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Arnold School of Public Health


USC Speech and Hearing Research Center provides individualized care, addressing uncommon disorders like selective mutism

October 29, 2015 | Erin Bluvas, bluvase@sc.edu 

While occasional shyness can be common among typically-developing children, some children may not communicate at all in certain situations. Though it is considered a low-incidence condition (i.e., 1-7 cases per 1,000 children) compared to other communication disorders, selective mutism can have a significant impact on the children it affects and their families.

Children who have selective mutism might interact minimally with others to have their basic needs met or they might avoid all forms of communication, including nonverbal. The range of ages of individuals who can be affected is broad and so is the severity of the condition. The extent of the condition may also vary according to context (e.g., a child may communicate fluidly at home but not at school). There is still much to be learned about selective mutism, but it is often tied to anxiety or other conditions that require treatment from mental health personnel.

Positive outcomes for children with selective mutism also rely heavily on speech-language pathology interventions. During the past 10 years of its 45-year history, the Department of Communication Sciences and Disorders’ (COMD) USC Speech and Hearing Research Center has not only successfully treated patients with selective mutism, but it has also become a recognized authority in understanding the condition and training the next generation of speech-language pathologists and researchers in its nuances.

“Over time, clinicians throughout the region and state have consulted with faculty at the Center when they have encountered patients suspected of having selective mutism,” says Clinical Associate Professor Angela McLeod. “USC is known to provide a professional training program for graduate students, and the COMD academic and research faculty engage in research and investigations on varied topics.”

Speech-language pathologists often request consultations with Center faculty. In turn, the clinicians, along with pediatricians, refer patients to the Center. “All faculty are constantly reviewing current research literature and facilitating students’ engagement as clinical scientists, demonstrating the importance of staying informed of best practice and professional standards in the field,” McLeod says.

Equally important is the COMD department’s mantra that every patient is an individual who deserves custom treatment in order to improve. For example, a young child may be affected by selective mutism to the extent that s/he does not convey basic intentions such as the need to eat or drink while in a classroom setting. In those situations, the child can be offered a non-threatening way to convey those needs, such as presenting a teacher with a photograph of a drink. “The intervention strategies vary according to the age of the patient, the symptoms exhibited and individual needs,” says McLeod.

The long-term goal of any treatment provided by the Center is to help patients become comfortable and capable of interacting with others in most situations to the extent that they achieve functional communication skills. To help them get there, the Center, which is led by Director Danielle Varnedoe, relies on the expertise of faculty like McLeod. 

A speech-language pathologist with more than 20 years of experience in a variety of settings, McLeod’s faculty appointment involves supervising graduate students who are providing clinical services at the Center and at several schools in the local community. “I guide them as they develop intervention plans and provide feedback to them during their clinical training experiences,” she says. McLeod also stays up-to-date on the literature on the various disorders that affect Center patients and has amassed a meaningful knowledge base pertaining to selective mutism along the way.

During her eight years at the Arnold School, McLeod has worked with graduate students to provide evaluations, treatment and referrals for other services for five different patients with selective mutism. She has even directed a student’s thesis project on the topic. Periodically, she provides consultation and guidance to practicing speech-language pathologists who work with children who have the condition.

“I am constantly reviewing research articles on the topic to stay informed of current practices and interventions,” says McLeod. “I have worked collaboratively with other clinical faculty who have similar interests, and we share treatment ideas and suggestions.” She also attends seminars and presentations at annual conferences throughout the country. McLeod does these things as a result of her desire to render effective, high quality services to patients and to properly mentor graduate students.

“Dr. McLeod is a perfect example of how the clinical faculty spend the time to identify high quality, clinical treatment evidence to support intervention services,” Varnedoe says.  “This type of dedication is what makes our Center a success both in terms of patient care and in graduate education.”