Accommodations for an employee with Selective Mutism

Accommodations for an employee with SM

including expressive language difficulties, ADD, and dyspraxia

By Sonja Zelic

Selective Mutism (SM) is a severe situational anxiety disorder which affects both children and adults. The condition generally starts in early childhood but can, if not treated early enough, continue into adulthood. Children and adults with SM are often fully capable of speaking (though many have masked speech problems / delays), but cannot speak in certain situations because they are phobic of initiating speech. (Carl Sutton, www.iSpeak.org.uk)

Personal experience and providing advice and help on iSpeak, has shown a need to address the experience of adults with SM in the workplace. There is very little for adults per se and nothing relating to employment. Adults with SM may also have additional difficulties relating to language/communication, such as expressive language difficulties, autism, ADD/ADHD, dyslexia, dyspraxia.

With gratitude to Carl Sutton who set up iSpeak, and is author of the research study 'Selective Mutism in Adults'; and author/Ed. 'Selective Mutism In Our Own Words', who has helped me come to terms with, and understand SM and above all remind me that I am not alone and that adults with SM exist.

This document has been adapted from others writing about SM: Marian Moldan, and Vivienne, (contributors to Selective Mutism In Our Own Words, by Carl Sutton and Cheryl Forrester); Ricki Blau (The Older Child or Teen with SM)

I have put this together over a few years, so huge apologies if you recognise your own words and I have not credited you, please get in touch via iSpeak and I will rectify, or if you have any concerns about the content. The document will continue to be updated.

A caveat

I believe that the social model of disability benefits all, and these 'accommodations' only need to be set down as such because society/employment, is based on specialised ways of being which have become the 'norm'. For those of us with speech/language/communication 'difficulties', I believe there is #morethan1way2speak. This document implicitly acknowledges the accommodations we have already made to try and fit in, often to our detriment, which remain unacknowledged sometimes even by ourselves.

Sonja Zelic - 17^th May 2016

SM and adults

Adults with SM may have received no treatment or may have suffered years of inappropriate treatment, negative responses or bullying from others. They may have been pressured to do the things they feared, such as speaking and developed unconscious (sometimes maladaptive) coping strategies, e.g. dissociation. They typically have learned to hide the appearance of fear; while children may freeze and show a blank expression, adults more commonly appear relaxed and “ok,” even when they’re terrified.

Adults who may have partially overcome their SM, still experience anxiety around speaking, though it is less obvious. They may not be able to speak in all situations or with all people. Someone who is able to respond to a question from an authority figure (verbally, in writing, or with a gesture), or even contribute to a discussion may be completely unable to initiate with that same person to ask a question or express a concern. In general, an individual with SM finds it much easier to respond than to initiate communication.

For an individual with SM self-consciousness usually extends to situations beyond speaking and commonly affects non-verbal as well as verbal communication. Mild expressive language difficulties may be more common in adults with SM, and they can be a source of added self-consciousness and anxiety. Subtle effects on oral and written expression can include: word retrieval glitches, terse writing with few descriptive details, and the use of non-specific language (e.g. “that thing” instead of a precise noun). They may find it hard to pass on a message to someone else, or articulate what they know.

These individuals are excessively self conscious. They are afraid of being embarrassed, judged or criticized, and of receiving scrutiny or attention, e.g. the employee may be unable to speak on the phone within earshot of someone who has been critical. The condition does not make an individual anti-social or even asocial, they can enjoy the company of others when in a familiar and comfortable setting.

If the individual is under stress, coping strategies built up over years can break down. Emphasising or pushing for communication in any form, non-verbal, written, or oral, is likely to cause the employee to withdraw. Communication will develop as they become less anxious.

