# Therapy for Selective Mutism

Canonical: https://pinnacleblooms.org/ask/what-therapy-helps-a-child-with-selective-mutism
Publisher: Pinnacle Blooms Network / Bharath Healthcare Laboratories Private Limited

Selective Mutism (ICD-11 6B06) is anxiety-based — the child can speak but cannot in certain settings. The most effective help is graded behaviour therapy that builds talking in small, low-pressure steps, with speech therapy where needed and close home–school partnership. Reduce pressure, reward courage; earlier support means smoother progress.

*When a child speaks freely at home but falls silent at school, the answer is not pressure — it is patient, graded confidence-building.*

## In short
Selective Mutism (ICD-11 6B06) is an **anxiety-based difficulty** — your child *can* speak, but anxiety stops the voice from coming in certain settings, most often school. The most effective help is **graded behavioural therapy** that gently builds talking in small, low-pressure steps, supported by speech therapy where needed and close partnership between home and school. With warm, consistent support, most children make real progress — and the earlier the support begins, the smoother the path.

## The therapies that help
Selective mutism responds best to approaches that lower anxiety and reward small communication steps — never to forcing or coaxing a child to speak.
- **Behaviour therapy with graded exposure (stimulus fading & shaping)** — the cornerstone. A trusted adult is gradually "faded in" to settings where the child is silent, and communication is built step by step: from a nod, to a whisper, to a single word, to full speech, each step rewarded.
- **Cognitive behavioural strategies** — for older children, gently naming and managing the anxiety behind the silence.
- **Speech and language therapy** — where there is also a speech, language or articulation difficulty alongside the anxiety, so confidence and clear communication grow together.
- **Parent and teacher coaching** — the home–school bridge is essential. Removing pressure to speak, avoiding the spotlight, and rewarding brave attempts make the biggest difference.

The golden rule for everyone around the child: **reduce the pressure, reward the courage**. Silence is not stubbornness — it is anxiety, and it eases with safety and time.

## When to seek support
If your child consistently speaks at home but stays silent at school or with unfamiliar people for **more than a month** (beyond the first settling-in weeks of a new school), it is worth a developmental check. Earlier support prevents the silence from becoming a settled habit and protects your child's learning and friendships.

## The Pinnacle way
AbilityScore® is part of Pinnacle’s developmental assessment. Diagnosis, where needed, requires an appropriately qualified healthcare professional — never from an article or a checklist. Our therapists build a graded, anxiety-aware plan around your child through [behaviour therapy](/behaviour-therapy) and, where needed, [speech therapy](https://www.pinnacleblooms.org/top-speech-therapy-center-india-proven-improvement-rate), beginning with a [structured clinician-led assessment](/ask/what-is-the-abilityscore-and-how-is-it-calculated). Learn more about [Selective Mutism](/selective-mutism) and how we support each family. With 4.95 lakh+ families served across 70+ centres, our work is steady, kind and child-led.

## Trusted sources
WHO ICD-11 describes selective mutism as a consistent failure to speak in specific social situations despite speaking in others. ASHA and AAP guidance support graded behavioural approaches, anxiety reduction and home–school collaboration over any pressure to speak.

**Next step —** Book a [developmental check at a Pinnacle Blooms Network centre](/selective-mutism) to begin a gentle, graded plan to help your child find their voice.

This is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.

## Sources
- WHO ICD-11: Selective Mutism (6B06): https://icd.who.int/browse11
- ASHA: Selective Mutism: https://www.asha.org/public/speech/disorders/selective-mutism/
- AAP HealthyChildren: childhood anxiety and communication: https://www.healthychildren.org

## Connected topics and perspectives
- Conditions: https://pinnacleblooms.org/ask/conditions
- Parent: https://pinnacleblooms.org/ask/lens/stakeholder/parent
- Emotional: https://pinnacleblooms.org/ask/lens/domain/emotional
- Support: https://pinnacleblooms.org/ask/lens/intent/support
- Act: https://pinnacleblooms.org/ask/lens/lifecycle/act
- Special Education: https://pinnacleblooms.org/ask/lens/route/special-education
- Family Empowerment: https://pinnacleblooms.org/ask/lens/empowerment/family_empowerment

