Helping Your Child, Treatment

How Shaping is Used to Treat Selective Mutism

Shaping provides reinforcement for any attempt at communication, starting with gestures or non-verbal communication that is gradually shaped to audible speech. It may include gestures, mouthing, making noises, making letter sounds and eventually leads to the child speaking words and sentences.

Advantages

  • Bridges the gap between nonverbal and verbal communication.
  • Makes use of many types of communication as steps toward speech.
  • Gradually moves the child from non-verbal to verbal communication.
  • Can be used to elicit speech from a child without the help of a parent or other person the child already speaks to.
  • Can be used within the fading-in process or during exposures.

Disadvantages

  • Progress might be slower than in some other treatment methods.
  • The child may become too comfortable communicating nonverbally and not see the need to move on to speaking.

How to use shaping

Sometimes shaping is applied in a very formal, structured way, moving the child from one sound to another and blending them together to make words, then phrases, then complete sentences. But for other children, shaping may take a more informal course, simply moving from mouthing to making sounds, to speaking words. The key, as in all treatments for selective mutism, is that small steps are taken that move the child’s communication toward audible speech.

Below are some examples of how shaping can be used to help the child.

 

Transitional Stage of Communication – SMart Center – see the paragraph on “ritual sound approach”


Our experience with shaping

Buttercup and Petunia made progress in many areas using fading-in and exposure therapy, but there were some situations when these techniques weren’t the right fit. In school, Buttercup benefited from fading-in combined with shaping. Even though we did several fading-in sessions with the school Speech and Language Pathologist (SLP), once I had faded out Buttercup was reluctant to speak but would communicate with some gestures. The SLP worked directly with Buttercup for many months to help her move from gestures to sounds to words and also applied these same steps to help Buttercup start speaking with teachers and peers.

baby blur boy child

How we did it

Within a small group of peers led by the SLP, Buttercup started with using gestures during activities, such as pointing to things and shaking or nodding her head to answer questions. Once she was comfortable being with the peers and interacting nonverbally with them, she moved on to mouthing and whispering during counting games. She began to vocalize more by laughing out loud and making animal sounds. Buttercup loves bunnies. She would make what she called “bunny noises” when playing with her friends. Next, the SLP encouraged her to begin saying ” uh-huh” when nodding her head to mean yes, or “uh-uh” when shaking her head to mean no.

After Buttercup was making sounds with peers, the SLP incorporated games that encouraged the use of words. (See recommended games here.) At first, the words came out in a masked voice that was hard to understand. Buttercup would try to speak very fast and in a whisper without moving her lips. This made it difficult to understand her, but it was a step closer to her speaking.

For several months, Buttercup seemed stuck at this point. She seemed not to want others to hear her true voice. We continued to work on decreasing her level of anxiety and encouraging continued attempts to speak in one-on-one and small group settings.  The SLP tried various activities to elicit a more natural voice. She strengthened her rapport with Buttercup. I visited Buttercup at school so she could practice speaking in her normal voice with me. We recorded videos at home with Buttercup speaking in her normal voice and then shared the videos with the SLP and classmates and teachers. The SLP also found the following apps for iOS to be helpful.

  • ChatterPix – Take any picture, draw a mouth on it, record your voice, and then play it to watch your picture talk.
  • Puppet Pals – Choose your actors and backdrops, drag them on to the stage, then tap to record your movements and audio. Playback later for lots of laughs.
  • Bla| Bla| Bla – Choose from a variety of faces on the app and then watch as the face responds to changes in the child’s voice volume and length of sounds. Increasing the volume and length of a sound produces more facial movement.
  • dB meter – Watch the scale level chart rise and fall in real time as the child speaks. This helps the child visually see how loud, or soft they are speaking.

These games/apps were fun and distracting and helped Buttercup to relax into a more natural voice and volume. The ChatterPix and Puppet Pals apps had an added benefit of being able to replay the speech for other people to hear. Eventually, Buttercup began using her natural voice and volume at school.


Helpful hints

  • Remember to repeat the same step over and over until the child is very comfortable before moving on to the next gesture/sound/word.
  • For a structured shaping intervention, make a chart with all the letter sounds for the child to look at. As they are able to make a particular sound, cross it off (offering a small reward for each sound may encourage participation). Then begin combining sounds. Start with voiceless phonemes such as /h/, /k/, /t/, and /p/.
  • If the child is already using gestures, have them add a sound as they make the gesture. Add more sounds to eventually make a word. For example, the child nods head and makes the “y” sound. Then the child nods and says “ye”. Lastly, the child nods and says “yes”.
  • Shaping can be used within the fading-in process. If it is too much for the child to begin speaking whole words and sentences, start with the gestures, letter sounds, or wherever the child is at while the new person fades in. Then gradually move toward speech in subsequent sessions.
  • Play games that incorporate animal sounds such as Animal Sounds Icebreaker. In this game, a group of children are blindfolded or in a darkened room. Each child is assigned an animal with a unique sound (make sure there are at least 2 kids assigned to the same animal so they can find their pair). When the game begins, the children must find their animal match by making their assigned animal sound.
  • Try having the child mouth their words as they play back a video they have previously recorded for a teacher or a friend. Then move on to whispering or soft voice, and eventually turn down the volume of the recording gradually as the child speaks with it so the child’s audible voice is heard louder than the recording.
  • For some children, writing, texting, speaking on the phone, and video chats may be steps toward, but not substitutions for, verbal communication.

Related Posts:

Treating Selective Mutism – What Works?

Fading In: Our Go-To Technique

Exposure Therapy: Climbing the Ladder

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