Selective Mutism

What is selective mutism? Also called elective mutism, selective mutism is a condition in which an individual (usually a child) does not speak in one or more settings despite being expected to speak; the individual can speak and does speak in other settings. For example, selective mutism can often occur with students in school. A student may not speak in school, but will be very talkative at home with his/her parents. Why would a student be selectively mute? It is not clear why a student stops talking in some situations. Research has suggested trauma, individual or family relationships and interactions, and anxiety as possible causes. While the causes of selective mutism remain unclear, behavioral techniques have been found to be effective in helping students to speak. What can teachers do to help? Students spend much of their day with their teachers, giving teachers a unique opportunity to influence student behavior. If you have a student with selective mutism, consider the following questions:

	In what situations does the student speak (either at home or in school)?
	Who does the student talk to?
	Does the student start conversations or does he/she only respond to other’s initiations?
	What topics will the student talk about?
	Do teachers, peers, family members expect the student to speak?
	If the student is asked a question that requires a verbal response, what happens? Do others ultimately answer the question for the student?

Use the answers to the above questions to think about interventions for selective mutism. Think about how to use the situations, topics, and people that the student already talks to in order to help the student talk in more situations, about more topics, and to more and different people. Think about how other people’s expectations and behaviors are supporting the selective mutism and how changing these things could help to support the student’s speech. The intervention strategies described below will help you combine the information collected from the above questions into an intervention plan for your student.

Shaping

Shaping can be understood as “taking baby steps”. There is an end goal in mind (e.g., verbally answering a question during reading class with a complete sentence), and this goal is divided into smaller steps; each time the person completes one of the smaller steps, he/she is positively reinforced for completing that step. Then the next larger step is introduced.
For example, a teacher discovered (by answering the above questions), that her student, Stephanie, talked at home with her neighbor Natalie (who was also in her class) about books they read. The teacher decided that because reading was interesting to Stephanie and she had a peer in the class that she already talked to (at home), she would work on increasing Stephanie’s speech in reading class. First, she wanted Stephanie to speak to Natalie in the classroom (which she had never done). During recess, she allowed the two girls to be in the classroom by themselves (with the teacher outside the door), so they could talk about the books they were reading. Once Stephanie spoke to Natalie in the classroom when they were alone, the teacher gradually entered the classroom: first the teacher was visible in the doorway as the girls talked; second the teacher sat at her desk; third the teacher moved to a desk that was closer to where the girls were sitting; lastly, she sat next to the girls and talked with them about the books. The teacher used similar procedures to slowly introduce Stephanie’s classmates to the book discussion, until Stephanie was able to verbally answer questions during reading class. Whenever Stephanie spoke at each step, she was given a cat sticker (her favorite); for each set of 5 cat stickers she earned, her mother agreed to buy her a book.
Shaping can be used in various ways. In the above example, the setting (in terms of the people to whom Stephanie was speaking) was gradually changed. Shaping can also be used with speech. For example, the student may first be required to whisper a one word answer in class. The teacher can gradually increase the expectation from whispering to a volume that can be heard across the room, as well as from one word to several sentences.

Positive Reinforcement

Positive reinforcement of speech is essential to helping students with selective mutism. Positive reinforcement is a way for the teacher to effectively communicate to the student that speech is expected and required. In order for a teacher to clearly communicate this message to a student with selective mutism, the teacher needs to eliminate any other reinforcement of the selective mutism. This means stopping other students or adults from answering for the student. Asking questions in a way that requires a verbal response rather than a nonverbal response is also important. Only requiring the student to talk when you are sure that they will talk will give you the best opportunity for positive reinforcement. Shaping and gradually increasing the expectation of speech will help with this goal. The selection of the reinforcement is also important. The reinforcement needs to be meaningful and important to the student; therefore the student’s preferences need to be considered.

References

Ford, M. A., Sladeczek, I. E., Carlson, J., & Kratochwill, T. R. (1998). Selective
mutism: Phenomenological characteristics. School Psychology Quarterly, 13,
192-227.
Garcia, A. M., Freeman, J. B., Francis, G., Miller, L. M., & Leonard, H. L. (2004).
Selective mutism. In T. H. Ollendick, & J. S. March (Eds.), Phobic and Anxiety Disorders in Children and Adolescents: A Clinician’s Guide to Effective Psychosocial and Pharmacological Interventions (pp. 433-455). Oxford, UK: Oxford University Press.
Rye, M. S., & Ullman, D. (1999). The successful treatment of long-term selective
mutism: A case study. Journal of Behavior Therapy and Experimental
Psychiatry, 30, 313-323.
Schill, M. T., Kratochwill, T. R., & Gardner, W. I. (1996). An assessment protocol
for selective mutism: Analogue assessment using parents as facilitators.
Journal of School Psychology, 34, 1-21.