Other manifestations of anxiety include:

☉ Perfectionism; worry that work is inadequate in quality and/or quantity
☉ Deadlines; may rush for fear of not finishing in time; may panic; may be too anxious to check work or may check work repeatedly and not finish
☉ Problems with open-ended or unclear assignments; worry that they don’t know what is wanted or that they will do the wrong thing
☉ Unable to ask for help or clarification; unable to express worries or complaints
☉ Afraid to express an opinion, even to express likes or dislikes
☉ “Blanking,” or panic-like reactions
☉ Easily frustrated
☉ Difficulties with team work; may be unassertive or passive; conversely, may be a “control-freak” if worried that the group’s work is inadequate
☉ Work related stress because of worries about work performance

The employee is not choosing to behave this way and is neither unmotivated nor oppositional. Individuals with SM are loyal to a fault to people who have been kind to them, they are acutely sensitive to others feelings, and can be extremely creative.

Appraisals and participation

The emphasis should be on helping the employee realise his/her potential, remain socially connected/decrease isolation, and will require flexibility about participation.

Measure success by how well the employee functions at work in general, and not by his or her communicative relationship with a manager. Even the most empathetic and skilled manager is an authority figure, and employees with SM are commonly more inhibited with managers and authority figures than with other employees at their level. Anxiety can affect performance in many ways, not talking is only the tip of the iceberg.

Managers should ensure that appraisals incorporate objectives that build the individual’s self-esteem and self-confidence, and reduce anxiety at work. Accommodations, such as those suggested in the following section, will support the employee's ability to 'perform' at work.

Accommodations and Workplace Strategies

Listed below are suggestions for strategies and accommodations that may be helpful for the employee with Selective Mutism:

☉ Anyone acting in a supervisory role to the employee should have an understanding of SM and how this affects her/him.
☉ Warm, flexible management with an understanding of SM as an anxiety condition will result in enhanced performance and engagement.
☉ New managers should allow for plenty of “warm-up” time. Start slowly with the goals of getting to know the employee, and gaining their trust.
☉ The individual needs to be actively involved and in control of any decisions affecting them, particularly because of their difficulties with communication.
☉ Facilitate opportunities for the person to get their views, opinions, objections or simply their side of the story across, and be mindful that initiating conversation may
☉ No threatening, limiting the employee’s participation, or punishment for any failure to communicate or participate that is due to/related to the anxiety condition.
☉ Avoid singling out the employee or calling attention to any differences.
☉ In general treat the employee as much as possible like any other employee.
☉ For those who find direct presentation difficult, alternative means to contribute to meetings/appraisals/other forms of participation as a substitute for speaking, should be allowed and encouraged, e.g:
★ Written presentations or mind mapped presentations rather than traditional written reports
★ Audio or video presentations/use of technology
★ Audio or video-recording
★ Collaboration with colleagues
★ Permission to practice/work at home
★ The use of another person as a verbal intermediary.
★ Individual work should be allowed if the employee is unable to participate in a group

Other accommodations and strategies to consider

☉ Clear, specific (not prescriptive) assignments and expectations that reduce the employee’s worries about what is expected, while giving the employee control over their work
☉ Extended time for writing reports and planning. Time for thought has been shown to improve the ability to respond, the complexity of responses, and the quality of responses for employees with and without language difficulties.
☉ When working as part of a team it is essential that the employee has a clear role understood by colleagues, and the roles of colleagues are clear.
☉ Use collaborative activities on longer projects in which the employee can assume a specific role within the team based on their strengths.
☉ Place trusted/supportive colleagues in the same team
☉ Establish a buddy system/mentor. Mentor to initiate regular check-ins with the employee to compensate for their difficulty in initiating verbal or non-verbal communication; ask if the employee has any questions or anything they want to communicate.
☉ Use small group meetings as a supplement to larger and interdepartmental meetings
☉ At meetings/conferences/training, seating in less conspicuous locations: back half of the room, towards the sides, away from the person delivering a presentation or talk (allows the individual to relax and focus)
☉ Seating next to a trusted/supportive colleague and or those identified as good work partners
☉ Vary modes of participation and forms of communication for meetings with opportunities to write a question or comment.
☉ Allow time for preparation for meetings; clear and specific agenda points for discussion topics, rather than open-ended topics. Be clear if employees need to give an update on their work, as to what is expected. Provide advanced warning if the employee will need to give a verbal update on their work at a group meeting be clear as to how this will be done (going round the table in turn…).
☉ If the employee is unable to respond at a meeting, politely move on rather than waiting for an answer, and give an opportunity to respond after the meeting.
☉ Advance notice for large projects; help break projects into smaller chunks to avoid overwhelming the employee.
☉ Alternative forms of participation in presentations. Many individuals with SM are too self-conscious to appear 'onstage' even in a non-speaking role but can contribute eg. as a writer, publicity artist/designer, etc. It is important to acknowledge their contribution as well as the more visible contributions.
☉ Support team building: identify potential work partners; initiate meetings with those colleagues.
☉ Disability awareness and sensitivity training for other employees/managers; monitoring for bullying.
☉ Allow time off work to attend therapy/counselling sessions related to the condition.

