Referral into speech and language service: The Bury Paediatric Speech and Language Therapy Team offer indirect treatment support for young people with Selective Mutism through teaching and training of family members and educational staff. School staff are expected to implement individualised interventions, following training by a Speech and Language Therapist.

A multi-disciplinary approach is recommended - involving professionals such as a Paediatrician, Educational Psychologist and other services such as CAMHS.

Apply a four steps approach:

• Educate the young person about selective mutism Information - SMIRA (selectivemutism.org.uk)

• Make environmental adaptations to reduce / remove the expectation on the young person to speak

• Educate people working with the young person around selective mutism Information - SMIRA (selectivemutism.org.uk)

• Implement a small steps programme, following a graded-exposure approach to enable the young person to overcome their fear of talking. School staff should work closely with the young person’s family and other professionals when carrying out intervention.

Without the four steps, a young person’s anxiety will often be too high to make any meaningful progress.

Please note: some autistic people with selective mutism do not have selective mutism as a phobic response, but a “freeze response” due to a high level of stress in some environments. Some autistic people may struggle to initiate vocal interaction or speak at all in school because their autism related needs aren’t being met. Meeting these needs can reduce anxiety enough for them to feel comfortable speaking, without needing to implement a small steps programme (please see this comprehensive resource about reducing anxiety and promoting good wellbeing for autistic young people, which was co-produced with neurodivergent young people and their families: Understanding Meltdowns | Autism Barriers to Education.

More information can be found here: Info: Planning and Managing Intervention with Small-steps Programmes - SMIRA (selectivemutism.org.uk) and through using the Selective Mutism Manual.

The ‘Sliding in Technique’ is a process that can be used to support a young person to talk in front of new people, using a gradual process of the new person ‘sliding in’.

Art therapy, drawing and talking and therapy dogs may also be supportive for selective mutism (please also see the SEMH section. 

School staff should support transitions from one year to by following a clear and carefully planned transition plan. More information can be found here: Info: Transition Plan - SMIRA (selectivemutism.org.uk)