other students. In the past she has physically displayed a blank stare or stiff body posture, look downs and becomes mute... According to a few psychologists, Her condition is called "Selective Mutism" and without proper intervention she will not just grow out of it! This condition seems to fall through the cracks and overlooked as being Shy! But my child is definitely not SHY,,,,, she functions very normally when in her comfort zone. (home) Unfortunately There has been a whole lot of learned behaviors and avoidance tactics that she has mastered in order not to use her voice. And... when we (myself) or other students in her class speak for her, then it re-inforces her NOT to speak. So...we have alot to UNDO and still trying to find the best equation to do this. I have had a difficult time finding a qualified professional who has experience with Selective Mutism. There are many who treat anxiety, but this is way more specialized and complex. Now it's my job to find the correct environment to help her relax and excel. (It's a slow process, I know. And I understand the frustration!) In addition to this condition, my daughter has had 5 seperate Seizure-like episodes during a sleeping state, where she props herself up while coughing, smacking lips (like chewing) & reflux gagging which is followed by vomiting. Her Eyes are open so she appears awake, although completely unresponsive, eyes deviated in a zoned out appearance, body limp but hands rigid. This lasts for about 15 minutes, then she falls fast asleep, then has no recollection when she awakes. All episodes where more or less the same. After some EEG's and a Brain MRI that presented itself clear, they said it was just benign PARASOMNIAS and are very common in young children which they grow out of around age 5 and not related to her SM. But, I have my concerns if it was truly a seizure vs. parasomnia, and more importantly is it somehow connected to her SM and the anxiety she has...(she also grinds her teeth excessively). Any one experienced anything like this in conjunction with your SM or Autistic kids? We will be starting Therapy soon with The Insititute for Children and Family Health, formerly CPC. I've heard that ABA = "Applied Behavior Anaylisis", although mainly used for Autistic children, works wonders with Selectively Mute. It's a different reason why they don't verbalize, but this technique apparently works the same for therapy. We have done many hours of play therapy where after about 5 sessions, behind closed doors, I can hear my daughers voice, but she doesn't look them in the eyes when she speaks. The true problem exists not behind closed doors, one on one, but in school or social settings. Now we are considering Small Group SpeechTherapy,(Traditional ST has not worked in the past), Social Skills Building Classes, and summer camp. We also reopened her case with FDLRS, even though they denied her special needs services last year. After some thorough tests (all nonverbal) her evaluation showed her fairly intelligent. But,all they could offer her was an Emotionally Disturbed Classroom. Of course I disagreed, as did they...but that's just it...there's no place for this problem! It's overlooked as just being shy. I'm glad to see that you are reaching out as I am and maybe we can help eachother in some way. I have read the other posts offering some sound advice. (Thank YOU!) I too am getting her a re-evaluation, considering her age. I also believe a Social Skills Building group (as long as it's small) with qualified therapists can make a big impact. I found one which may be forming at the Pinecrest Community Center. Not sure where you are located, but I'm happy to provide the details if it may help you. My question to you or anyone reading this? Does this condition (Selective Mutism) qualify my daughter with "special needs" and if so, how do I prepare an IEP if FDLRS denies her services? Also, if there is any type of support group out there for SM, please include me. Thanks! findhervoice Mari67 wrote: I hope I can find someone who can relate to my son's issues. Hi my son is 6 and has a combination of issues. He has an expressive/receptive language delay for his age. At home he expresses his wants, needs, is assertive, plays with brother, etc. and functions fine with everything but as soon as he gets to school, he's very quiet, won't talk the the other kids/teachers only whispers to them sometimes. He's a little angel in school everybody loves him including the kids and always answer things for him.
