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Effective strategies used by general education teachers to address the learning needs of students with selective mutism

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Effective strategies used by general education teachers to address the learning needs of students with selective mutism

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EFFECTIVE STRATEGIES USED BY GENERAL EDUCATION TEACHERS TO ADDRESS
THE LEARNING NEEDS OF STUDENTS WITH SELECTIVE MUTISM

by

Rene Irma Gaudet

A Dissertation Presented to the
FACULTY OF THE USC ROSSIER SCHOOL OF EDUCATION
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF EDUCATION

December 2020

Copyright 2020 Rene Irma Gaudet

ii
ACKNOWLEDGMENTS
I would like to begin by saying that thank you is not enough for all the time, patience, and
encouragement I received from my dissertation committee. First, I would like to thank Dr.
Patricia Tobey for always believing in me, for providing me with encouragement, guidance, and
support beyond anything I could imagine. Dr. Tobey was instrumental in helping me determine
the focus of my study. I would also like to thank Dr. Wayne Combs for his words of
encouragement and guidance during my dissertation journey. Dr. Combs enlightened me with
his experience from his dissertation journey and allowed me to learn from him. I would also like
to thank Dr. Patrick Crispen who was with me at the beginning part of my dissertation journey I
will be forever grateful for his wisdom and expertise in writing. Dr. Nasser Cortez jumped in to
assist me on my committee. His willingness to support me in my journey helped me to bring this
dissertation to completion. Lastly, I would like to thank my editor, Guadalupe Montano. You
were the last missing piece I needed to finish. Thank you!
I would also like to sincerely thank my parents, Robert and Alicia Forgues, who taught
me from a very early age that education was important. You both never deterred me from
achieving what I wanted to and always encouraged me no matter what I wanted to do. You both
supported me throughout my academic career whether it was financial or just allowing me time
to study. Even though there were times when I thought about giving up, you both encouraged me
to pick up and keep going. Dad, thank you for showing me the value of a strong work ethic that
continues today. Mom, thank you for showing me the importance of family. Both of you
deserve to share in my accomplishments because I never would have been able to do any of it if I
did not have you both as my parents. Even after I had my own family, both of you still
supported me in taking care of James and Katherine so I could complete my studies.

iii
James and Katherine, you both deserve a tremendous amount of thanks as well. There
were many nights over the years that I was away at school and many late nights I stayed awake
after I put you both to sleep to finish reading and writing. I know at times it was difficult when
you were little and wanted to spend time with me; it was very difficult for me too, but I knew I
was teaching you at the same time that education, perseverance and commitment was important.
I remember the sign I put on the office door “Mommy loves you! Mommy is studying!” Even
though my goal of completing this dissertation was important, I always made sure that both of
you knew how important you were to me. This dissertation journey has taken much longer than I
anticipated but I would not do anything different if I had to do it again. Both of you are my
biggest accomplishment.
Finally, I would like to thank my amazing and incredible husband, Craig. If it was not
for your love, understanding, and patience, I never would have been able to complete my
dissertation. Thank you for being my biggest cheerleader and giving me the time to work on my
academic career. Thank you for encouraging me when I thought I did not have the strength or
energy to continue. Thank you for telling me how you understood when I couldn’t keep up with
family obligations. Thank you for telling me so many times how proud you were of me because
your faith in me is what pushed me to finish. Thank you for being my rock and my one and
only.

iv
TABLE OF CONTENTS
Acknowledgments ........................................................................................................................... ii
List of Tables .................................................................................................................................. vi
Abstract .......................................................................................................................................... vii
Chapter One: Overview of the Study .............................................................................................. 1
Background of the Problem ................................................................................................. 1
Statement of the Problem .................................................................................................... 3
Purpose of the Project and Questions .................................................................................. 4
Significance of the Study ..................................................................................................... 5
Limitations and Delimitations ............................................................................................. 6
Organizational Stakeholders ................................................................................................ 7
Stakeholder for the Study .................................................................................................... 8
Definitions and Terms ......................................................................................................... 8
Organization of the Study .................................................................................................... 9

Chapter Two: Literature Review .................................................................................................. 11
History of Selective Mutism .............................................................................................. 11
Assessment and Diagnosis .......................................................................................... 15
Treatments ................................................................................................................... 16
Anxiety Disorders in Children ........................................................................................... 19
Ecological Risk Model ................................................................................................ 19
Consultative Approach ................................................................................................ 20
Parental Characteristics ............................................................................................... 21
Selective Mutism ......................................................................................................... 21
Support for Anxious Children ........................................................................................... 23
Early Childhood Therapy ............................................................................................ 24
Family Therapy ........................................................................................................... 25
Treatment Approaches in the School Setting .................................................................... 26
Identification ................................................................................................................ 27
Teacher Professional Development Workshops .......................................................... 28
Role of Elementary Classroom Teacher ...................................................................... 29
Multidisciplinary Interventions ................................................................................... 30
Treatment Considerations ............................................................................................ 33
Conceptual Framework ..................................................................................................... 33
Basic Concepts of the Ecological Theory ................................................................... 34

