Pediatric Mental Health Counseling For Selective Mutism

Pediatric Mental Health Counseling For Selective Mutism | New Horizons Wellness Services Occupational Therapy Clinic Pediatric Therapy Adult Therapy Portland Tigard Oregon

Every parent wants what’s best for their child.

So when they don’t seem to be developing at the same rate as their peers, it can be worrisome.

However, what can be even more confusing for parents is when a child seems to be growing along with their peers in some situations, but not in others.

For example, if they seem to be developing communication at home, but then are unable to speak while at school, you might be wondering what is going on.

As a kids’ mental health counseling clinic in Tigard Oregon, today we’re going to look at why this could be happening – one reason is a condition called selective mutism.

Keep reading to find out more.

What Is Selective Mutism?

Selective mutism is a condition in which a person will talk in some situations, but not others.

The person experiencing selective mutism fully understands the language, and is capable of speech, but is incapable of speaking in certain, specific situations.

In most cases, selective mutism coexists with social anxiety.

The true hallmark of selective mutism is not just reluctance, but the actual inability of a child to speak in certain social settings.

Selective Mutism Symptoms

You may want to consider a psychological evaluation for selective mutism if you notice the following symptoms in your child:

  • They speak in specific situations, such as at school, but will speak outside of that specific location
  • They’re struggling to make friends
  • They’re struggling in school
  • This pattern of not speaking lasts longer than one month
  • They don’t speak despite knowing the language – if a child is in a situation where they are unfamiliar with the language being spoken, and they don’t talk, this is not considered selective mutism
  • There are no other speech or language issues at play which could cause them to not speak, like stuttering or autism spectrum disorder

Selective Mutism Causes

Selective mutism can sometimes be used to help diagnose other conditions and may be considered a symptom itself.

Children displaying selective mutism may also have:

  • Extreme shyness
  • An anxiety disorder
  • A desire to be alone and not interact with others
  • Fear of embarrassing themselves

It’s important to note, however, that selective mutism is not just shyness.

Children with selective mutism tend to be shy and to steer clear of unfamiliar social situations, but it’s not the same thing.

A shy child can generally be coaxed into speaking in unfamiliar social situations, but a child with selective mutism is actually incapable of speaking in such situations.

Selective Mutism Vs. Social Anxiety – What’s The Difference?

Social anxiety and selective mutism are similar in many ways.

They both involve anxiety in social situations, for example.

And they can both present barriers for developing social skills.

However, they’re not quite the same thing.

Kids with social anxiety will feel anxious in certain situations, but kids with selective mutism will be unable to speak in certain situations.

They may want to speak, but are unable to.

As well, social anxiety tends to be more widespread.

Symptoms can occur in a variety of different situations, including situations where there is no immediate reason to feel anxious.

On the other hand, the signs of selective mutism only happen in specific settings, like when they’re around strangers.

What can further complicate things is that your child can have social anxiety and selective mutism at the same time.

Either way, both situations can be disruptive to your child’s social development.

But you and your child are not alone.

Testing For Selective Mutism

If you suspect your child may have selective mutism, a pediatric psychologist can screen for this condition.

A psychologist is able to make a formal diagnosis of selective mutism. The testing process will generally include:

  • Discussing your child’s medical history and development
  • Looking at your child’s understanding when spoken to
  • Listening to your child’s ability to speak, express ideas, and answer questions

Due to the nature of selective mutism, some children will not speak directly to their psychologist or other healthcare providers – in these situations they may request a video of your child talking instead.

What is selective mutism? | New Horizons Wellness Services Occupational Therapy Clinic Pediatric Therapy Adult Therapy Portland Tigard Oregon

Counseling and Psychotherapy For Selective Mutism

Treatment for selective mutism will vary from person to person, depending on the underlying causes of the condition and which skills they need to develop.

Some methods which your psychologist may use may include:

1. Shaping

Shaping involves offering praise when your child makes an attempt to communicate.

But of course, there’s more to communication than just speaking.

This can include anything from pointing and gesturing to mouthing and whispering words.

This praise can encourage your child to begin communicating more openly in more situations.

2. Self Modeling

With the self modeling technique, your child will watch videos of them speaking in situations where they feel comfortable.

From there, they’ll watch edited videos of themselves that look like they’re speaking in situations where they might not be able to.

As these videos are repeated, your child will start to get used to hearing themselves speak in such situations.

That can help them start to believe they’re able to do so.

3. Stimulus Fading

With stimulus fading, your child’s psychologist will slowly introduce them to more and more speaking situations.

This approach starts with your child speaking in a situation where they already feel comfortable.

From there, your pediatric psychologist will gradually introduce unfamiliar elements.

For example, they may have your child speak to you alone, while they leave the room.

From there, they will enter the room but not interact with you and your child.

Then, they’ll join the conversation, giving your child the chance to slowly adjust to these unfamiliar elements.

4. Other Techniques

Other psychological approaches that may help your child with selective mutism include:

  • Systematic desensitization
  • Contingency management
  • Cognitive strategies
  • Social skills training

Your pediatric counselor may recommend one or more of the above options, depending on your child’s condition.

Book Your Appointment With New Horizons Wellness Services Today

Do you have a child who is super happy and talkative at home, but the feedback you’re getting from their teachers at school is that they are quiet and never speak?

Are you worried this might be interfering with their ability to make friends or their performance in school?

If this is the case, your child may have selective mutism.

At New Horizons Wellness Services, we offer pediatric occupational therapy, pediatric psychological assessments, and counseling for kids and families in and around Tigard, Oregon.

If you’re worried about your child’s ability to interact comfortably in different settings, our team can help.

Book your appointment with New Horizons Wellness Services today.

Yours in Health,

New Horizons Wellness Services
13333 SW 68th Pkwy,
Tigard, OR 97223


New Horizons Wellness Services provides a true multidisciplinary approach to mental & physical health treatments for children, adults and families.