How SM Is Treated

After a careful diagnostic evaluation, children who have been diagnosed with selective mutism should begin working with a mental health provider, ideally a psychologist who has experience treating selective mutism. Treatment consists of specialized behavior therapy with techniques that prompt speech and then reinforce successful speaking experiences with lots of labeled praise and small incentives.

Part of the treatment involves helping children with SM face the situations that make them anxious instead of avoiding them. This will help their anxiety fade away over time. However, children with selective mutism should never be coaxed or pushed to speak. The pace of treatment should be very gradual and children shouldn’t be asked to do something that is too difficult for them. The goal of treatment is to help build the child’s confidence by accumulating more successful speaking experiences. Pushing a child to do something more than she can handle can have a negative effect if she fails to be able to meet the expectation.

Because children with SM are often young, treatment should also involve direct work with parents, caregivers and other adults who support the child so that they learn how to help the child speak and engage. The child’s treatment provider should also teach caregivers to avoid “rescuing” the child by answering for her or accepting an overreliance on nonverbal communication. It is common for very well-intended adults to automatically do this, but it can actually reinforce the child’s SM.

Knowing when — and how — to ask a child with selective mutism to participate in class can be difficult. That’s why it is extremely important that teachers know what a student is working on in therapy and get guidelines about how best to support and reinforce the progress she is making. Experts who treat selective mutism have found that children have the most success when their teachers, parents and therapist all partner together to form a team, sharing goals, tips and feedback. This partnership is essential because even if the child is making progress in the clinician’s office, if her gains aren’t translating into progress in the classroom, her treatment is missing the mark.