Chapter Three: Methodology ....................................................................................................... 36
Research Design ................................................................................................................ 36
Sample and Population ................................................................................................ 38
Instrumentation ............................................................................................................ 41
Data Analysis ............................................................................................................... 44
Trustworthiness and Credibility ........................................................................................ 44
Conclusion ......................................................................................................................... 46

v
Chapter Four: Findings .................................................................................................................. 47
Description of Teacher Participants .................................................................................. 49
Research Question 1: How do general education teachers apply strategies to address the
learning of selectively mute children in the classroom? .................................................... 51
School Environmental Support .................................................................................... 52
Increased Personal Interactions ................................................................................... 54
Summary of Findings for Research Question 1 .......................................................... 59
Research Question 2: What strategies do general education teachers employ with
selectively mute children in the classroom? ...................................................................... 59
Focus on the Student ................................................................................................... 60
Summary of Findings for Research Question 2 .......................................................... 64
Research Question 3: How does working with a selectively mute child impact on a
teacher’s thoughts, feelings and behaviors? ...................................................................... 65
Processing Emotions ................................................................................................... 66
Summary of Findings for Research Question 3 .......................................................... 72
Research Question 4: How does the setting and support groups affect the strategies used
by general education teachers? .......................................................................................... 73
Supplemental Supports Within the School/Family Setting ......................................... 73
Summary Findings for Research Question 4 ............................................................... 78
Summary ............................................................................................................................ 79

Chapter Five: Discussion, Implications, and Recommendations .................................................. 81
Purpose of the Study .......................................................................................................... 82
Summary of Findings ........................................................................................................ 83
Summary of Findings for Research Question 1 .......................................................... 84
Summary of Findings for Research Question 2 .......................................................... 85
Summary Findings for Research Question 3 ............................................................... 85
Summary Findings for Research Question 4 ............................................................... 86
Implications for Practice .................................................................................................... 86
Recommendations for Future Study .................................................................................. 91
Conclusion ......................................................................................................................... 93

References ..................................................................................................................................... 96
Appendix A Interview Protocol ................................................................................................... 101
Appendix B Informed Consent to Participate in Interview ......................................................... 103
Appendix C Bronfenbrenner: Ecological Systems Theory ......................................................... 106

vi
LIST OF TABLES
Table 1: Matrix of Research Questions to Instrument and Element of Conceptual Framework ... 43
Tsble 2: Description of Participating Teachers ............................................................................. 51

vii
ABSTRACT
Selective Mutism is a very complex anxiety disorder (American Psychiatric Association,
2013). Students who are diagnosed with Selective Mutism are at significant disadvantage in the
classroom setting as more and more of the curriculum involves students verbalizing their
findings and presenting the findings to their peers in the classroom.
The purpose of this research was to gain an understanding of general education teachers’
knowledge of and awareness about Selective Mutism (SM) and their experiences with children
who were selectively mute as well as the strategies used in the classroom. This problem is
significant because the literature is still limited, does not include a comprehensive list of which
treatments are given or their success rates (Cohan, Chavira, & Stein, 2006). A secondary
purpose was to study the effectiveness of the strategies employed by teachers who have students
with Selective Mutism in their elementary classrooms and how the strategies coupled with the
environment affects a selectively mute student.
The conceptual framework that guided this research project was Bronfenbrenner’s
Ecological System’s Theory model (1979). The four participating teachers were the roster-
carrying teachers in elementary general education classrooms. They were interviewed and the
data was triangulated and categorized through a series of interviews from each participating
teacher. Questions included demographic information as well as specific strategies used by the
teaches to increase verbal speaking. Findings from this study suggest that when personal
interactions between student, teacher, and parent were increased, the student’s level of anxiety
decreases. Findings also indicated that multiple behavior implementation strategies were needed
such as environmental changes, stimulus fading and contingency management plans.
The implications from this study can help early education and elementary teachers
recognize the signs and symptoms of selective mutism and establish early intervention protocols.

1
CHAPTER ONE: OVERVIEW OF THE STUDY
Background of the Problem
Somewhere in an elementary classroom, amid a teacher, a teacher’s assistant, and 24
faces on the first day of school, there is one student who just nods. The teacher asks the students
to sit down at their new desks, which they all do promptly, but one just takes an extra couple of
seconds as the new environment is absorbed. The student does not draw much attention as no
words are uttered. In the hustle and bustle of the busy first day, this shy, quiet, and reserved
child tries to avoid any activity where speech is expected. Of course, there are other students
who are adjusting as well, however for some students, their silence slowly fades, and they make
positive growth within the classroom. But still, there is one student. There is nothing to draw
the attention to the teacher, as there is still silence. Without direct intervention, this student will
continue to avoid any instance where speech is expected. Peers in the classroom will begin to
speak for this student, and even tell other adults that the student does not talk.
Selective Mutism is a very complex anxiety disorder (American Psychiatric Association,
2013). Students who are diagnosed with Selective Mutism are at significant disadvantage in the
classroom setting as more and more of the curriculum involves students verbalizing their
findings and presenting the findings to their peers in the classroom. The school environment is
foreign to small children. The diagnosis of Selective Mutism has several criteria. It must not be
made in the first month of school, or if the lack of language can be explained by another
disorder, such as a hearing impairment, however it can be made after one month of mutism
(American Psychiatric Association, 2013).
Children in elementary settings who suffer from Selective Mutism are often labeled shy
and sometimes defiant (Crundwell, 2006). Most educators have had both diagnosed and
undiagnosed selectively mute children in their classrooms as well. When children enter school,