## Related question paths

### Understand the subject
- How Selective Mutism Affects a Child's Daily Life: https://pinnacleblooms.org/ask/how-does-selective-mutism-affect-a-child-s-daily-life
- Is Selective Mutism considered a disability?: https://pinnacleblooms.org/ask/is-selective-mutism-considered-a-disability
- Is Selective Mutism Genetic or Hereditary?: https://pinnacleblooms.org/ask/is-selective-mutism-genetic-or-hereditary
- What are common myths about Selective Mutism?: https://pinnacleblooms.org/ask/what-are-common-myths-about-selective-mutism
- What are the types or levels of Selective Mutism?: https://pinnacleblooms.org/ask/what-are-the-types-or-levels-of-selective-mutism
- What Causes Selective Mutism in Children?: https://pinnacleblooms.org/ask/what-causes-selective-mutism-in-children
- What is Selective Mutism?: https://pinnacleblooms.org/ask/what-is-selective-mutism
- What is Selective Mutism in Early Childhood?: https://pinnacleblooms.org/ask/what-is-selective-mutism-and-what-does-it-look-like-in-early-childhood
- What other conditions often occur alongside Selective Mutism?: https://pinnacleblooms.org/ask/what-other-conditions-often-occur-alongside-selective-mutism
- Early Intervention Outcomes for Selective Mutism Under 7: https://pinnacleblooms.org/ask/what-does-current-research-show-about-early-intervention-outcomes-for-selective-mutism-in-children-under-7
- What is Selective Mutism, and what are its ICD-11 features in early childhood?: https://pinnacleblooms.org/ask/what-is-selective-mutism-and-what-are-its-icd-11-features-in-early-childhood
- What is the ICD-11 classification for Selective Mutism?: https://pinnacleblooms.org/ask/what-is-the-icd-11-classification-for-selective-mutism

### Recognise signs & concerns
- Can Selective Mutism Be Cured?: https://pinnacleblooms.org/ask/can-selective-mutism-be-cured
- Can Selective Mutism Be Prevented?: https://pinnacleblooms.org/ask/can-selective-mutism-be-prevented
- Do Boys Show Selective Mutism Differently?: https://pinnacleblooms.org/ask/do-boys-show-selective-mutism-differently
- Selective Mutism in Girls: https://pinnacleblooms.org/ask/do-girls-show-selective-mutism-differently
- Should I be worried my child might have Selective Mutism?: https://pinnacleblooms.org/ask/should-i-be-worried-my-child-might-have-selective-mutism
- Early Signs of Selective Mutism: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-selective-mutism
- Early Signs of Selective Mutism in a 1-Year-Old Boy: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-selective-mutism-in-a-1-year-old-boy
- Early signs of selective mutism in a 1-year-old girl: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-selective-mutism-in-a-1-year-old-girl
- Early Signs of Selective Mutism in a 12-to-18-Month-Old: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-selective-mutism-in-a-12-to-18-month-old
- Early signs of Selective Mutism in an 18–24-month-old: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-selective-mutism-in-a-18-to-24-month-old
- Early Signs of Selective Mutism in a 2-Year-Old: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-selective-mutism-in-a-2-year-old
- Early Signs of Selective Mutism in a 2-Year-Old Boy: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-selective-mutism-in-a-2-year-old-boy

### Explore causes & influences
- Are boys more likely to have selective mutism?: https://pinnacleblooms.org/ask/are-boys-more-likely-to-have-selective-mutism
- Are girls more likely to have Selective Mutism?: https://pinnacleblooms.org/ask/are-girls-more-likely-to-have-selective-mutism
- What Causes Selective Mutism in Young Children?: https://pinnacleblooms.org/ask/what-causes-selective-mutism-in-young-children
- Early Intervention for Selective Mutism: Advancing UNCRPD and the SDGs: https://pinnacleblooms.org/ask/how-does-early-intervention-for-selective-mutism-advance-un-child-rights-uncrpd-and-the-sdgs
- Contributing Factors for Selective Mutism: https://pinnacleblooms.org/ask/what-are-the-known-contributing-factors-for-selective-mutism-in-early-childhood
- Cost-effectiveness of early therapy for Selective Mutism: https://pinnacleblooms.org/ask/what-is-the-cost-effectiveness-of-early-therapy-for-selective-mutism-in-young-children
- What is the prevalence and public-health burden of Selective Mutism among young children in India?: https://pinnacleblooms.org/ask/what-is-the-prevalence-and-public-health-burden-of-selective-mutism-among-young-children-in-india

