When seeking treatment for selective mutism (SM), several types of professionals may be involved and able to provide treatment. Psychologists, speech language pathologists, counselors, behavior analysts, and social workers are common professionals that may provide treatment for SM. Psychologists are most commonly sought for services as they are able to provide a comprehensive evaluation for mental health, cognitive, language, and behavioral difficulties, and they also provide treatment for SM along with other disorders that may co-occur. However, given a high occurrence of speech and language difficulties in youth with SM, speech-language pathologists can be a key professional on the team. Thus, it is helpful to have an understanding of speech-language pathologists and the treatment they may provide for children with SM.

What is a speech therapist?

A speech therapist also referred to as a speech-language pathologist (SLP), is a professional trained to diagnose and treat communication and swallowing disorders in people across the lifespan. Their areas of expertise include: articulation (how sounds are pronounced when speaking), fluency (rate and smoothness of speech, including stuttering), voice, language (including grammar, sentence structure, vocabulary, and social language), augmentative and alternative communication (including picture cards and speech-generating devices), cognition (including memory, planning, organizing, reasoning, and problem-solving), hearing (as it relates to speech and language), and dysphagia (swallowing disorders).

What credentials do speech therapists have?

All speech therapists should have a Master’s degree in speech-language pathology or communication sciences and disorders. Speech therapists may also have their Certificate of Clinical Competency (CCC-SLP), which is a national certification regulated by the American Speech-Language-Hearing Association (ASHA). It requires that SLPs complete a 1-year fellowship with supervision after graduate school and maintain their certification by engaging in a specified number of continuing education credits. Instead of or in addition to the CCC-SLP, speech therapists may possess a license from their state licensing agency, which also requires them to complete continuing education credits.

How do speech therapists help?

Speech therapists can play an integral role in the diagnosis and treatment of SM and are key professionals to have as part of your child’s team. SLPs can aid in the diagnosis of SM by providing a comprehensive evaluation of your child’s speech and language abilities and can identify or rule out any underlying speech or language difficulties that may be contributing to your child’s difficulty with speaking. SLPs are highly trained in understanding all components of communication and can provide individualized therapy addressing your child’s needs. This therapy includes addressing both the complexity of the language being used (vocabulary, sentence structure, types of questions, etc.) as well as the purpose of language, known as “social language” or “pragmatic language”. Pragmatic language includes the use of language for a variety of purposes, such as using greetings and farewells, asking for help, initiating a conversation, making a relevant comment, and taking turns in a conversation, as well as nonverbal communication, such as making eye contact, maintaining appropriate personal space, and using gestures. A speech therapist can work with your child on each of these pragmatic language skills in order to increase their ability to communicate with more people across more environments.

Where do I find speech therapists?

All public schools, and many private, charter, or parochial schools, have a school-based speech therapist that works with their enrolled students. Depending on your state regulations, school district, or individual school, your child may first need to be evaluated by the speech therapist to see if they qualify for school-based services before they begin receiving speech therapy at school. Outside of school, many hospitals have outpatient therapy clinics where speech therapists are employed. Additionally, many speech therapists have private practices or clinics of their own. To find a certified SLP near you, check out ASHA’s ProFind search engine (https://www.asha.org/profind). Your child’s pediatrician or school guidance counselor may also have recommendations.

What questions should I ask when looking for a speech therapist?

Of course, the first question you want to ask when finding a speech therapist is what kind of experience they have with selective mutism. Ideally, you’ll find someone who has diagnosed and/or treated children with selective mutism in the past. Another question to ask is in what contexts the speech therapist is willing to work with your child. School-based SLPs are limited to working in the school setting with your child. Clinic-based SLPs likely are limited to working within the clinical setting. Private speech therapists will generally have more flexibility and may be willing and able to work in the home setting, community settings, and/or school settings, providing the most flexibility. Ask the speech therapist what they feel the most important goals would be to focus on with your child and look for someone who shares the same goals that you and your child do. Finally, be sure to ask about what payment options are available to you. School-based speech therapy services are provided to your child free of charge if they qualify for services. Clinic-based and private practice SLPs may accept various forms of insurance or may offer a sliding scale for payment.

Emily R. Doll, M.A., M.S., CCC-SLP/L
SMA Board of Directors