Selective Mutism Overview: Tips for Parents

Children with selective mutism (SM) struggle to speak in specific situations (e.g., school) or with individuals (e.g., peers). However, they can talk comfortably at home with their parents or siblings. Parents or caregivers of these children who know about this anxiety disorder and are concerned can work with a therapist or teacher to transfer the child’s experience of talking at home to the school and other settings. Achieving this goal will require a plan of action that includes speech and behavioral strategies with cognitive components. Plural Publishing designed this quick reference to share with parents and caregivers. Here are six immediate interventions for children with SM that parents can implement with a therapist or teacher.

1. Assessment – Before starting treatment, the therapist makes a comprehensive assessment. They collect information from the home and school to estimate the level of functioning and the child’s emotional state, strengths and abilities, and any other additional difficulties.

2. Home and school therapy sessions – Once the initial home therapy sessions begin, the parents facilitate and conduct them with the therapist. Together they plan who is to be present, set the time and place of the sessions, and ensure that the activities are enjoyable and appropriate. Similarly, the parents’ cooperation is required when school therapy sessions occur. Frequently parents are requested to help prepare homework for sessions, which is usually taping recordings or videos of the child at home. Parents should also go to the child’s school or kindergarten for short, enjoyable talking-playing sessions. These are informal sessions where the parent plays and talks with their child in school or kindergarten.

3. Inviting friends to the home – Inviting classmates to play can help the child overcome SM. If they speak to a friend at home, then a significant barrier will break—the classmate will have heard their voice, which will make it easier for them to speak freely in school.

4. Skill-building at home – Parents can implement a vocal language program at home, taking the child from silence to verbalizing in small, structured steps. Parents would reference the modules and use interactive games and activities in Plural Publishing’s user-friendly manual, ECHO: A Vocal Language Program for Easing Anxiety in Conversation to guide the child. The book provides suggested strategies parents can do with their kids to bridge the gap from vocalization to conversation! The ECHO Framework has been developed for populations who experience anxiety related to communication and concerns about social evaluation. It targets children with selective mutism and social (pragmatic) communication disorders who range in age from the older elementary years through high school and beyond.

5. Lowering anxiety and modeling – In all the interventions described here, the lighter and more playful the tone, the more effectively they will lower the child’s anxiety. Parents must show the child that they are not overly anxious about the SM. It’s common for parents to worry about their child’s SM; therefore, parents may need to work on their own anxiety management.

6. The Five-Second Rule – Many parents may not wait for the child with SM to respond, so they respond on their behalf. The five-second rule helps adults give the child a chance to answer. If someone asks the child a question, the parent (or teacher) can count to five in their head. The adult can restate the question to the child, giving a couple of verbal responses that a head nod can’t answer. For example, ask, “What do you like to do outside of school?” Then wait a further five seconds.

Perednik, R (2012). The Selective Mutism Treatment Guide (tips inspired by and adapted from this book)