2
and have to adjust to a structured setting that includes new routines and surroundings, most
children will exhibit what educators call shyness to an extent, yet after some period of
adjustment, these students acclimate well to their new environment. For some students however,
the silence continues in their elementary setting (Crundwell, 2006). Selectively Mute students are
overcome with the expectation of speech and the anxiety that comes with speaking that they fail
to speak (Harwood & Bork, 2011). There is a lack of knowledge about Selective Mutism among
teachers and parents as well as those in the medical field. If a child is speaking at home, and
communication does not take place between the educator and family, then the child might slip
through and fail to be diagnosed. Educators could also interpret the inability to speak at school
as a behavior that the student will grow out of at some point. Parents may also not understand
the serious implications and may contribute to the continued manifestation to the Selective
Mutism. Due to the difficulty in identifying children with Selective Mutism, inappropriate ways
to respond to a child with Selective Mutism may further exasperate the child and reinforce the
mute behavior (Shipon-Blume, 2006).
There have been many studies about Selective Mutism and many researchers are trying to
understand the anxiety disorder in order to discover what type of therapy works best to increase
speaking in unfamiliar environmental settings and decrease the anxiety in the same setting
(Sloan, 2007). Previously, medical professionals believed that trauma was the single cause of
Selective Mutism. However, recent research indicates that the temperament and anxiety
components of a child play the major role in the cause of Selective Mutism (Sloan, 2007).
The onset age typically coincides with a child entering school for the first time, and the
Selective Mutism typically occurs inside the classroom (Harwood & Bork, 2011). With this
knowledge, educators in preschools and primary grades play a massive role in supporting these

3
children to help them find their words so they can express themselves inside the classroom
without the fear of being seen or speaking (Harwood & Bork, 2011).
Statement of the Problem
Selective Mutism is a childhood disorder characterized by a persistent failure to speak in
certain social settings in which speech is typically expected (e.g., at school), despite speaking in
other situations (American Psychiatric Association, 2013). Considering that the school
environment is the primary setting for the onset, identification, and the continued manifestation
of Selective Mutism, there is a lack of evidence based research studies that are focused on
successful interventions that teachers and school staff can use in the elementary setting for
students who have Selective Mutism. This deficiency contributes to a lack of referrals, treatment
procedures, and implementation of strategies to use in the school setting. School Psychologists
can assist students and work with teachers, parents and support staff to provide school-based
interventions that can decrease the severity of the Selective Mutism and the impact it has on
students (Busse & Downey, 2011). In order for support to be provided to the student, the teacher
needs to be able to recognize the symptoms and understand that excessive shyness could also be
Selective Mutism (Harwood & Bork, 2011). Interactions with children who seem to be stubborn,
defiant, unsociable, or extremely shy must be responded to in an appropriate manner, otherwise
inappropriate reactions with adults may contribute to a stronger case of Selective Mutism
(Harwood & Bork, 2011). Children with Selective Mutism typically engage in social
conversation with parents and siblings at home, however not in the school environment. This
paper presents the pilot study research questions and briefly reviews the study’s research design
and methods, including a reflection on data collection.

4
Purpose of the Project and Questions
The purpose of this research will be to gain an understanding of general education
teachers’ knowledge of and awareness about Selective Mutism (SM) and their experiences with
children who are selectively mute as well as the strategies used in the classroom. This problem
is significant because the literature is still limited, does not include a comprehensive list of which
treatments are given or their success rates (Cohan et al., 2006). A secondary purpose will be to
study the effectiveness of the strategies employed by teachers who have students with Selective
Mutism in their elementary classrooms and how the strategies coupled with the environment
affects a selectively mute student.
No more than four teachers who have worked with Selectively Mute students in a general
education elementary classroom will be interviewed. Due to the difficulty selectively mute
children have with speaking in the elementary setting, no students will be interviewed. The
interviews will help to determine how the elementary teachers have recognized that the student is
selectively mute. It will also determine how the teachers learned what works best with these
students and if certain instructional strategies were more effective than others. The results will
hopefully determine through reflection why some strategies were better than others and how the
teacher was able to identify which instructional strategies worked best to increase verbalization
within the classroom if any.
As such, the questions that will guide the promising practice study are the following:
1. How do general education teachers apply strategies to address the learning of selectively
mute children in the classroom?
2. What strategies do general education teachers employ with selectively mute children in
the classroom?

5
3. How does working with a selectively mute child impact on a teacher’s thoughts, feelings
and behaviors?
4. How does the setting and support groups affect the strategies used by general education
teachers?
The Ecological Systems Theory identified by Urie Bronfenbrenner (1979), will guide this
study. Also called the Ecology of Human Development, his theory is based on five
environmental systems in which humans can interact. The five systems consist of the
microsystem, the meso-system, the exo-system, the macro-system, and the chrono-system. For
the purposes of this study, the focus will be on the individual and the relationships between the
microsystem (school environment) and meso-system (teacher).
The microsystem is any group or institution that directly affects the development of the
child such as school, peers, and the family. The Mesosystem involves any interactions between
the individual and those groups within the microsystem, such as the parents and the teachers, and
the student and the teacher (Bronfenbrenner, 1979). As this study is focusing on the student
within the classroom, only the microsystem and mesosystem will be discussed as it relates to the
educational setting of the students with Selective Mutism.
Significance of the Study
This research study will present documented instructional strategies that have been
successful in the classroom with students who are selectively mute. This study will also
highlight what is missing in terms of knowledge on behalf of the teachers and parents of students
with Selective Mutism. As this is a complex anxiety disorder most of the research discusses
other interventions outside of the classroom, such as psychotherapy (Harwood & Bork, 2011). It
is important to understand that the positive experiences a child has within the classroom can

6
decrease the anxiety, which can lead to more successful interventions with increasing
verbalizations.
This study will also increase the awareness of Selective Mutism to the 85% of adults
surveyed per a recent Harris Poll who have never heard of selective mutism (Selective Mutism
Association, 2017). There is a misunderstanding about Selective Mutism and how it manifests in
children. Most of this stems from ignorance (Johnson & Wintgens, 2001). Professionals, at
times, believe that the child simply will not speak out of defiance, stubbornness, or shyness. The
anxiety that a Selectively Mute child feels increases with each instance in which they are
expected to speak. The anxiety associated with speech outweighs any incentive they have to
speak without professional therapy (Johnson & Wintgens, 2001). When a child does not warm
up after a few weeks, then it is time for the teacher to ask preliminary questions. This study will
address when teachers begin to ask preliminary questions and what prompted them to delve
further to investigate Selective Mutism.
What is also significant in this study is the effect of the Ecological Systems Theory on
students with Selective Mutism. The interactions between the microsystem and the mesosystem
involving Selectively Mute students are important for research. Depending on the type of
interaction in these systems, the interactions can exacerbate the mutism or improve the mutism in
the classroom.
Limitations and Delimitations
Some anticipated limitations would be the honesty of the teachers during the interviews
and whether the strategies implemented in their classroom are done with fidelity. The data that
will be collected during interviews will be analyzed to determine any discrepancies between the
teacher interview responses.

