Overcoming selective mutism involves psychotherapy to address behavioral issues and underlying anxiety and sometimes medication, according to Dr. Priscilla Wong. Treatment depends on the age of the child and how long the condition has been present.
Selective serotonin reuptake inhibitors may help with coexisting social anxiety that may be at the root of selective mutism, according to Dr. Wong, but medication for anxiety and depression may help only some children, states clinical psychologist Robert Schum. Schum advises using a combination of individual therapy and a behavior program at the child's school, which involves pairing the child with a favorite peer at school; having social interactions in his home and the home of the peer; and exercises to reduce self-consciousness, such as playing with finger paint or drawing pictures to express events.
According to Dr. Wong, behavior therapy can include self re-enforcement, which involves receiving an award for speaking; self-modeling, in which the child views videos of himself speaking in a classroom and receiving an award; response initiation, in which the child spends time with the therapist until they speak, usually one to two hours but sometimes over four hours and up to a day; teaching the child's teachers and parents to stop negative re-enforcement, such as assuming the child may not speak; and family therapy, which may help the child overcome anxiety.