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Selective Mutism

One of my main specialties is in the area of selective mutism. Since 1995,  I have worked with over 150 children and teens with selective mutism.  I typically have anywhere from 12-18 people with selective mutism on my caseload at any given time.

People with selective mutism talk at home, but don't talk at school or in public settings. Some of these children are shy, quiet, and experience social anxiety. A small percentage of quiet children have selective mutism. Selective mutism is typically first encountered in preschool or kindergarten age children, when a child who is very talkative at home does not talk to adults, students, or anyone at school. The child appears very uncomfortable and freezes up when he/she is spoken to in public or at school.  

Children with selective mutism do not like crowds or being judged by others, so school is always the most difficult place for them to talk. They do not like to be the center of attention and freeze up when they feel pressured to answer a question or speak to others. Children with selective mutism can work up to talking with others and answering questions in school and in public, but until they feel comfortable it is best for adults to ease pressure and not force them to speak.  Most children with selective mutism are not expressing themselves at school as they do at home.  From my nine years of experience as a school psychologist, I can work with parents, teachers, and school staff members on best practices in teaching children with selective mutism at school.  This may involve a 504 plan or in less common situations an IEP.  I can also educate parents and school staff how to work with the child at school to improve the child's communication and academic performance. When a child or teenager is on his caseload,  I am available for free consultation with school staff members on how to best help the student with selective mutism improve communication and academic performance at school. 

Many people have never heard of selective mutism and not many therapists in Illinois specialize in working with children with selective mutism. Cognitive behavioral therapy has proven to be very effective in helping diminish the freezing response of children, providing them with the tools to feel more socially comfortable. A therapist who specializes in selective mutism will help the child to make step by step progress. For example, in the first few sessions the child may begin by responding to questions non-verbally with thumbs up or down, then respond to yes/no questions, and later build up to answer simple forced choice questions (Which color do you like better, blue or pink?)

In my office, I have had significant success in helping children talk in public by reducing the freezing and discomfort that occurs in social situations. To help children be more comfortable in my office I play fun talking games, do graduated exposures, and use the fading in (also called sliding in) technique. When children are comfortable talking in my office I work on helping them to talk to others. A frequent occurrence in my office is two or more families with selective mutism children meeting to share commonalities they see with their children and talk about what has been successful in helping their children talk in public. I use this social opportunity to help the child with selective mutism work on talking with adults, children, or both.

After children and teens are comfortable talking to others, the next stage is improving their confidence and communication skills when they talk in groups, public speaking, increasing content and quality of written school assignments, communicating at longer lengths, reducing the fear of being judged, dealing with feelings, and reducing perfectionism.

Children with selective mutism are often well behaved in public and some of them have control and behavior issues with parents which range from mild to significantly high. I work on reducing the control and behavior issues and offer parents specific parenting strategies to use with their children.