7
Another anticipated limitation would be the participant pool. Teachers selected for this
study will have been referred as a teacher of a student of selective mutism. The problem that I
foresee is that some teachers who have selectively mute students may not know it. Some may
say they have a selectively mute student, when in fact the student may speak in the classroom.
It needs to be stated that the researcher does have a son who was diagnosed with
Selective Mutism in Kindergarten. Some of the interventions implemented are the same as some
mentioned in this research paper as well as some that are not. As each child with Selective
Mutism is unique, different techniques and strategies are used based on the severity of the
mutism. The researcher’s son became fully conversational in school at the end of third grade.
Organizational Stakeholders
For the purposes of this study, the stakeholders will include school staff, teachers,
parents, and the students. School staff is the stakeholder group that may not realize the
implications of any conversation they have with selectively mute students. Typically, these
stakeholders do not participate in any professional development related to students’ emotional
status. The next stakeholder includes parents, as they will communicate any known emotional
needs to the teacher. Students are important stakeholders in this research as they are the purpose
for this research. Understanding their interactions within the ecological systems theory and how
they communicate with peers and teacher will be invaluable to those who work with the
selectively mute students. Lastly, teachers are most important to this research, as it is the teacher
who instructs the student and implements any accommodation for the student. The teacher is the
one who must assist the student between the micro and meso systems to increase spontaneous
conservation in the elementary classroom.

8
Stakeholder for the Study
While the joint efforts of all stakeholders will contribute to the success of the students,
the key stakeholder that will be the focus of this research will be the elementary classroom
teacher of a student with selective mutism. The success of the selectively mute student depends
on the elementary teacher. Their instructional practice must be appropriate for all learners.
Students come into the classroom with mixed ability as well as different emotional states. A
highly skilled teacher will adapt to the selectively mute student to make them comfortable within
the elementary classroom. The teacher is the one who works with the selectively mute student
day in and day out, and they can manipulate the selectively mute student’s microsystem and
microsystem.
Definitions and Terms
There are several terms that must be defined to understand the context of this research.
The terms are defined below:
Selective Mutism: a childhood disorder characterized by a persistent failure to speak in
certain social settings in which speech is typically expected (e.g., at school), despite speaking in
other situations (American Psychiatric Association, 2013).
Anxiety: an emotion characterized by feelings of tension, worried thoughts and physical
changes like increased blood pressure (American Psychiatric Association, 2013).
Cognitive Behavior Therapy: complex and evolving model of treatment that has been
developed for and applied to a wide range of mental and physical problems and disorders
(American Psychiatric Association, 2013).
Environmental Systems: different environments throughout our lifespan that may
influence our behavior in varying degrees (Bronfenbrenner, 1979).

9
Microsystem: the smallest and most immediate environment in which the child lives. As
such, the microsystem comprises the daily home, school or daycare, peer group or community
environment of the child (Bronfenbrenner, 1979).
Mesosystem: encompasses the interaction of the different microsystems, which the
developing child finds himself in. It is in essence, a system of microsystems and as such,
involves linkages between home and school, between peer group and family, or between family
and church (Bronfenbrenner, 1979).
Exosystem: pertains to the linkages that may exist between two or more setting, one of
which may not contain the developing child but affects him indirectly nonetheless. Other people
and places, which the child may not directly interact with but may still have an effect on the
child, comprise the exosystem. Such places and people may include the parents’ workplaces, the
larger neighborhood, and extended family (Bronfenbrenner, 1979).
Macrosystem: the largest and most distant collection of people and places to the child
that still exercises significant influence on the child. It is composed of the child’s cultural
patterns and values, specifically the child’s dominant beliefs and ideas, as well as political and
economic systems (Bronfenbrenner, 1979).
Chronosystem: Includes the useful dimension of time, which demonstrates the influence
of both change and constancy in the child’s environment. The chronosystem may thus include a
change in family structure, address, parent’s employment status, in addition to immense society
changes such as economic cycles and wars (Bronfenbrenner, 1979).
Organization of the Study
Five chapters will be used to organize this study. This chapter provided the reader with
the key concepts and terminology commonly found in a discussion about Selective Mutism and
strategies employed by elementary classroom teachers to decrease anxiety and increase speaking

10
within the classroom setting. The stakeholders that this study will focus on were introduced. It
also provides information regarding limitations and defines important terms relative to the study.
Chapter Two will provide a review of current literature surrounding the scope of the study.
Discussions of the history of Selective Mutism, environmental settings, and interventions will be
addressed. Chapter Three will detail the assumed causes for this study as well as methodology
when it comes to choice of participants, data collection and analysis. In Chapter Four, the data
and results will be assessed and analyzed. Chapter Five will provide solutions, based on data and
literature, for addressing the perceived needs for these students as well as recommendations for
an implementation and evaluation plan for the solutions.

