My daughter who is 3 1/2 years old has been diagnosed with selective mutism. She does not talk in her classroom nor to most people. Only a select few. At home she is very animated and loud but in school has a flat affect, is mute and seems stressed out most of the time. She does not cry when we drop her off and she says she likes school. I believe her SM may be related to some type of high anxiety (possibly from being ill and hospitalized when she was 1 years old). If we are able to shape her behavior in school by a reward-type chart what then happens to the anxiety? Where does it go? Will it manifest into something else?

Thank you for your time.


Very interesting question you have here. I would not just do stickers….especially if you are not doing any other therapeutic measures to help decrease anxiety. Because, in my experience, sticker systems need to be incorporated with other ‘therapies’, whether it be other methods of behavioral modification, medication, etc. Because you are correct. Just using stickers as rewards will probably not get you very far simply because you are not doing anything to lesson anxiety. Our main goal of treatment for Selective Mutism is lowering anxiety (by various tactics) and raising self-esteem (emphasizing positives).