Twilight Children: Three Voices No One Heard – Until Someone Listened. Torey Hayden
nodded.
“Your mom has told me you use words with her. I’m thinking it would be helpful if you used words to talk to me, too. So that’s what you and I are going to do in here together. I’m going to help you to start using words. You see, my special job is working with boys and girls who find it hard to talk. Just like you. Just exactly like you. So I’m very good at helping people start to talk again.”
This seemed to please Drake enormously. He nodded enthusiastically, as if I were suggesting just the best idea in the world.
I was struck yet again by his physical presence. He was such a gorgeous kid. His features were so symmetrical and well formed, his eyes so vibrant. I was even growing accustomed to his unusual hairstyle. It was part of him, part of what made him seem so ethereal, like a lost angel.
“Because I’ve worked with lots of other boys and girls who’ve had trouble talking, just like you, I know how hard it is to get started. I know it can be scary when you’ve been used to not talking. But usually it’s just the first time that’s hard. We’ll work together. I’ll be right here, helping you. And I know you can do it.”
Again, the wholehearted nod.
I reached into my box and pulled out a set of cards I’d made. They were about five by seven inches in size and made from magazine pictures I’d cut out and pasted. Each showed a clear, appealing picture of common items: a car, a cat, a dog, a man, a child, and so on. I chose one that was very popular. It was a close-up of a little red-haired boy and a black cat. The boy was holding an ice cream cone and as he licked it on one side, the cat, long pink tongue extended, was reaching out to lick it on the opposite side of the cone. Children never failed to respond both to the inherent humor in the picture and to the almost universal desire to share experiences with animals.
Drake laughed noiselessly and pointed to the boy and the cat and then looked up to assure himself that I too was seeing how funny it was.
“Yes, that’s a good picture, isn’t it? What’s happening? What’s this?” I asked, pointing to the cat.
He gestured, tapping his finger against the picture.
“Yes, what is that? What’s it a picture of? What animal is this?”
He was exhaling, pushing air out quite audibly but it was nowhere near a word. Just breath.
“What is this? What animal is this?” I continued pointing to the cat. My experience in getting elective mutes over this first hump of speech was that I had to provide an opportunity to speak early on in the session and then pleasantly but persistently keep at the request, ignoring the silence that was thrown up; indeed, never allowing the silence to develop any kind of potency. So I continued to ask, rephrasing the question repeatedly, tapping the picture, pointing to it, staying forever on task.
Right from the onset, Drake appeared to make a genuine effort. He exhaled. He made noisy breathy sounds that didn’t approximate words, but nonetheless appeared to be authentic attempts.
Because he was so young and because he did seem to be working hard, I didn’t want to stress Drake too much by becoming more insistent, as I often did with older children. So I changed tactics. “Is this a dog? Is this boy sharing his ice cream cone with his dog?”
Drake grinned and shook his head.
“Is it a dinosaur? Is the horse eating his ice cream cone?”
Again, the cheerful shake of the head.
“Is it Friend?”
Drake laughed noiselessly and shook his head hard.
I went on through half a dozen other absurd possibilities until Drake seemed almost unable to control his hilarity at this funny game. Then I said, “What animal is it?”
He opened his mouth wide and leaned down close to the picture.
“What animal is this? Come on. Let’s use the word.”
He kept his mouth wide open.
I made my voice suddenly intense. “What animal is this?” Not anger, just focused no-nonsense intensity.
Drake got the message immediately. His laughter dropped away abruptly and he stared at the picture. Reaching over, he clutched Friend around the neck. His body began to rock slightly back and forth in the chair. His eyes remained fixed on the picture.
“What animal is this? Here. Now, Drake. What animal is this?”
Deep, noisy respirations.
“What animal is this?” I tapped the card more insistently. “Tell me what we have here. What’s this?”
He started to cry. This too was almost noiseless. He didn’t even whimper, but huge tears formed and rolled over his cheeks.
“I know it’s hard,” I said. “It’s hard and it’s scary when you haven’t been used to talking, but only the first time is so bad. Once this is over, it won’t be this hard again. What animal is this?”
A long moment of intensely expectant hesitation. Then he put his head down on the table and sobbed.
I had to give up.
Giving up, however, wasn’t the obvious decision it appeared to be. An extraordinary degree of manipulation underlies many cases of elective mutism. In almost all instances, it is unconscious behavior, but it is manipulation nonetheless. So a child bursting into tears isn’t usually enough to deter me. Even with a child who doesn’t appear manipulative, to stop at the first sign of tears tends to reinforce the mutism as a successful defense. So stopping wasn’t a decision I took lightly. However, given Drake’s age, I was very concerned about putting him under too much pressure. Moreover, all along he genuinely had appeared to be trying. Thus, it seemed wise to go with my instinct to stop.
So I said, “You’ve been working very hard. This isn’t easy. I know.” He had pulled Friend across and sat, face buried in the fake fur of the tiger’s head.
Taking a tissue, I leaned over to mop him up. “You did try hard, didn’t you?”
He nodded.
“Here, come here.” I opened my arms. He and Friend came willingly onto my lap for a hug. “Don’t worry about it,” I said. “Don’t feel bad. When it’s time, it’ll happen.”
After taking Drake back to the ward, I returned to the observation room and started to rewind the videotape. It was a puzzling session. Drake had given me the impression of trying so hard. Right from the visit out in Quentin, he had not seemed fearful, obstinate, withdrawn, or in any other way unwilling to comply. He had always appeared focused and genuinely enthusiastic for what we were doing. So why hadn’t my methods worked straightaway?
Popping the tape out of the machine, I took it back to my office to play it on the VCR there. Helen was in the room when I came in. A tall, slim, quite elegant woman in her early fifties, Helen had a tenderhearted, maternal approach to working with the children, which was quite different from my more pragmatic methods. When I put the tape in, I said, “If you have a sec, would you watch this with me?”
“What a cutie!” she cried, seeing Drake on the screen. “How absolutely adorable. And look that big toy tiger!”
We then watched the tape in silence.
The advantage of videotaping sessions was that it allowed the opportunity to go back and see all that was missed. For me, occasionally this could be quite a lot, because I have quite an extraordinary ability to focus on what I am doing. The plus side is that I seldom miss even the subtlest cues from whatever I am centered on. The minus side is that I can miss everything else. Indeed, I had become the subject of much good-natured teasing after one video showed me so absorbed in how quickly