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CHAPTER TWO: LITERATURE REVIEW
This literature review consists of five major sections. The first section will provide a
brief history of Selective mutism that will include what it is, how a student is identified as having
Selective mutism, how the development of Selective mutism has changed through the years, and
how a student is finally diagnosed as a student with Selective mutism. The second section will
address how Selective mutism is identified as an anxiety disorder. The third section will
describe how the support systems affect students who have selective mutism. The fourth section
will address interventions strategies used by general education teachers in an elementary school
setting with students who have selective mutism. The fifth and final section will discuss the
conceptual framework that will guide this study.
History of Selective Mutism
Selective mutism and its symptoms have been reported for over 100 years. As early as
1877, this condition was called ‘aphasia voluntaria’ by Adolf Kussmaul (Johnson & Wintgens,
2001). The name was later changed to ‘elective mutism’ by Moritz Tramer in 1934 (Johnson &
Wintgens, 2001). The essential feature of selective mutism is the persistent failure to speak in
specific social situations (e.g., at school, with playmates) where speaking is expected, despite
speaking in other situations (e.g., at home); the disturbance interferes with educational or
occupational achievement or with social communication; the disturbance must last for at least
one month and is not limited to the first month of school during which many children may be shy
and reluctant to speak; the disturbances is not accounted for by a communication disorder and
does not occur exclusively during the course of a pervasive development disorder, schizophrenia,
or other psychotic disorder (American Psychiatric Association, 2013). Elective mutism was
renamed selective mutism in the DSM- IV in 1994 as the child ‘selected’ which environment

12
they would speak (Ponzurick, 2012). More recently, the DSM-V now classifies Selective Mutism
as an anxiety disorder (American Psychiatric Association, 2013).
The conceptual basis for Selective Mutism has evolved through the years. The consensus
being that social phobia and anxiety components are major etiological factors (Berger,
Jaworowski, & Gross-Tsur, 2002). The failure to speak impacts a student’s educational
achievements and social communication. The failure to speak is not due to the child’s lack of
knowledge of, or the comfort with the spoken language required for the social interaction. Other
disorders have to be excluded include various communication disorders (phonological disorders,
or expressive language disorders), lack of knowledge of the language, pervasive development
disorder, schizophrenia, other psychotic disorders, and severe intellectual disabilities (Berger, et
al., 2002).
The school environment is extremely important, as this is the most frequent social context
in which the child will manifest the symptoms of selective mutism. Typically, the teacher is the
one who will not be spoken to by the selectively mute child, and it is the classroom environment
where the speaking will not occur. A selectively mute child may speak on the playground with
peers (Sharkey & McNicholas, 2008). Instead of communicating verbally, children with
selective mutism will use gestures, nodding, pulling, pushing, or monosyllabic utterances
(Krysanski, 2003). When a child is allowed to communicate in another way besides speaking,
others will stop asking the child to speak thus reinforcing the mutism. The major concern with
the diagnosis of selective mutism is that it may negatively impact a child because there are
limited opportunities for social interactions with peers, there could be language delays, and it
limits involvement in daily school activities with peers (Krysanski, 2003).
Etiology

13
Etiology of selective mutism has changed over the last 100 years as researchers and
practitioners could not agree on a single etiology (Anstendig, 1998). Early causes saw selective
mutism as a manifestation of unresolved conflict (Krysanski, 2003). Other researchers believed it
was a symptom of other disorders, while others believed it was best understood through the
child’s environment. More recent research placed the etiology with genetic and environmental
factors that affected the child, especially social anxiety disorders and social phobia (Sharkey &
McNicholas, 2008). These children have been described as being slow to warm up in their
infancy and early childhood. Once in the school environment, these children have expressed fear
of being judged along with the physical symptoms of anxiety in social settings. They exhibit
avoidance when confronted with the feared situation (Sharkey & McNicholas, 2008).
Families of selectively mute children have been described as shy, and a number of studies
have reported a very strong bond between mother and child (Sharkey & McNicholas, 2008). As
selective mutism and social phobias are closely connected, this suggests that there may be a
genetic vulnerability to the development of selective mutism, which may be compounded by the
child’s environment. Cohan et al. (2006), suggested that a child who experiences a high level of
anxiety may be highly sensitive to verbal interactions with others. This may be triggered by an
environmental stressor, such as school entry, which may lead to a failure to speak in a given
setting, despite being able to do so.
Researchers found that selectively mute children were most likely to speak at home and
to family members. A family history of social phobias and selective mutism was common
among children in 70% of those diagnosed (Sharkey & McNicholas, 2008), however Roberts
(2002) noted that there was a history of trauma in 13% of those diagnosed. The mutism was
typically exhibited at school with unfamiliar adults (Roberts, 2002). Roberts (2002) also found
that the children with selective mutism also had a diagnosis of social phobia, avoidant disorder,

14
or a simple phobia, but these children rarely had symptoms of psychiatric disorders. Due to
these additional diagnoses, many researchers believe that selective mutism is a disorder of the
anxiety spectrum (Krysanski, 2003). Finally, per the fifth edition of The Diagnostic and
Statistical Manual of Mental Disorders (American Psychiatric Association, 2013), selective
mutism was classified as an anxiety disorder.
Black and Uhde (1995) conducted a pilot study to ascertain the characteristics of children
with selective mutism. They investigated whether there was a causal relationship between a
psychologically or physically traumatic experience and the development of selective mutism.
They also looked at parent and teacher ratings of anxiety symptoms in the children. Finally, their
study looked at the situations and environment in which the children with selective mutism spoke
and the severity of their reluctance to speak across varying situations and environments.
The study included approximately 30 children from elementary schools in Maryland,
Virginia, and the District of Columbia who referred by the school counselors. Parents completed
a parent questionnaire and participated in an interview. The children also participated in an
interview with yes/no questions. They were encouraged to nod, gesture, or write if they could not
respond verbally. Family history was screened to determine if any family member had social
anxiety, as a child or adult, or a fear of public speaking.
The findings did not support that trauma is a common etiological factor of selective
mutism (Black & Uhde, 1995). Based on the parent and teacher rating of anxiety, the study
found that there was a difference in the variation between the anxiety observed by parents and by
the teacher. Keeping in mind that the situation and environment are important factors in
determining whether a selectively mute child will speak, the results are not surprising. The
results indicated that the selectively mute children were more reluctant to speak away from
home, more reluctant to speak to adults rather than children, and most reluctant to speak to

