What is Selective Mutism?

Selective Mutism (SM) is an anxiety disorder characterized by an individual’s inability to speak in select social settings, despite being able to speak comfortably in other settings. Children with SM may be described as chatterboxes at home, but they have limited speaking in certain settings (eg, at school) or with certain people (eg, teachers, extended family members, or peers). SM interferes with daily functioning, social development and educational achievement.

How Do You Diagnose Selective Mutism?

Selective Mutism should only be diagnosed after a comprehensive evaluation using information from a number of sources and across different settings, including the child’s teachers and other school staff (when relevant), medical professionals, etc. After obtaining a thorough history from the child’s parent or primary caretaker(s), we conduct the Selective Mutism Baseline Observation Task (SMBOT) to assess the child’s baseline level of communication in different social situations through a one-sided mirror and “bug-in-the-ear” device.

What Does Treatment for Selective Mutism Look Like?

Providing graduated opportunities for “brave talking practice” is central to the evidence-based approach to the treatment of SM, often starting in the clinic or home setting and moving on to school and community settings. Parent training is essential to treatment. We use an adaptation of Parent-Child Interaction Therapy to teach parents how to increase comfort and communication in a low-demanding environment and then teach parents the most effective ways of prompting and reinforcing “brave talking.” The adaptation of Parent-Child Interaction Therapy (PCIT SM) has been inspired by Dr. Brittany Roslin’s dissertation and Dr. Steven Kurtz’s work. Therapists assign practice assignments in-between sessions. We collaborate closely with school personnel to ensure that treatment goals are also being supported within the school setting by providing additional opportunities to practice with peers and school staff.

What Services Do We Offer?

We recommend once weekly sessions. We also offer the below intensive services to address specific tasks (eg, speaking to peers, doing presentations, speaking in front of a group) and to increase gains in a shorter period of time.

Club Confidence Playgroup: A monthly weekend 90-minute “playgroup” for children to gain additional practice brave talking with peers and participating in school-related activities in a small group setting (February 2019-June 2019)

Club Confidence Camp: 4-day summer intensive program allows for brave talking practice within a simulated classroom setting, while parent workshops are presented simultaneously. The Club Confidence Camp program is modeled after the intensive group program developed by Dr. Steven Kurtz. Children will practice raising their hands, answering questions, asking questions/initiation, conversational skills, and presenting in front of a group (show and tell), all while engaged in fun activities. Each program will also involve “brave practices” in the community. Each child is assigned a “brave coach” to prompt and reinforce specific goals.

Customized intensive programs – For families who are in need of more intensive programs, we work with parents to design the most effective interventions to suit the child’s needs. An intensive program may consist of sessions more often (eg, several days in the week) and/or the length of session time increased (eg, 3 hour session)

We also frequently provide didactic workshops, training opportunities and consultation for teachers, school personnel and other clinicians.