This is affecting his learning and he'll be repeating kindergarten and transferred to new school which I'm very upset about. He needs the one on one instruction due to his shyness and not communicating to others, it's hard for them to know what he knows and no one can figure him out. I wasn't prepared for his IEP and was very emotional after they told me all the negatives about him. The psychologist only did a one sided evaluation report, only including his school behavior and transfer to a new school in an autistic class. His psycholgist at Miami Children's didn't find him to be autistic but his behavior -not talking, staring into space, shyness make them think that. He just needs someone to direct him on what to do. I don't know what to do. I'm very frustrated and feel horrible moving my son to another school again. Can anyone help me or give me some advice. thank you this is a wonderful site Mari 67
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6/16/2009 1:39:03 PM
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 miamirn Posts 40
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Hi findhervoice,
I have plans to write more to you, but for now I just want to address the issue about your concern about your child having seizures. I don't know what you have or have not done at MCH or when, but I may have some suggestions that might help. I used to work as an RN on the neurology floor at Miami Children's Hospital in 1990. I got to know the Neurology doctors and their specialty nurse assistants well. I am including some links. One is of Dr. Duchowny, he is THE doctor for seizures at MCH. If anyone can help you diagnose your daughter, he can. He has a nurse that is still at Miami Children's and I presume is still working with him as his assistant, her name is Pat Dean. I worked closely with them both. Pat Dean has more nursing experience in the field of diagnosing seizures than any nurse in south Florida.She is a rare breed, because she is still practicing the same specialty for so many years. You can imagine what kind of knowledge and expertise she has amassed after all this time at Miami Children's. I do believe that it is important to find out whether your child has seizures or not, because if she does have seizures and medication is indicated, and if it is necessary,the medication may help your child's selective mutism. In other words, they may be indirectly related. Dr. Deray is a neurologist that specializes in sleep disorders in children. I have worked with him also. Sometimes sleep disorders appear like seizures and sometimes seizures appear like sleep disorders. Between the two doctors working together you have a good team and can come up with a final diagnosis. It sometimes takes a long time, even with doctors to proove that seizures exist. Some seizures don't appear on EEG's, unless they occur at the time the EEG is in progress. I have given you the links. If you have any questions please feel free to ask or PM me.
http://www.mch.com/medicalServices/findPhysician/physicianDetails.aspx?doctorID=513 http://www.mch.com/page/EN/2429/Brain-Institute/Clinical-Services.aspx https://braininstitute.mch.com/wiki/Patricia_Dean
Have a good day, I'll write as soon as I can,
miamirn/Elona edited by miamirn on 6/16/2009
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6/16/2009 2:38:48 PM
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 lbustos Posts 6
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Hello to everyone,
I just want to take a quick moment and give out some basic information about evaluations and the IEP process. When you attend a staffing to review an evaluation or reevaluation you are not obligated to complete the IEP on the same day. You can take that evaluation home and have it explained to you again by a medical professional of your chossing (private phsychologist, phsychiatrist, etc..). U can arrange to meet with the school and develop the IEP when your more prepared to advocate for your child. Try not to go alone to IEP meetings it's easier when you have someone who can support you (spouse, friend, therapist, etc..). Please remember that: 1. you are a member of the team making the decisions and 2. if you do not agree with the results of the evaluation or the IEP you have the right to appeal. You should not feel intimidated about enforcing your rights, as a parent you want to be able to make informed desicions about the educational needs of your child and you can not make desicions if you do not understand or agree with the evaluation. I know how overwhelming these meetings can be, that's why sometimes it's better to just stop the meeting and have them reschedule for another day. I'd rather wait a few days and get better informed than agree to things I either don't understand or feel may not be right for my child. You can also review the IEP at anytime and make changes.
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6/16/2009 9:44:41 PM
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 Guest
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Hi miamirn,
Thank you very much for your valuable feedback. After the bigger Seizure-like episode last Sept. we had our daughter seen at MCH-neurology dept. and they performed an MRI of the brain, then a 6 hr. video monitored EEG, which came up with nothing unusual. (Thankfully!) Then after another episode one month later, they recommended doing a full 24 hr. EEG to try and capture an event. Without the "smoking gun" there's really no proof, other than what I described to have witnessed. What is peculiar is that it meets alot of the charateristics of a seizure, but always happens during a sleeping state and plays out in the same manner. (more or less) There seem to be many different types of seizures and parasomnias as well, which some can easily be mistaken for one another, I'm told. What seems to distinquish these from typical seizures is the duration...(more than 10 minutes). After the second EEG was done and came up with no inacurracies, it was the doctors position to let it be since we wouldn't want to give medication if we truly were unsure of the source or reason for the episodes. (Especially considering her young age.) I agreed. Basically, with this type of situation, there may not be an answer, unless it's captured. Therefore, I took it upon myself to do just that...I've captured via video most of the last couple episodes. Still, after reviewing the video, there is still the same conclusion....Parasomnias. At this point, all I can do is educate myself so that I can understand better whether it goes either way, or get a second opinion. (I think I will do both!) I have all of her medical records, although they do not list some of the episodes that I called in to report. Can you recommend another good Nuerology team? I not sure they have all the resources as MCH, but that's ok. It's just another professional opinion. Thanks again miamirn. I appreciate your insight and support and look forward to hearing back from you. findhervoice
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6/16/2009 10:02:40 PM
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 miamirn Posts 40
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Hi,
It is the same old story. I've seen it many times. Unless you can catch the episode on EEG and preferably Video/EEG there is no way to know whether is it definately a seizure or not. But, assuming it is a sleep disorder, have you been to Dr. Deray. He is the director of sleep medicine and a neurologist? Let me know. PM if you wish.
