When I first qualified as a speech and language therapist, I thought becoming a better clinician meant learning more strategies.

Whenever I felt stuck with a child, my first thought was, What haven’t I tried yet? I assumed there must be another intervention, another assessment or another technique that would unlock progress. Like many newly qualified therapists, I spent years building my toolbox, attending courses and searching for the next idea that might make a difference.

Looking back, none of that learning was wasted. Those strategies still have an important place in my work today.

But after more than twenty-five years of working alongside children with selective mutism, speech and language difficulties, and anxiety-related communication differences, I’ve realised something that university never really taught me.

The greatest breakthroughs in my career haven’t come from knowing more strategies.

They’ve come from understanding children more deeply.

That realisation changed one simple question that I ask myself.

Instead of asking, “What strategy haven’t I tried yet?”, I now ask, “What am I not understanding yet?”

Whenever I’m stuck, I always look underneath first.

That sentence has become one of the guiding principles of my clinical work.

Why therapists naturally focus on behaviour

As therapists, we’re trained to observe.

We assess communication, analyse language, identify strengths and difficulties, and compare what we see with developmental expectations. Observation is one of the most important clinical skills we develop.

The difficulty is that we can become so skilled at analysing behaviour that we forget behaviour is only the visible part of the story.

Psychology tells us that our brains are naturally driven to solve problems. When we notice that a child isn’t speaking, isn’t joining in or isn’t responding, our clinical brain immediately starts searching for a solution.

Which strategy should I use?

What intervention might work?

How can I increase participation?

Those are important questions, but sometimes we ask them too early.

Before we think about changing behaviour, we first need to understand what the behaviour is communicating.

Behaviour is information, not the problem

A child who refuses to answer a question.

A child who hides behind a parent.

A child who avoids eye contact.

A child who appears frozen during registration.

A child who whispers only to one person.

These are not the problem.

They are clues.

When we only focus on the behaviour, we risk treating the symptom rather than understanding its purpose.

Children with selective mutism are not choosing silence because they are stubborn, defiant or unmotivated. In most cases, their nervous system is responding to perceived threat. Speaking doesn’t feel safe in that moment, so the brain does exactly what it has evolved to do—it protects.

Once we understand that silence is often a protective response rather than a behavioural choice, our role as therapists begins to shift.

We stop asking, “How do I get this child to talk?”

Instead, we begin asking, “What is making talking feel unsafe?”

That single change in perspective transforms everything.

Curiosity changes clinical practice

One of the most powerful skills any therapist can develop is curiosity.

Not curiosity that searches for another technique, but curiosity that seeks to understand the child’s internal experience.

When we become curious, we slow down.

We notice patterns instead of isolated behaviours.

We wonder about the child’s sensory experiences, their relationships, their previous experiences, the expectations placed upon them and the environments in which they feel safest.

We also become curious about the family.

Parents of children with selective mutism are often carrying years of worry, uncertainty and well-meaning advice that hasn’t helped. If we only focus on the child’s behaviour, we miss the emotional experience of the people supporting them every day.

Looking underneath means understanding the whole picture, not just the moment we see in front of us.

Safety comes before speech

This is the principle that sits at the heart of everything I do.

Children cannot communicate freely when their brain is focused on staying safe.

When anxiety is high, the nervous system prioritises protection over participation. That means speech, play, learning and social interaction all become harder—not because the child lacks ability, but because their brain is working incredibly hard to keep them safe.

This is why I encourage therapists to think differently.

Rather than asking how we can encourage more speech, we should first ask how we can create more safety.

Safety doesn’t mean removing every challenge.

It means creating relationships, environments and expectations that allow a child to take brave steps without feeling overwhelmed.

When safety increases, communication often follows naturally.

Looking underneath changes us too

Perhaps the biggest surprise in my own career is that looking underneath hasn’t just changed the children I work with.

It has changed me.

I feel less pressure to have the perfect strategy.

I’m more comfortable sitting with uncertainty while I learn about a child.

I’m more willing to collaborate with families instead of trying to fix problems alone.

Most importantly, I’ve realised that children don’t need us to arrive with all the answers.

They need us to arrive with genuine curiosity.

Because when a child feels understood rather than judged, something remarkable happens.

Trust begins to grow.

Safety begins to grow.

And from that place, communication has the opportunity to grow too.

A question to take into your next session

The next time you find yourself feeling stuck with a child, pause before reaching for another strategy.

Ask yourself:

• What might this behaviour be protecting?
• What is this child’s nervous system responding to?
• What am I not understanding yet?
• If I looked underneath first, what might I discover?

Those four questions have shaped the therapist I am today.

After twenty-five years, they’ve taught me that behaviour is rarely the whole story.

Whenever I’m stuck, I always look underneath first.

And perhaps that has been the most valuable lesson of my entire career.

After all, safety comes before speech.