### Understand assessment
- How AbilityScore Tracks Progress in Selective Mutism: https://pinnacleblooms.org/ask/how-does-abilityscore-track-progress-in-a-child-with-selective-mutism
- How Selective Mutism Is Assessed in a Young Child: https://pinnacleblooms.org/ask/how-is-selective-mutism-assessed-in-a-young-child
- How Is Selective Mutism Assessed in Children Under 7?: https://pinnacleblooms.org/ask/how-is-selective-mutism-assessed-in-children-under-7
- What an AbilityScore of 0–100 Means for a Child with Selective Mutism: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-0-100-mean-for-a-child-with-selective-mutism
- AbilityScore® 100–200 in Selective Mutism: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-100-200-mean-for-a-child-with-selective-mutism
- What does an AbilityScore of 200–300 mean for a child with Selective Mutism?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-200-300-mean-for-a-child-with-selective-mutism
- What an AbilityScore of 300–400 Means in Selective Mutism: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-300-400-mean-for-a-child-with-selective-mutism
- What an AbilityScore® of 400–500 means in Selective Mutism: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-400-500-mean-for-a-child-with-selective-mutism
- What an AbilityScore of 500–600 means for Selective Mutism: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-500-600-mean-for-a-child-with-selective-mutism
- What does an AbilityScore of 600-700 mean for a child with Selective Mutism?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-600-700-mean-for-a-child-with-selective-mutism
- What does an AbilityScore of 700–800 mean for a child with Selective Mutism?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-700-800-mean-for-a-child-with-selective-mutism
- What does an AbilityScore of 800–900 mean for a child with Selective Mutism?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-800-900-mean-for-a-child-with-selective-mutism

### Explore therapy & support
- How Therapy Supports a Child with Selective Mutism: https://pinnacleblooms.org/ask/how-is-selective-mutism-supported-through-therapy
- What therapies help a young child with Selective Mutism?: https://pinnacleblooms.org/ask/what-therapies-help-a-young-child-with-selective-mutism
- Treatment and Therapy Options for Selective Mutism: https://pinnacleblooms.org/ask/what-are-the-treatment-and-therapy-options-for-selective-mutism
- How speech and language therapy helps a child with selective mutism: https://pinnacleblooms.org/ask/how-can-speech-and-language-therapy-help-a-child-with-selective-mutism
- How do I choose the right therapy for a child with Selective Mutism?: https://pinnacleblooms.org/ask/how-do-i-choose-the-right-therapy-for-a-child-with-selective-mutism
- Can a child with Selective Mutism attend a mainstream school?: https://pinnacleblooms.org/ask/can-a-child-with-selective-mutism-attend-a-mainstream-school
- Can a Child with Selective Mutism Attend a Regular School?: https://pinnacleblooms.org/ask/can-a-child-with-selective-mutism-attend-a-regular-school
- Can a Child with Selective Mutism Grow Up to Live Independently?: https://pinnacleblooms.org/ask/can-a-child-with-selective-mutism-grow-up-to-live-independently
- How can we support emotional development in a child with Selective Mutism?: https://pinnacleblooms.org/ask/how-can-we-support-emotional-development-in-a-child-with-selective-mutism
- How Is Selective Mutism Diagnosed in a Child?: https://pinnacleblooms.org/ask/how-is-selective-mutism-diagnosed-in-a-child
- Selective Mutism AbilityScore — what to do next: https://pinnacleblooms.org/ask/my-child-with-selective-mutism-has-an-abilityscore-of-0-100-what-should-we-do-next
- Selective Mutism: AbilityScore 100–200 — What To Do Next: https://pinnacleblooms.org/ask/my-child-with-selective-mutism-has-an-abilityscore-of-100-200-what-should-we-do-next

### At home & in everyday life
- How can I support my child with Selective Mutism at home?: https://pinnacleblooms.org/ask/how-can-i-support-my-child-with-selective-mutism-at-home