Miamirn/Elona
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6/16/2009 10:14:48 PM
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 findhervoice Posts 7
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Hi, Yes, I know. It is frustrating! But it is what it is, so we manage. : )
Did you mean: Marcel J. Deray, MD 3200 SW 60 Court Suite #302 Miami, FL 33155 Phone: 305-662-8330 Fax: 305-662-8312
Maybe I should make an appt with him for the second opinion from his prospective.
Thanks! findhervoice
miamirn wrote:
Hi,
It is the same old story. I've seen it many times. Unless you can catch the episode on EEG and preferably Video/EEG there is no way to know whether is it definately a seizure or not. But, assuming it is a sleep disorder, have you been to Dr. Deray. He is the director of sleep medicine and a neurologist? Let me know. PM if you wish.
Miamirn/Elona
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6/16/2009 11:27:03 PM
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 miamirn Posts 40
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Hi,
Yes, that's him. Health care has changed so much since I was at MCH. With that in mind, even the best of doctors can get lost in the muck of the health care system. A long winded word of advise: Be your child's advocate and be prepared. Call up, tell them you want to make an appointment for a consultation and 2nd opinion, tell them that you are dropping off (or sending) your child's neurology records and a detailed letter of all your concerns, suspicions, questions for the doctor and a description of what you want the doctor to do (in detail)(don't be shy). Tell them, don't ask that you want the doctor to review all this BEFORE your appointment. You do not want to waste your time nor the doctors, you are not new to neurology nor Miami children's Hospital. When you get to your appointment make sure you have your agenda on paper you can refer to. Bring your copy of the letter you sent to the doctor, so if per chance you or he want to refer to it. You can do it together. Make sure you leave, with his answers, remarks and instructions in writing. You both can share in doing this. Make sure you leave understanding what he has said to you. If he feels that he is not a specialist in this particular area, ask him does he know or can he find another MD that is the guru in this field in another area of the state or another state. Bring someone with you for emotional support and if possible to share taking notes. I know this seems laughable in some ways, but it is what it is here in the new world of health care. This visit will be fast paced, I'm sure you don't want that reminder. lol so you have to be proactive. Make sure you get a follow up appointment. Dr Deray has all sorts of tricks up his sleeve. He is always up on the latest stuff. By now, he's probably as sick of the state of the system as you are, but knows how to work it. Make sure if you need more time to tell him that this appointment is not completed and you need to have another appointment time to finish it all up. I don't want you to leave without what you need for your daughter and neither does Dr. Deray. But if you don't make sure everythihng is done he'll do his best and send you on your way. Hmm maybe I've been to blunt. I hope you don't find my manner to imposing. I just want to help and by the way, I've done it myself with mystifying success 
The best to you and your little one,
miamirn/Elona
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6/17/2009 10:38:44 AM
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 miamirn Posts 40
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Hi,
Forgive me, I have been busy. I'll get back you about the social skills group this evening. In the meantime, if you want, you can post me what in particular you are interested in about it.
Have a good day,
miamirn/Elona
Hi miamirn,
Can you provide more info on the Social Skills group which your Grandson attended for nine weeks sponsered by CARD?
It's so great to see a Grandma advocating so well for her grandson!
Your post was very informative regarding SM vs. Autism....(some food for thought)
Thanks! findhervoice
miamirn wrote:
Hi,
I agree with srancano. My grandson is 7 years old. He has high functioning Autism PDD-NOS. He has an expressive/receptive language disorder, related to his Autism. He is doing very well. He has problems talking to children and adults in certain circumstances. It even happens with his Mom, Dad and me. It would appear as if it is Seclective Mutism, but it is his Autism. It was only a couple of years ago he was speaking like he had a stroke, in jargon and appeared mute most of the time. He improved both on his own and with the help of his family and a little therapy. (wish we could have afforded more). A speech therapist evaluated his language problems, and a thorough psycho-education test evaluated his problems both psychological and educational. The evaluation also included a ADOS and ADIR evaluation. There were interviews and questionaires as well as ongoing observations during the entire process in to make a diagnosis of Autism (The ADOS and ADIR are considered the Gold Standard in testing for Autism). In other words there are specific tests that can diagnose Autism that are used in conjuction with a general psychoeducational evaluation to diagnose Autism. There are other tests that are used to diagnose Selective Mutism. A medical doctor depends on these evaluations to make their diagnosis(s), they don't pull it out of a hat.They need these evaluations in order to make psychologic and psychiatric diagnoses.IQ An evaluation by a psychiatrist may, necessary. Especially if there is a suspicion of Selective Mutism.
