What About You?
A book for children with Selective Mutism, personalized for your child!
Email address *
What is your child's first name? (If they typically use a nickname, please use the name they prefer to be called.) *
Please list the people who live in your house and what your child calls each person. For example, Mommy, Daddy, a brother named Tim and a sister named Sarah. *
Please list 3 things your child likes to do. *
Please list 2-3 things your child loves to eat.
Please list one thing (an activity, a food, etc.) that your child does NOT like. *
For EACH person you listed in question #2, please indicate 1-3 things they like to do. *
For EACH person you listed in question #2, please indicate one thing they do NOT like. *
For EACH person you listed in question #2, please indicate one thing that is HARD for them. *
Does your child receive any tangible reinforcements for speaking to other people? For example, some people use stickers and prizes. Some use high fives and special activities. Please indicate what your system is, if anything. *
How do you refer to your child's Selective Mutism? For example, some people say they are working on "Brave Talking". What words to you use with your child? *
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