Selective Mutism Advanced Skills: Tools for Treating Complex Cases

Selective mutism (SM) is an anxiety-based disorder that prevents a child from speaking in specific situations (i.e., school). Children with SM have significant disadvantages compared to peers in both social and academic functioning. SM prevents a child from engaging in meaningful conversational exchanges with adults and peers, and thus, from learning vital social norms and skills, as well as age-appropriate vocabulary and language structure. Academically, children often experience limited involvement in school routines and activities, which can lead to delays in oral reading and word attack skills. Additionally, studies have found that between 35-75% of children with SM have additional speech and language needs. Selective mutism clearly affects social/pragmatic language and functional communication skills and falls under the scope of practice of a speech-language pathologist, according to the American Speech-Language-Hearing Association.
SLPs are often involved in the assessment and treatment of children with SM, particularly in the school setting. Although resources for working with this population are increasing in our field, SLPs are reporting growing numbers of cases of SM and increasingly difficult variables to consider. Treatment for SM may be complicated by the severity of the disorder; family/cultural beliefs and involvement; comorbidities, including autism spectrum disorder and other mental health diagnoses; and the role of virtual instruction or need to conduct sessions via teletherapy, to name a few. This session will discuss case studies of “tricky” or severe presentations of SM and present practical treatment strategies and activities that can be used to address these needs.