15
unfamiliar non-family members. Teachers’ ratings indicated that the selectively mute children
were significantly less reluctant to speak to other children than to teachers or other adults. What
is not included in this is where the speech occurred and who was present. If the teacher
witnessed the verbal interaction and the proximity to the selectively mute child is also missing.
Assessment and Diagnosis
Assessing a child involves a multidisciplinary diagnostic assessment across a variety of
settings. Selective mutism should not be diagnosed if the individual's failure to speak is due
solely to a lack of knowledge of, or comfort with, the spoken language required in the social
situation (Cohan et al., 2006). As stated previously, selective mutism is not diagnosed until a
child begins school after normal conversations have taken place in the home. The teacher is
crucial to informing parents whether the child is communicating in the classroom with speech
(Sharkey & McNicholas, 2008). Selective mutism manifests with a combination of other
factors, and it has to last more than one month and not at the beginning of the school year or
change in schools (Cohan et al., 2006).
Assessments should also include a comprehensive evaluation to rule out other
explanations for the disturbances of language use and to assess for co-morbid factors (Krysanski,
2003). Due to the nature of selective mutism, interviews with parents are crucial. Information
regarding the history of speaking should be given as well as any other communication
difficulties. It should also be noted where the child speaks and to who the child speaks.
Understandably, it might be difficult to interview the child with selective mutism, but if an
interview is possible, then the evaluator should take note of the child’s social interactions and
expressed communication. Psychiatric symptoms should also be assessed. If other disorders
were identified, then the diagnosis of selective mutism would be ruled out (Krysanski, 2003).
Medical history should also be taken to rule out unidentified neurological injuries that could be

16
the cause of the selective mutism (Roberts, 2002). Academic assessments should also be given to
test cognitive ability in case there may be a learning disability (Roberts, 2002). Lastly, a
comprehensive speech and language assessment should be given to look at speaking complexity
and fluency within the home, nonverbal communication, and to see if there was any history of a
language delay which may influence the child’s speech and language (Krysanski, 2003).
Treatments
Over the years, treatment approaches to children with selective mutism have evolved as
the research was limited and the lack of long-term follow up to indicate preferred treatment
methods. Success has been limited with a single treatment, however multi-modal approaches
have been more effective. Behavioral methods are most frequently recommended and treatment
approaches indicate the importance of effective management being with the people in the
situations where the mutism occurs (Johnson & Wintgens, 2001).
Education. The first approach to treatment is educating the parents and teachers making
sure they are aware that the child has selective mutism, an anxiety disorder, and that the refusal
to speak is symptomatic not deliberate (Roberts, 2002). Once dialogues have been open between
the parents and teacher, support can be given to the student rather than consequences for the
inability to speak in the school environment. Education can provide support to the student and
decrease frustration and confusion the school staff may have about selective mutism. Education
can also assist school personal in creating guidelines to support the student (Roberts, 2002).
Cognitive behavior therapy. Selective mutism has been described as a learned response
that a child develops to manage anxiety (Sharkey & McNicholas, 2008). Popular behavior
therapy techniques include reinforcement, stimulus fading, token procedures, shaping or
prompting, contingency management, and response initiation procedures. For example, a child a
child is rewarded for verbal behavior and not reinforced for the mute behavior. As the most

17
common setting for the mutism is at school, a therapist must be willing to meet with school
personnel. The therapist typically sets up a home and school program that rewards
communication and socialization and discourages behaviors that increase anxiety, such as
punishment for non-verbal behavior, insistence on speech, or pressuring a child to speak
(Roberts, 2002). It is important that parents and teachers communicate to make sure the child
does not feel more anxiety with speech expectations, but that balance is achieved for
encouraging communication with rewards.
Family therapy. Family therapy is not used exclusively. Family therapy may bring
families closer together, however may not actually get the child speaking (Johnson & Wintgens,
2001). With the genetic disposition towards social phobias, there may also be a reluctance of
socially anxious families to interact within therapy (Sharkey & McNicholas, 2008). In the case of
dysfunctional family patterns, family therapy can bring the unhealthy family systems to light to
determine if the family dynamic could be reinforcing the mutism (Krysanski, 2003).
Interventions employed within family therapy were designed to help problematic family
dynamics and not directly addressing the symptomatology of the child’s mutism (Anstendig,
1998).
Pharmacotherapy. Pharmacotherapy is the use of medication or drugs to combat
selective mutism. It is only early 1990 that medication has been prescribed as treatment using a
selective serotonin reuptake inhibitor (SSRI) such as fluoxetine (Johnson & Wintgens, 2001).
The medication has been used as a single intervention, but it is more commonly used in
conjunction with cognitive behavior therapy (Roberts, 2002). Monoamine oxidase inhibitors
(MAOIs) have also been used as they have been successful in treating adults with social phobias.
The dopamine receptors increase talkativeness of those use MAOIs (Sharkey & McNicholas,
2008). It was reported that the children who respond best to pharmacological interventions were

