A Physiological Approach to Vocalization and Expanding Spoken Language for Adolescents with Selective Mutism

Selective Mutism (SM) is a childhood anxiety disorder characterized by the persistent inability to speak in specific social settings while being able to speak freely in more comfortable environments, such as at home with family. This condition often leads to significant impairments in social, academic, and occupational functions. This article presents a novel treatment methodology that integrates the physiology of vocal production with pragmatic language instruction through teletherapy, administered to two adolescents diagnosed with selective mutism (SM). The frequency of speaking on the Selective Mutism Questionnaire increased from 35% to 86% and from 25% to 55% for the two children. Pragmatic language skills on the Social Communication Skills: Pragmatics Checklist improved from 47% to 96% and 13% to 40% after treatment. It is crucial to emphasize vocal control for speech initiation and pragmatic language for verbal expression. Detailed strategies, specific activities, and treatment outcomes are provided.