Treatment of selective mutism

The specialist may coordinate a behavioral treatment program to increase verbalizations. Behavioral treatment is based on the premise that the child who is selectively mute is using the behavior in response to anxiety in social situations. The focus of the specialists intervention is to reinforce communication with a gradual progression from non-verbal to verbal. This may be accomplished through stimulus fading, in which the specialist sets simple goals (e.g., using a gesture to communicate) and gradually increases expectations until speech is achieved. Another behavioral treatment technique called shaping reinforces mouth movements that approximate speech (e.g., whispering) until true speech is achieved. Another technique sometimes used, when the child is willing, is the self-modeling technique where the child watches videotapes of himself or herself performing the desired behavior (e.g., communicating effectively at home) to facilitate self-confidence and carry-over of this behavior into the classroom. The specialist should also focus on reducing the child’s anxiety.

The specialist may also work with specific speech and language problems that are making the mute behavior worse. For example, some children with selective mutism are afraid to speak because they feel they may say the wrong thing. The specialist may use role-playing activities to lessen the child's anxiety and increase confidence with speaking to different listeners in a variety of settings. Other children with selective mutism may not want to speak because they feel their voice "sounds funny." If necessary, the specialist may work on speech pronunciation to increase the child's confidence and clarity of speech. 

Additionally, the specialist is likely work in the child's classroom with its teachers to encourage communication and lessen anxiety about speaking. For example, the specialist may help the teacher implement the use of small, cooperative groups within the classroom that are less intimidating for the child with selective mutism. Then, the specialist will work with the child within this group to facilitate more effective communication with peers, first using non-verbal communication methods, such as signals or cards, to contribute to small group discussions and gradually adding goals to include speech. The specialist will work with the child, family, and teachers to generalize learned communication behaviors into other speaking situations.

The specialist continues to work as part of the school based interdisciplinary team to treat the child with selective mutism. 

The type of intervention will differ depending on the needs of the child and his or her family. The child's treatment may use a combination of strategies, again depending on individual needs.  
For further details, please read the following articles on selective mutism:
Symptoms of selective mutism
Associated features of selective mutism.
What parents can do if they suspect their child has selective mutism