Monitoring for bullying

As SM affected individuals begin to recover their functional speech assertive speaking is the last form of speech to develop (if it develops at all). Although the individual may appear to be speaking freely, speech is usually compliant in nature – The ability to initiate assertive speech is likely to be missing. This may leave individuals lacking verbal control and influence over situations and can leave them vulnerable to bullying, unable to defend themselves verbally; or at the very least being ignored, excluded and not getting their views heard.

It is very easy for the individual to become excluded both from activities and interaction with others at work. Lack of intervention, due to intransigence or neglect on the part of managers, coupled with the SM sufferer’s absolute inability to initiate, when left out, creates a recipe for exclusion. Deliberate social exclusion is a form of bullying. Managers/colleagues may take the view that if an individual 'refuses' to talk to them, then they won’t talk to that individual. This is bullying.

The fact that individuals with SM often can’t speak up for themselves can create a power imbalance which may lead to controlling behaviour. The workplace, with its hierarchical structures can actually make this more likely, with those in positions of power over the individual unfortunately in an ideal position to exploit the dynamic, whether consciously or unconsciously.

Employer's have a duty of care to employees and should be alert, aware and monitor situations particularly where an employee has a disability:

☉ There should be regular check-ins with new employees, where SM (and/or any other disability) has been disclosed.
☉ Be alert for issues around the appointment of new managers, e.g. if an employee who has been working well with an organisation for a number of years suddenly has extended periods of sick leave.
☉ Monitor the situation if an employee discloses SM (and/or any other disability) to a manager in order to ask for accommodations, as this can leave the employee vulnerable.
☉ Be alert to manifestations of anxiety, e.g. in response to overbearing supervision or scrutiny by an authority figure.

Expressive Language Accommodations

Communicating and producing ideas orally and in writing

People with SpLDs should be helped to make the most of their strengths in their work role. With appropriate strategies, they can usually function well, and many have already done this for themselves. However, they often have to put in more time and effort to achieve the same results as their colleagues. Deadlines or other pressure can create even more stress. It is important to realise that simple awareness, and a few common-sense allowances for a difficulty, can sometimes be enough to enable the person to manage better. Adjustments need not be expensive or difficult to implement, and can often benefit other employees. If there are cost implications, the Access to Work programme, administered by JobCentrePlus, can help – see below.

If the organisation follows inclusive principles, such as adopting appropriate style guidelines for documents, or having flexible working hours, then the need for additional adjustments will be reduced. Each SpLD person will benefit from different things, but here are a few examples of what can help:

☉ Alternative means to contribute to meetings/appraisals/other forms of participation should be allowed and encouraged
☉ Aids to memory such as wall charts, planners, personal notebooks
☉ Images as well as words on labels
☉ A voice recorder for messages and meetings, where appropriate
☉ Mind mapped presentations rather than traditional written reports
☉ Minor adjustments to work allocation, or swapping certain duties
☉ A mentor or buddy, e.g. to check written work or discuss communication
☉ Smartphones, mobiles, voicemail; Outlook task list, reminders and calendar
☉ Receiving individual skills training from a specialist
☉ Text-to-speech software
☉ Coloured background and/or fonts on computer screens
☉ Having some time to work free of interruptions, e.g. at home, in a side room
☉ Performing tasks in the most suitable way and at the right pace

Complexity of information

The language (literate/management jargon) used in the workplace and found in text materials are typically more complex and confusing than that used in daily social contexts or tabloid reading materials. An employee who is competent in practical language use may be intimidated by 'management speak', and struggle with the complexity of expressing their knowledge in the workplace/or in an academic setting.

