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                                           Therapy -  Build Social Comfort


In over 90% of cases Selective Mutism is associated with social anxiety. This means that the silence is just the tip of the iceberg. Below the surface the individual is not only struggling with the difficulties of not speaking but also with the fear associated with any social interaction where there is an expectation for the individual to be involved. This is why more often than not individuals with SM are seen as the “shy” person. As such any assessment and intervention must consider all activities where anxiety is affecting the individual and focus intervention on developing comfort in all interactions, not just those that are verbal. This will include strategies that focus both on the individual and those in their environment.


For individuals with SM where the anxiety is specific to speech they may present as very confident in interactions in all environments but are unable to speak – they can often be seen using a variety of methods to get around talking e.g. animated gesture, writing.


In both cases it is important to recognise improvements that are verbal and/or relate to the broader behaviours linked to wider anxieties if we are to continue to encourage progress for our children and families over time.


A comprehensive treatment programme for social comfort requires the involvement of a range of strategies. You should have access to a range of health professionals if you see difficulties in a range of areas. This article outlines the typical roles that health professionals can take within an intervention targeting SM.


Schum, R. L. (2002, September 24). Selective Mutism : An Integrated Treatment Approach. The ASHA Leader.




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