Hi In selective mutism, it s important to understand that when the mutism happens, the child is not voluntarily refusing to speak but is literally unable to speak, feeling frozen. In time, they learn to anticipate the situations that provoke mutism and do all they can to avoid them. Experts believe SM is a phobia of talking. Most children will work their way through SM with sympathetic support, although they may remain reserved and anxious in social situations. With appropriate handling and treatment, most children overcome selective mutism – but the older they are, the longer it takes. They should gradually progress from relaxing in their school or nursery, to saying single words and sentences to one person, before eventually being able to speak freely to all people in all settings. Treatment does not focus on the speaking itself, but focuses on reducing the anxiety that your child has for speaking to and being overheard by people outside their immediate circle of family and friends. The need for individual treatment can be avoided if family and staff in early years settings work together to reduce this anxiety by creating a positive environment for the child. This means: -not letting the child know you are anxious -reassuring them that they ll be able to speak when they re ready -concentrating on having fun -praising all efforts the child makes to join in and interact with others (such as passing and taking toys, nodding, pointing) -showing no surprise when the child speaks, but responding warmly as you would to any other child As well as these environmental changes, older children may need individual support to overcome their anxiety. The most effective forms of treatment are behavioural therapy and cognitive behavioural therapy.