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Some children freely participate in conversations with family and friends, but fall silent when they are in stressful or unfamiliar social situations. This is more than just shyness—it’s selective mutism, a form of social anxiety, in which children struggle to speak consistently. This can affect a child’s ability to build relationships, enjoy activities, and excel in school.
At the Selective Mutism Service at the Child Study Center, part of Hassenfeld Children’s Hospital at NYU Langone, we carefully evaluate your child and determine the treatment options best suited to their needs, including behavior therapy, cognitive behavior therapy, family therapy, medication, and combinations of these methods in an individualized plan.
Behavior therapy helps children with selective mutism to overcome anxiety by gradually exposing them to speaking in feared social situations and providing high doses of positive reinforcement for meeting speaking goals. Throughout treatment, we systematically move children from comfortable speaking settings to more challenging situations, in order to increase their comfort, and ensure that they feel successful while doing so. This gradual exposure approach helps children gain confidence and courage without overwhelming them or causing them to shut down. We aim to make exposure activities fun yet challenging, so that your child learns to overcome anxiety and decrease avoidance of verbal interactions. During the treatment course, exposures to speaking are carried out both within our office and throughout the community, in settings that your child might typically encounter difficulty speaking.
As part of a course of behavior therapy for selective mutism, we also train parents, teachers, and relevant school professionals in the skills necessary to increase the child’s comfort in social situations at school and in the community, and facilitate on-the-go exposures to speaking. Weekly exposure practice between sessions is important for generalizing treatment gains to situations that children will encounter frequently in their day to day lives. Therapists also frequently consult with teachers to identify appropriate speaking goals in school, provide recommendations for navigating challenging social situations, and obtain progress updates. In addition, we offer school-based intervention, where the therapist will promote child’s speech with teachers and peers in the classroom.
Cognitive behavioral methods are used, when appropriate, to help children learn that their worried thoughts about speaking may not be correct or helpful. Anxiety about making mistakes or beliefs that they might receive harsh responses is often addressed with these methods.
When appropriate, as part of the work with parents, we may review other aspects of family relations to assure that all members are making comfortable communication a shared goal.
In addition to our traditional weekly therapy sessions for selective mutism, we offer intensive treatment programs which condense a full course of weekly therapy for selective mutism into a one-week-long session.
Camp Courage is our four-day intensive summer treatment program aimed at helping children ages 4 to 11 communicate verbally in various social situations. The program helps children increase comfort in group settings that are similar to those settings encountered in their real lives and lead them to use their voices with new adults and peers.
To accomplish this, we create simulated classroom and camp settings, we hold arts and crafts sessions, go on field trips, encourage playdate practice, and engage in sports and movement activities. Each of these activities incorporate graduated exposures to speaking throughout the intensive week, including but not limited to, answering questions, asking questions, initiating conversation, raising a hand to participate, ordering food, and presenting in front of the larger group. Through repeated practice and graduated exposure, children begin to conquer their fears about speaking and joining in with others.
Camp Courage is for children who have had some behavior therapy, which creates a foundation that increases your child’s ability to benefit from group exposure experiences. Camp Courage will be held this summer from August 5 to 8, 2024.
Experts in selective mutism work one-on-one with children to facilitate speech and reward verbal communication. All clinicians are trained and supervised by Dr. Rachel A. Kupferberg and Dr. Richard Gallagher, experts who have over 30-years combined experience in treating selective mutism.
For more information or to register, please contact us by phone at 646-754-4958 or by email at CampCourage@NYULangone.org.
Similar to our Camp Courage summer program, we host a small, three-hour intensive treatment group during one Sunday of each month. During this group, your child participates in group exposure activities with the help of a therapist who helps prompt and facilitate verbal communication. Your child works on individualized brave communication goals during activities that are similar to situations that they may face at home, at school, and in the community, such as circle time, arts and crafts, playdates, show and tell, turn and talk, and placing food orders.
During the sessions, your child’s verbal communication is rewarded with “Courage Cash” and a visit to the prize store at the end of the day. Children have multiple opportunities to try out new verbal behaviors while having fun and feeling successful.
We offer individualized intensive treatment programs over multiple, consecutive days for families who are able to travel to New York City from elsewhere in the state or country. This treatment option is ideal for families of children with selective mutism who are unable to find experienced therapists in the area where they live. The length of the customized program and its goals are based on an initial evaluation and information collected from parents and teachers who know the child well.
In addition to providing services for younger children, we also provide both weekly and intensive treatment options for older children with selective mutism who are 12 years and older. We recognize that tweens and teens with selective mutism often have a distinct clinical profile that requires specialized, developmentally appropriate care. As such, we can help your child make and maintain friendships, initiate verbal conversation with others, decrease avoidance behaviors, and practice speaking during hangouts with same-age peers.
We offer training workshops and professional development seminars for therapists and other school mental health professionals. During these consultations, we discuss our evidence-based intervention methods and train professionals in the strategies that have been reported in clinical research literature. These workshops and consultations are tailored to meet the specific needs of therapists, individual professionals in school districts, or entire teams of school district professionals.
For more information about any of our selective mutism programs, please contact our care management team at 646-754-5000 or email us directly at CampCourage@NYULangone.org.
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