Selective Mutism

Selective Mutism: key things to know

  • Selective mutism is a persistent failure to speak in specific social situations (e.g. at school), despite speaking fluently in familiar situations.
  • Children with selective mutism can appear socially withdrawn, oppositional, perfectionistic, or have an increased degree of emotional or sensory sensitivity.
  • Early intervention leads to better outcomes and reduces negative effects on social development, educational progress, and emotional health.
  • Psychologists and speech pathologists both play important roles in treating children with selective mutism.
  • Treatment usually involves a combination of behavioural, speech, and family therapies, teaching the child that they can have more control over their environment by using their words.
  • Community desensitisation is a program that exposes a child to communication situations with controlled, gradual increases in verbal expectations.
  • The goal of therapy is to reduce anxiety and increase confidence in speaking.
  • Therapy involves creative and fun activities (e.g. drawing, colouring, turn-based games), with natural consequences.
  • The desensitisation hierarchy involves four stages: nonverbal, ghost/whisper, motor/voice, and generalisation.
  • It’s important there is a carryover in expectations at each stage in therapy to other contexts, such as at school and at home. Parents and teachers should be actively involved at all stages.
  • Speech pathologists often include oral language, speech or social goals into their activities to address secondary language or speech issues contributing to selective mutism.
  • For more on selective mutism treatments, read our article: When silence is not golden: evidence-based treatment for children with selective mutism.

Principal sources: Richard, G. J. Selective Mutism: Assessment and Intervention Strategies. Retrieved from here; Sharkey, L. & McNicholas, F. (2008). ‘More than 100 years of silence’, elective mutism. European child & adolescent psychiatry17(5), 255-263.

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Hi there, I’m David Kinnane.

Principal Speech Pathologist, Banter Speech & Language

Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.

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