18
diagnosed with social anxiety; it was unclear whether the use of fluoxetine should be used for all
children who are selectively mute with social anxiety (Anstendig, 1998).
Speech and language therapy. There may be children with selective mutism who need
speech therapy. This treatment has worked best with younger children who have a mild form of
selective mutism whose speech makes them feel self-conscious (Johnson & Wintgens, 2001).
However, the child must be diagnosed with selectively mutism, and different approaches may be
necessary. Speech therapy has been unsuccessful with more severe forms of selective mutism
where their anxiety is reinforced because they cannot participate in the treatment program as
prescribed.
Self-modeling. There are very few accounts of treatment approaches using video or
audiotapes of selectively mute children as a single intervention (Krysanski, 2003). Audio or
videotapes are pieced together to show the selectively mute child appearing to speak in situations
where they have been mute. They have been used in conjunction with behavior therapy (Johnson
& Wintgens, 2001).
Group therapy. Group therapy is not typical as there are usually not enough children
referred at the same time. A variety of strategies are used in group therapy. They included
behavior modifications, shaping, modeling, role-playing, and relaxation techniques (Sharkey &
McNicholas, 2008). Group therapy sessions were also held for the parents to assist them in
evaluating the child’s speaking.
Play Therapy. Play therapy has not been used as a sole intervention, however several
research studies have included play therapy techniques as part of a multimodal treatment
approach (Sharkey & McNicholas, 2008).

19
Anxiety Disorders in Children
Anxiety is one of the most common psychosocial problems reported by children.
Anxiety can affect how children function in school (Barrett, Dadds, & Rapee, 1996). Childhood
anxiety disorders can impair children and can be associated with later emotional difficulties. By
looking at risk factors, identification can be made earlier for at-risk children leading to
prevention efforts. Anxiety disorders represent one of the most pervasive mental health problems
(Mian, Wainwright, Briggs-Gowan, & Carter, 2011). Symptoms of anxiety in toddlers and
preschoolers have been shown to persist for at least one year or longer. Research on prevention
can have long reaching benefits.
Ecological Risk Model
When looking at the emotional development of a child, most of the research has focused
on individual risk factors within one level of the child’s ecology (Mian et al., 2011). There is
strong empirical evidence that supports the notion of temperamental and environmental
influences from multiple levels of an individual’s environmental systems on childhood anxiety.
Mian et al. (2011) conducted a study look at risk factors for early childhood anxiety. They
looked at the family, community, and school environments of approximately 1109 children
between 22 and 48 months old, again in kindergarten, and finally in second grade to determine
whether there were early identifiers that could predict childhood anxiety.
The study gathered informational data about early risk factors for toddlers. Prevention
models were used with a questionnaire and the data showed evidence that ecological risk factors
affect the severity of a child’s anxiety. This longitudinal study gathered data at three intervals
over several years. Although violence and maternal affective symptoms were associated with a
child’s anxiety, the study found that temperament and a child’s symptoms were the biggest
predictor of anxiety in kindergarten and second grade. The findings in this study suggest that

20
perhaps focusing on child factors may be the best way to assess early risk for childhood anxiety
disorders.
Consultative Approach
Auster, Feeney-Kettler, and Kratochwill (2006) discussed the treatment of childhood
anxiety disorders using a consultative problem-solving framework in the school setting. The role
of consultation as a service delivery model in a school setting and the contribution that
consultation has in in the movement towards evidence-based practices in school psychology are
discussed as well. They describe the multiple models of interventions used to treat childhood
problems. With consultation, a clinician used problem-solving strategies to address the needs of
the child and the teacher, parents, and peers. The clinician implements the plan and the parents,
teachers, and peers carry out the service model with the child. There is limited research on the
use of this service model for children with anxiety; however, this model could yield positive
results for children with SM. When compared to traditional treatments for anxiety, this service
model allows for the teachers, parents, and peers to receive extensive guidance, professional
development, and ongoing training so they can become intervention agents themselves (Auster et
al., 2006). Cognitive behavior therapy has proven to be successful with children who are
selectively mute (Barrett et al., 1996). When you combine cognitive behavior therapy with the
consultation service model, there is significant improvement in decreasing anxiety rather than
with only cognitive behavior therapy (Auster et al., 2006). Research is not abundant in terms of
how many children with SM have been treated successfully with this approach. However, this
approach allows for all who are in contact with the child to positively reinforce the behaviors
needed to speak in all settings.

21
Parental Characteristics
Children are active participants in their environment (Edison et al., 2011). When children
have anxiety, parents try to control the environment to decrease a child’s anxiety. In a social
situation, children are reacting to or causing other’s behavior. When an anxious child is in an
anxiety-provoking situation, the child may display different behaviors, which causes different
parenting behaviors than those of a non-anxious child. When a child displays fearfulness, it is
natural that a parent may feel concern, sympathy, or even frustration. The parent then may try to
manipulate the environment to decrease the child’s anxiety and their own. Past experiences
between parent and child in anxiety-provoking situations guide future behaviors.
In a study done by Evans et al. (2011), they took a sample of 63 children along with their
primary caregivers who were referred to a child’s mental health site. They looked at the
questionnaire to identify which children had anxiety and place them in an anxiety group and a
non-anxiety group. They observed the children with their primary caregivers to see which group
of parents had more control of their child. Situations were created for the child and parent from
free play to stressful situations. Specifically, the study sought to determine whether parental
characteristics were dependent on their child, and thus the parents would engage in greater
control of the situation when their child was anxious. The study found that the parents of
anxious children were more controlling in any situation. The higher the observed anxiety in a
child, the higher the more the parent attempted to control the situation to lower their child’s
anxiety.
Selective Mutism
Contemporary research suggests that Selective Mutism is an anxiety related disorder or
frequently occurs with anxiety (Black & Uhde, 1995). When looking at selective mutism as an
anxiety disorder, the implication is that there is an adverse physiological arousal of automatic

