Selective Mutism

Children with selective mutism (SM) exhibit distinct differences in their ability to speak at home compared to at school. They communicate fluently with parents and become completely mute with strangers or in public. Selective mutism can be conceptualized as “situational speaking phobia.”

These children often are shy growing up. Sometimes, they tend to be socially anxious, become embarrassed easily and have sensitivity to critism. Children age from 4-9 years old who immigrate to a country speaking a foreign language are particularly vulnerable to this condition. Selective mutism does not resolve over time and should not be considered as an adjustment issue during the transition of immigration or moving to a different country/culture.

The diagnostic process usually encompasses two main parts, including developmental history from parents (and school), and objective child behavioral observation of language proficiency, ability to answer different types of questions and reaction in different social setting. Social anxiety disorder (SOC) is a common comorbid condition which also responds well to exposure-based cognitive behavioral therapy. In some cases, the masked neurodevelopmental process, such as autism spectrum disorder (ASD), or communication disorders can complicate the presentation and different treatment approaches are often needed for a successful treatment outcome.

Treatment of selective mutism includes cognitive behavioral therapy or parent-child interaction therapy (PCIT) with children, parents and school. The involvement of parents are very critical to the treatment of selective mutism. Therefore, a therapist with language proficiency in parent’s native language is an important factor to consider. Remede Therapy provides Mandarin-speaking therapy and proudly serves the unique needs of this population.

In addition to individual counseling with children and parents, exposure-based intensive one-week group therapy, Brave Bunch, can add extra benefits when the children are ready to engage in exposure treatment in a group!

“Don’t talk. T-A-L-K-ing is scary!”