☉ Provide choices where the employee is required to show knowledge, e.g. as suggested accommodations in this document, and/or provide examples of filled in forms/reports/planning activities.

Prioritization

The employee may have trouble determining the relative importance of what they hear or read, and will produce effectively when task demands are limited, but crumble when faced with multiple, simultaneous demands on language skills.

☉ Provide a model for planning and organizing activities involving language.
☉ Make priorities explicit so the employee knows where to devote their effort and energy.

Format modifications (e.g. for training)

Use multiple formats for presenting and requiring learning. Employees with language differences often can learn and express their knowledge through other modalities.

☉ Substitute project-type activities (e.g. models, scrapbooks, demonstrations, illustrations, photography) for written reports.
☉ Alternate highly verbal activities with non-verbal activities.

Special devices

Allow employees to use a variety of tools for easier manipulation of information and enhancement of written output.

☉ Voice recorder to record thoughts and ideas for later writing.
☉ Assign designated peers as note takers or editing partners.
☉ Allow the employee to use visually based computer software programs to produce professional looking products.

Managers and appraisals

Managers may have little knowledge or understanding of the effects of ordinary working practices on SpLDs, e.g. office noise, time pressures, last-minute demands, interruptions, insistence on following procedures in certain ways. They may not realise the undermining effect of struggling with memory and organisation, or difficulty with apparently “simple” tasks.

Sometimes there may be issues following from workplace restructuring, increased productivity demands, changes to a job description, promotion, a new post or a new manager. These need to be addressed, and the employee supported, to develop effective strategies to manage these changes.

Sometimes a key concern is the long hours the employee needs to invest to get the job done. It’s nearly always the case that the employee is concerned with their employer’s and/or their own expectations in relation to accuracy, time and/or quality of work.

Employees often want to develop more effective ways of doing their job, involving less time, effort and stress. Organisation and memory are frequently key issues.

Dyspraxia / ADD

Difficulty:

☉ Responding to questions and thinking in order to give organised, concise answers; may talk less or give rambling answers.
☉ Organizing ideas and putting them in proper sequence.
☉ Getting ideas out of head and on paper; written answers, discussion questions or reports may be brief, or long and involved not coming to the point.
☉ Following directions: becomes confused with lengthy verbal directions, may not “hear” or pick out assignments from a meeting.
☉ Identifying and remembering key facts from reading; linked to executive functioning deficits (holding key information in working memory).
☉ Identifying key points to write while taking notes; loses main point
☉ Written expression is adversely affected by deficits in key executive skills: working memory and analysis, sequencing and synthesis.
☉ Slow processing of information: reads, writes, and responds slowly; may take twice as long to do written work.
☉ Can’t remember what is read, then has to read it again; difficulty understanding and remembering what is read; difficulty with long reading passages.

Working Memory (executive function)

☉ Difficulty holding information in mind while actively processing it; for example, may have difficulty holding a math problem in short-term memory while reaching into long-term memory to retrieve needed formulas and math facts to solve the problem.
☉ Difficulty retrieving information from long-term memory that is needed in working memory to solve a problem.
☉ May take longer on assignments and answering questions because of poor access to memory.

Funding for support

The aim of the government’s Access to Work Scheme (AtW), administered by Jobcentre Plus, is to help disabled people find and remain in work. AtW funding (subject to assessment) may be available for specialised equipment, assistive software and individual training from a specialist. It pays 100% of the cost if applied for in the first six weeks of employment. After that, the employer pays a proportion of the cost, and AtW pays the balance.

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