ECHO

Cesar E. Ruiz, SLP.D, CCC-SLP, BCS-S, is a Full Professor at La Salle University in the Department of Communication Sciences and Disorders where he has taught for 18 years. Dr. Ruiz is a licensed and certified speech-language pathologist. He holds Board Certification in Swallowing and Swallowing Disorders and is a Voice Clinical Specialist. Dr. Ruiz received the Lindback Distinguished Teaching Award in 2015. He is engaged in private practice and teaches, supervises, and advises students pursuing degrees in speech-language pathology. His areas of specialization include selective mutism, dysphagia, voice disorders, and bilingualism. Dr. Ruiz co directs the CASTLE Center at La Salle University in Philadelphia. The CASTLE Center is a specialized comprehensive assessment center where children with Selective Mutism are evaluated. ***** Evelyn R. Klein, PhD, CCC-SLP, BCS-CL, ASHA Fellow, is a Full Professor at La Salle University in the Department of Communication Sciences and Disorders where she teaches, supervises, and advises students pursuing degrees in speech-language pathology. She also co-directs the CASTLE Assessment Center at La Salle. Dr. Klein is a certified and licensed speech-language pathologist and a licensed psychologist with postdoctoral training in clinical neuropsychology and cognitive behavioral therapy. She is a Board-Certified Specialist in Child Language and Language Disorders affiliated with ASHA. Dr. Klein received the Lindback Distinguished Teaching Award in 2011 and Faculty Distinguished Scholarship Award in 2018. ***** Louis Chesney, BSc, is a well-respected neurodiversity expert and researcher. Currently serving at Whil, a Rethink Company, Louis manages the DEI/neurodiversity program, delivering employer support to drive workplace inclusion and strengthen interpersonal skills through digital learning. Louis provides his knowledge in learning and development to industry leaders seeking to further their diversity and inclusion initiatives. He continually aims to make a positive impact on those who are underserved. As part of his efforts, he has served on the Disability:IN committees and the Selective Mutism Association board of directors.

Acknowledgements
Reviewers

Introduction
The ECHO Program

Whom the ECHO Program Serves

The Modules

How to Initiate the ECHO Program

Setup for Face-to-Face and Virtual Online Sessions

Gathering Information

Connections Between Social Anxiety and Communication
The ARC Model - Generalizing Skills

Anxiety Tolerance

Rescue Reduction

Communication Confidence

Documentation and Progress
References



Module 1. Vocal Control: Gaining Control of Your Voice for Speech Initiation
Background Introduction and Theoretical Framework

Proposed Hierarchy for Face-to-Face and Online Sessions: How to Begin

Process of Vocal Control

Activity Game 1: Sound Off
Activity Game 2: Pitch Pipe
Activity Game 3: Ramp it Up!
Activity Game 4: Vocal Marathon
Activity Game 5: Tag Along Words
Activity Game 6: What's Up?
Activity Game 7: Let's Face It
References

Module 2. Building Social Pragmatic Communication for Children and Teens Who Experience Anxiety in Speaking Situations
Background Introduction and Theoretical Framework
Overarching Goals for Module 2

Activity Game 1: Word Think -The First Word That Comes to Mind
Activity Game 2: Pinpoint - Words to Sentences
Activity Game 3: Actors' Corner - Interactive Scripts
Activity Game 4: Barriers - Following Directions
Activity Game 5: Question Match - Answering Questions
Activity Game 6: More Information Please - Changing Questions
Activity Game 7: See-Saw - Keep the Conversation Going
Activity Game 8: Road Runner - Stay on Topic Track
Activity Game 9: Conversation Wheelhouse
Activity Game 10: Conversational Role-Plays: Pragmatic Language
Activity Game 11: Chat Spin - Informal Conversations
Module 2: Outreach Activities
References
Appendix 2-A. Suggestions for Facilitating Activities for Children and Teen with Selective Mutism
Appendix 2-B. Suggestions for Facilitating Activities for Children and Teen who Stutter

Module 3. Role-Play Simulations for Conversation
Background Information
Theoretical Framework

Using the SMQ as a Guide for Activity Selection and Tracking Progress

Role-Play Structure

Facilitator
Player
Scenario
Personal Stories
In Preparation for the Role-Play
Role-Play / Activity
Roles
Situations
Reflections
Cognitive Distortions


Scenario 1: Talking to General Peers at School
Scenario 2: Talking to Selected Peers at School
Scenario 3: Being Asked a Question by the Teacher
Scenario 4: Asking the Teacher a Question
Scenario 5: Speaking to Teachers or Staff at School
Scenario 6: Speaking in Groups or in Front of the Class
Scenario 7: Talking to Family Members at Home When Others are Present
Scenario 8: Talking to Family Members While in Unfamiliar Places
Scenario 9. Talking to Family Members Who Don't Live With Me (e.g., grandparent, cousin)
Scenario 10: Talking on the Phone to Parents and/or Siblings
Scenario 11: Speaking with Familiar Family Friends
Scenario 12: Speaking to at Least One Babysitter or Caregiver (not family member)
Scenario 13: Speaking with Other Kids Who I Don't Know
Scenario 14: Speaking with Family Friends Whom I Do Not Know
Scenario 15: Speaking with my Doctor or Dentist
Scenario 16: Speaking to Store Clerks or Waiters
Scenario 17: Talking When in Clubs, Teams, or Organized Activities Outside of School Photo Cards
References

Appendix A. DSM-5 Diagnostic Criteria for Selective Mutism, Childhood-Onset Fluency Disorder (Stuttering), and Social (Pragmatic) Communication Disorder
Appendix B. The ECHO Checklist
Appendix C. ECHO Program - Information About Me
Appendix D. Social Communication Skills - The Pragmatics Checklist
Appendix E. EXPRESS Selective Mutism (SM) Communication Questionnaire

Index