Selective Mutism
Selective Mutism is a severe anxiety disorder characterized by an inability to speak in certain social settings, such as with teachers and peers at school, with extended family, and in public settings.
Selective mutism affects roughly 1 in 140 children, although this is believed to be an underestimate. The disorder interferes with the child’s ability to develop age-appropriate social relationships, demonstrate their knowledge, participate in activities, and advocate for their needs. Without effective treatment, behavioral patterns often become further ingrained over time and as such, harder to treat.
Brighter Outlook is proud to specialize in and offer evidence-based assessment and treatment services for children with Selective Mutism. The goals of our programming are to increase and enhance the speech and social interaction skills of children with Selective Mutism across contexts: school, community, and family.
Treatment Approach
Our collaboration begins with an assessment that includes the collection of rating scales, a parent interview, a teacher interview or classroom observation, and a play observation. We integrate information on symptoms and impairment and an understanding of your child’s developmental and social history to establish an accurate diagnostic picture and detailed recommendations.
If your child meets the criteria for Selective Mutism and you would like to pursue treatment, we will collaboratively develop an individualized treatment plan that is grounded in research-supported approaches for the treatment of Selective Mutism. For more complicated presentations with multiple presenting needs, we will discuss integrating other treatment approaches, the appropriate sequencing of treatment elements, and other referrals and resources as needed.
The evidence-based treatments we incorporate include Parent-Child Interaction Therapy for SM (PCIT-SM) and exposure and behavioral therapy models. PCIT-SM is a research-supported protocol that teaches parents, teachers, and other caregivers a specific set of skills for reinforcing verbal responses in the context of play interactions. PCIT-SM facilitates the ability of the child to “warm up” and respond to various prompts that are delivered in the right context and with the right timing.
We discuss and coach these skills in the clinic, on the playground, in community settings, and at school, with the goal of generalizing speech and social interaction to as many contexts as possible. That is, we strive to expand your child’s speaking boundaries and social confidence through step-by-step behavioral exposures that are carefully designed and individualized for your child. Bravery practice typically starts one-to-one in the clinic setting and progresses to community locations such as the library, sweet shop, playground, restaurants, stores, and playdates.
We believe strongly in a systemic approach. This means we work directly with your child’s teachers, childcare providers, coaches, and other involved adults to provide education, coach skills, set realistic and developmentally appropriate treatment goals, develop formal and informal school support plans (e.g., IEP and 504 plans), establish reward systems, track progress, and troubleshoot obstacles. Our work together may include parent training and coaching support, school observations, teacher meetings and consultations, peer dyadic work, direct school-based intervention, and intensive support through our summer camp program.
