Selective Mutism (SM) Program

Home Treatment & Wellness Treatment Programs Selective Mutism (SM) Program

What is Selective Mutism?

Selective Mutism (SM) is an anxiety disorder in which children and adolescents who are comfortable speaking at home to their families struggle to speak in other places, like school, with friends and even to their extended family. Kids with SM might not speak at all in places outside the home, while others might speak outside the home to a lesser extent. Sometimes kids with SM appear frozen and may be described as a “deer in the headlights” by adults. Parents are sometimes surprised to learn from a teacher that their child is unable to speak at school because they typically have no trouble speaking at home.

SM shares some symptoms with social anxiety disorder. SM is more than “just being shy” and the inability to speak is not due to a child’s willfulness or defiance. Many kids with SM are eager to talk but feel too nervous to speak up.

While selective mutism is relatively uncommon (about 1% of the population), it can greatly impair a child’s functioning. Children usually begin to show symptoms when they enter school or daycare, but there can be a delay in detecting the disorder, especially when the child is “well behaved” and is able to participate nonverbally in school. Why some children develop SM is not clear, but it is likely due to a combination of factors, including an inhibited temperament and/or a genetic predisposition for anxiety. Once SM develops, it continues and may worsen if left untreated as children get accustomed to not talking in school, during social interactions with peers and in other social situations. If untreated, this anxiety disorder can continue for years, which negatively impacts a child’s social and educational functioning and can lead to other problems, such as other anxiety disorders and depression.

Fortunately, SM can be effectively treated. At CBC, we offer PCIT-SM (Parent-Child Interaction Therapy for Selective Mutism), which is an evidence-based treatment for children with SM. This is an adaptation of a well-researched intervention and involves caregivers heavily in the treatment process. We offer standard (weekly) treatment, weekly SM group, intensive treatment options and school consultation.

SM Intensive Treatment

We offer intensive treatment for children or teens with more severe symptoms or for families who are traveling long distances for treatment. Our intensive treatment services permit an individual to be seen for several hours a day or several days a week, depending on need. Children and teens of all ages can benefit from intensive treatment. All families start with a consultation to identify the individual needs of the patient and family and guide treatment planning. The treatment used is PCIT-SM (Parent-Child Interaction Therapy for Selective Mutism), which is an evidenced-based treatment for SM.

Highlights of CBC's SM Intensive Treatment

  • We provide a dull diagnostic evaluation that takes the whole child into account and includes a parent-child observation, collection of scales and a review of video in which the child is comfortably talking at home.
  • We teach parents specific skills to increase speech and plan for opportunities to reinforce those skills at home. We also provide live coaching for parents to make sure they master the skills.
  • We guide the child to practice “brave talking” by systematically bringing the therapist closer while the parent and child play, then gradually fade the parent out of the room.
  • We use generalization, which means taking therapy “on the road” – we go to stores and other places in the community to help the child practice. We provide multiple contexts for practicing “brave talking,” including a weekly practice peer group.
  • We assign homework so parents can practice out of session and keep momentum going.
  • We collaborate with the child’s school, provide staff trainings and offer specific strategies for use in the classroom.
  • CBC provides treatment in person or virtually, or a combination of both

CBC is offering Voices Rising, a one-day, group intensive SM treatment program, on Dec. 19. There will be additional sessions in August 2022.

PCIT-SM Certified Therapists