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Selective Mutism


What is Selective Mutism:

Selective Mutism is an anxiety disorder in which a child is not able to speak in certain settings, such as school or public venues, or to certain people (e.g., extended family, teachers, classmates, strangers). Children with Selective Mutism usually feel intense anxiety about speaking and might fear that others will judge them or reject them if they do speak. As such, they feel unable to speak in certain situations even though they can comfortably speak at other times, such as when they are at home with their parents and siblings. Parents might not realize their child has trouble speaking around others since talking is not a problem at home. About 1% of children suffer from Selective Mutism. Selective Mutism usually begins before five years of age.

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Selective Mutism Symptoms Include:

  • Being talkative, outgoing, and gregarious at home, but completely or mostly nonverbal at school, around strangers, or other unfamiliar people or places.
  • Appearing frozen with fear, or “shutting down,” when asked to speak outside the home or with strangers. However, some children don’t actually look anxious, and might instead appear outwardly calm when expected to speak outside the home or with strangers.
  • Using gestures, facial expressions, and nodding to communicate. Alternatively, some children with Selective Mutism also struggle with and avoid nonverbal communication and interaction with individuals other than their immediate family.
  • Speak only in a whisper or with an unconventional voice or tone to teachers or peers.

Selective Mutism Treatment:

Selective Mutism treatment for children is best started as early as possible to get better outcomes. Treatment for Selective Mutism involves a combination of approaches, including Parent-Child Interactive Treatment for Selective Mutism (PCIT-SM), behavior therapy (specifically, exposure therapy), and contingency management (prompting children using techniques that increase the likelihood of speech and reinforcing successful speaking experiences). PCIT-SM is the research-documented treatment approach developed to help therapists, parents, and teachers working with children overcome Selective Mutism (SM). PCIT-SM has been tested and found to be effective in both the individual/family format and the intensive group format.

Treatment helps children face situations that make them anxious instead of avoiding them, and it aims to increase the child’s confidence in their ability to speak in anxiety-provoking situations. Treatment involves the child, parents, and, whenever possible, school personnel and teachers.

Several of our clinicians at Anxiety Specialists of Atlanta, have been trained by and consult regularly with nationally recognized Selective Mutism experts, as well as experts in PCIT, CDI, and VDI skills.

**Currently, our staff is only providing services to children and families, specific to PCIT skills, for children five years or younger. If your child is over the age of 5, we are happy to speak with you and provide regional and national resources for Selective Mutism in older children and adolescents.**

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