Episode 84 features Dr. Elisa Shipon-Blum and Dr. Jenna Blum, Director and lead clinical psychologist at the SMart Center’s Counseling and Assessments department, taking on a question they hear from families all the time: “We’ve been in treatment for years and tried everything. Why isn’t it working?”

Their answer starts with a reframe. A lack of progress isn’t failure. It’s information, and a signal that something in the plan needs a second look. Dr. E and Dr. Jenna walk through the most common barriers to progress and close with an eight-question reset for parents.

Uncovering the Whys: When Speech Is the Only Goal

Episode 84 begins with the most foundational barrier: focusing on how to get a child to talk instead of asking why communication is difficult for this particular child. Selective mutism is rarely caused by one thing. Dr. Jenna explains that it’s usually a recipe: a timid temperament, speech-language challenges, sensory sensitivities, learning or processing challenges, ADHD, autism or bilingualism. Dr. E adds stress at home, where silence can become one way a child holds on to control.

Speech, Dr. E reminds listeners, is the observable symptom. When treatment focuses only on speech, it misses whether a child is comfortable, connected and confident, which is what actually leads to communication. If progress has stalled, she encourages parents to stop and ask their provider: “Are we missing something?”

Apple Maps and the Missing Link: Meeting Kids Where They Are

The next barrier is asking a child to do something they aren’t ready to do yet. Dr. E uses a simple analogy: imagine landing at the airport and being told to drive to the SMart Center with no GPS. Kids and teens with SM need a roadmap too: preparing for likely questions, role-playing ahead of time, and starting where the child is on their feelings chart.

Dr. Jenna then introduces the “missing link,” Stage 2 of the Social Communication Bridge®, between nonverbal and verbal. She shares the story of a teen who had never spoken at school or with extended family. Using the ritual sound approach one step at a time, Dr. Jenna became the first person outside the teen’s home she ever spoke to.

Sounds to Words: Why Lowering Anxiety Isn’t Always Enough

Dr. E explains why so many comfortable, low-anxiety kids and teens still can’t make the leap into speech. After years of conditioned mute behavior, lowering anxiety alone often isn’t enough, and more medication isn’t the answer. Stage 2 strategies like the ritual sound approach and verbal intermediaries help them unlearn it.

Both doctors stress acknowledgement and assessment. When kids rate their feelings and see where they are on the bridge, they become active participants in their own progress.

Talking in Therapy but Nowhere Else: Implementation and School

Many families see progress in the therapy room that never carries over into daily life. Dr. Jenna’s message is direct: implementation is key. Dr. E compares it to wanting stronger biceps without going to the gym. Wishing won’t do it. Everyday outings and small changes to routine all count as exposure.

School is the other missing piece. Plans that say “don’t ask questions” or “sit them near peers” aren’t enough without teachers trained on how, when and with whom to facilitate. Even a school that has “worked with SM before” may need the SM School Evaluation Form to understand this child.

Too Comfortable and Measuring the Wrong Progress

The episode closes with two quieter barriers. Treatment can become too comfortable. Dr. Jenna calls this decreased expectation, and explains the happy medium between too much pressure and none at all. Families can also overlook real gains because the only measure is talking. Dr. E’s suggestion: say three positive things to your child that have nothing to do with speech.

Key Takeaways from Episode 84

  • Lack of progress is information, and a signal to reassess the treatment plan
  • Speech is the symptom; comfort, connection and confidence come first
  • Kids need a roadmap and a realistic starting point before they’re asked to speak
  • Progress in therapy has to be implemented at home, at school and in the real world
  • School plans need individualized interventions and trained staff, not just accommodations
  • Too little expectation can stall progress just as much as too much pressure

Final Thoughts

Dr. E’s eight-question reset asks parents whether they understand the whys, know their child’s stage on the bridge, and can describe what has improved in the last three to six months. If several answers are “I don’t know,” it’s time to step back. Stalled treatment doesn’t mean a child can’t make progress. It means the right why, the right starting point or the right strategy hasn’t been found yet. So stop asking, “Why isn’t my child talking?” Ask, “What’s preventing my child from comfortably engaging, and what’s the next realistic step across the bridge?”