The Public School System does IQ tests ,pscyoeducational evaluations, interviews and does a very good job at screening for problems, but they do not diagnose children.They also do screening evaluations for Speech/language, occupational and physical problems relating to these therapies with a particular focus on educational function. The purpose of all school testing is to evaluate how a child is functioning in the school setting academically and behaviorally and what services, within the school system would benefit the student in order for the child to excell with the learning process. Their focus is narrow, but effective. If your child has Selective Mutism, their screening process may come up with an indication that it may be this diagnosis and recommend further testing done outside the school system by a trained professionals. Teachers sometimes have good intuition, of what kind of problem their student may have and recommend that the school screen for a diagnosis, but it is only a screening.The evaluations are not in depth tests. The testing shows that certain types of programs, classes and services in the school system will benefit their students. This may be where they came to the conclusion that your child would be best served in a class with Autistic children. Autism has a classical symptom of children having difficulty understanding and or expressing themselves. The placement may be a good one, even though the label of Autism may not be appropriate. My son, who is 25 now, was in several types of programs. He has Bipolar and ADHD. When he was 20, a diagnosis of Asperger's Disorder was made. He was inEH- Emotionally Handicapped,SED- Severely Emotionally Distrurbed,LD GIfted- Gifted Learning Disabled,VE- Variable Exceptionality,BG- Behavioral Gifted. Pick the one you like the best. lol. Now it makes me laugh to see me writing all these programs. He was still the same child in all the different programs. I had him placed in SED, because it was the finest program in the school system at the time. Was he severely emotionally disturbed? No! SED was a label. Yes some of the students were severe, but the program afforded him the best educational and behavioral approach there was. It was an excellent program. Ideally. He should have been in an "ADD/BP/GIFTED" Attention Deficit, Bipolar, Giifted Program. Laugh out Loud!
When all is said and done. It is up to us, as parents, to make sure our children are diagnosed and placed in the best school program we can find. Is a challenging, arduous, stressful? Yes, but it is ultimately a very rewarding experience. I know I couldn't have done it without a lot of work, research and help from others; family friends, aquaintences, professionals. For my son, the adventure continues. It is never really done. And now it is my turn for my grandson.(It is hereditary in my family). This time I have experience. I am a lot more confident and hopeful. I know things do get better, in time. Life does get easier. The children do have fruitful lives.
Today, I do laugh at the school system, the health care system, myself and all those that are mine.
Please stay strong and do ask for help frequently and don't forget to find the humor in life.
miamirn/Elona
PS.Recently, my grandson attended a Social Skills group for nine weeks sponsered by CARD. There has been a noticable, mild improvement. I am so pleased. He has learned to be a little more comfortable with expressing himself; he has also learned that it is an expected social norm. All the other children improved in some way in the group. It was an inspiring experience. The children learned from the psychologists and each other. The parents and I were directly involved, the last 4 sessions with the children, using the skills we observed and learned from the psychologists.There was a one way mirror and closed circuit TV's.
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6/17/2009 11:18:14 AM
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 Guest
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Thanks YRODRIGUEZ. This is helpful information that you have shared about your son. I hope he is doing well now. I will do some more research on Petit Mal Focal seizures and bring it to the doctors attention.
My apologies to everyone for moving the conversation from Selective Mutism/Speech Delay/School Shyness to SEIZURES. But I believe it's somehow connected in my daughter's case. Thanks for your support and advise. findhervoice
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6/17/2009 11:26:02 AM
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 Guest
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Hi MIAMIRN,
No problem at all. I wanted to let you know that I found a previous post that you described the CARD program (Univ. of Miami) so no need to reply w/ details. Thank you!
As for the social skills group, Because of her silence in school, the obvious concerns are her academic progress, not to mention the social and emotional ramifications. In fact, this is already limiting where she may end up going to school.
I want to intervene, even at this young age. In addition to Cognitive therapy (play therapy), I would love to find a small group whereby she can practice and enrich her social skills. Ideally this group would have qualified Speech and Psycho-educated therapists who have dealt with this particular condition which is anxiety based.
I am thinking to check with the local Speech and Language Centers or Community Centers. Any advice from anyone?
Thanks for the support, This is a great site! findhervoice
PS. I appreciate your straight forward information, and I bet I can speak for others reading your wisdom. This is the best advice I've gotten, really. Thanks! Any such thing in my local area?? (Miami, FL)
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