The Missing Link in Most Treatment Approaches: “The Transitional Stage of Communication”

Dr. Elisa Shipon-Blum’s Social Communication Anxiety Treatment® (S-CAT®) recognizes the Transitional Stage of Communication as “Stage 2” on the Social Communication Bridge®.  Typically, not implementing the right strategies—when the individual feels an expectation to speak—only reinforces their anxiety. Therefore, the person will remain “stuck” in nonverbal communication.

  • The child with SM is often stuck in the nonverbal stage (stage 1) and cannot just begin speaking.
  • For older children/teens who have been mute for years, they are that much more stuck, even if they appear comfortable and relaxed.

So often we hear, “He is right there! I just know it! He will start to speak any day!” Sadly, this rarely happens within an environment where the child has been mute for a long time. The saying, “So close, but yet so far,” is more appropriate for the majority of older children and teens, especially those who have been mute for many years in one specific location (such as school) and with specific people (such as select relatives/friends).

Q: How then do you get someone to speak if lowering anxiety is not enough?

A:  The Missing Link is helping the person unlearn their conditioned mute behavior and using transitional strategies (Stage 2) to bridge from nonverbal (Stage 1) to verbal communication (Stage 3).


Q: What are the missing link strategies*?

A: Use a Verbal Intermediary® (Use of person or object that child/teen uses to communicate), Sounds-to-Words or perhaps the Ritual Sound Approach (RSA)® (Fun, nonchalant shaping of sounds to words and using phonetics in a structured and purposeful way), Augmentative Devices to help the child get used to having their words heard or for school-based accommodations.

*Please note that all strategies are developed by the clinician and individualized to the child/teens needs. Strategies are then taught to parents and teachers to work on with the individual. The individual is often an active participant via playing fun games/charting or doing purposeful goals to cross the Social Communication Bridge®.  

A key factor in S-CAT® is to remember that we cannot expect individuals with SM to jump across the Bridge® from nonverbal (Stage 1) to verbal (Stage 3) in environments that they are not comfortable. The “missing”, transitional stage (Stage 2) allows for incremental improvements in communication, making this “jump” seem less daunting.