As a group, the Selective Mutism Treatment and Research Team has had experience with children with selective mutism and social anxiety that goes back nearly 20 years. The NYU Child Study Center, since its inception in 1997, has focused on research and practice with children who are selectively mute and socially anxious. Selective mutism and social anxiety usually become apparent in group settings and impair social functioning with peers and with adults outside of the nuclear family. They are often not noted until the child attends a daycare setting or school. Selective mutism and social anxiety impair a child's growth in many areas - social development, social acceptance, and academic achievement.
Therapy step-by-step
To improve a child's comfort level and help the child speak freely, we have been experimenting with several steps that seem to be effective. First, we set up play and game situations with the child and family members in our clinical setting. We let the child know that we will not interfere and not attempt to hear the child speak at the beginning. We ask parents to present questions and conversational statements and praise the child for speaking in that setting.
Second, we let the child know that we are interested in having the child talk to family members while we gradually move into the vicinity. With care, we very gradually decrease the distance between ourselves and the family group while providing the child with praise and small rewards for continuing to speak even though we are getting closer.
Reminders for parents and teachers
-Be patient
-Ask, wait, move on
-Ask "forced choice" questions
-Provide positive reinforcement
-Provide labeled, specific praise
-Rewards
-Provide graduated talking opportunities
-Be happy for progress
-Let the child "own" the anxiety
-Wait for responses
Don't
-Mind read
-Ask "yes/no" questions
-Ask open-ended questions
-Be overly excited
-Pressure to be among the "chosen few"
-Label the child as "shy"
-Repeat questions without waiting
-Rescue too soon
Contact Information:
Richard Gallagher, Ph.D, and Steven Kurtz, Ph.D, NYU Child Study Center, phone: 212-263-6622