22
nervous system in response to certain stimuli (Shriver, Segool, & Gortmaker, 2011). For
selectively mute children, the anxiety - the adverse physiological response - occurs when there is
a presence of other people in the environment. The manifestation of the anxiety could merely be
the presence of other people, or when attention is directed toward the child (Shriver et al., 2011).
After time, the child learns an alternative form of communication without speech when in the
presence of others or as a response to a particular setting.
It is common understanding among recent research studies that selective mutism exists in
conjunction with other co-occurring conditions (Schum, 2006). Some young children experience
enuresis or other toileting issues. Oppositional disorders are believed to be a form of passive
aggressiveness in which the mutism is the refusal to comply with what is being asked of the
child. Research (Schum, 2006) indicates that the oppositional behaviors are usually an
expression of the child’s attempts to cope with the underlying anxiety, which is in direct
proportion to the amount of pressure exerted by adults to encourage talking and socialization.
Selectively Mute children are not diagnosed with oppositional defiant disorders, rather the
behaviors function to avoid the anxiety the child feels due to adult pressure to speak.
Self Control. Moldan (2005) discussed prior research in which she suggested a theory of
self-control. This theory suggests that a child uses self-control as a controlled response to restrain
any verbalizations. The child can control the appropriateness of his or her response and evade
punishment. Parents are often unaware of the silence until the child is enrolled in school, and the
child’s emotional needs are not being met in that environment. As the parents were unaware of
the silence, they were unable to validate the silence with the child as a state of anxiety. The child
continues the silence outside the home. There were also other instances reported where the
mutism is viewed as being oppositional or defiant. The child is then punished. When looking at
selective mutism and self-control, the child’s anxiety is never truly acknowledged within the

23
child’s regulatory system. As a result, the child tries to regulate on his or her own without any
external assistance. The mutism is reinforced to keep the anxiety at bay when outside the home.
Another form of self-control with a selectively mute child is ignoring when directly
questioned. Adults are not familiar with the visual cues of anxiety displayed by the child. The
adult then questions the child again, putting more pressure and drawing more attention to the
child by asking questions such as “What’s the matter? or “Are you going to talk?” or “Why
aren’t you answering me?” When parents observe this, they usually answer for the child, as they
know the child will not respond when directly questioned. This parental behavior has typically
been described as “enabling”, however parents typically try to decrease the anxiety by answering
for the child because they can pick up on the visual cues of frustration. The tension the child
feels is a result of an uncomfortable communication interaction.
Support for Anxious Children
Children with selective mutism often engage, interact, and communicate verbally within
comfortable surroundings, such as at home or with trusted peers, however when placed in
structured social settings, such as school, this is when the selective mutism becomes apparent
(Camposano, 2011). Children with Selective Mutism are often mischaracterized as students who
are shy and who will grow out of it. Other misconceptions attributed to Selectively Mute children
are willful, stubborn, and unsociable (Harwood, & Bork, 2011). With characterizations such as
these, it is easy to see why the setting is important to a child with selective mutism. These
children will not grow out of shyness, unless they have the proper supports to assist them in
regulating their anxiety.
Cohan et al. (2006) state there have been some successful psychosocial interventions for
children with selective mutism. They conducted a meta-analysis of 23 studies. Interventions
included in their meta-analysis were behavioral/cognitive behavioral approach, behavioral

24
language training approach, family systems approach, psychodynamic approach, and multimodal
approaches. Fading, shaping, and contingency management plans have been successful
behavioral and cognitive-behavioral interventions. The family approach involves all relevant
members of the family, and through various techniques, promotes a positive and constructive
environment that seeks to remove the conditions that maintain the selective mutism for the child.
Psychodynamic approaches include art and play therapy in which the child would be allowed to
express inner conflicts with the expectation that he or she will no longer need to remain silent.
With studies that have a multi-modal approach, there are few published reports that
include speech therapists or school personnel. The meta-analysis supported the use of behavioral
and cognitive-behavioral interventions. The authors acknowledge that much of the literature on
selective mutism consists of retrospective record reviews, uncontrolled case studies, and a small
number of single-participant experiments of varied methodological quality. There is a lack of
adequate descriptions of diagnostic procedures, number and content of treatment sessions, and
outcome measures (Cohan et al., 2006). Also, the current literature may not be an accurate
reflection of selective mutism treatments as unsuccessful trials may not be published.
Early Childhood Therapy
Young children do not have the capacity to effectively use established treatments for
anxiety, which results in the children internalizing the anxiety in misguided ways (Carpenter,
Puliafico, Kurtz, Pincus, & Comer, 2014). Approximately 9% of preschoolers have anxiety
disorders and when left untreated, the disorders can be associated with disruptions within the
family and at school. When children have early onset anxiety, it can interfere with a child’s
development. If the anxiety disorders remain untreated, they can persist into adulthood and into
other medical disorders. There is a need for early effective intervention of childhood anxiety
disorders.

25
Treatment activities in which children reflect on how other might perceive situations
differently require theory of mind skills and perspective taking abilities that are not present at
earlier developmental stages. Children have limited executive functioning, poor organizational
skills, and restricted attention, which cause them to internalize much of the symptoms of anxiety.
Preschoolers are very much reliant on their parents for all of their basic life skills and emotional
support, and they also pick up on their parents’ biases and reactions to situations. Anxious
parents inadvertently teach their children what to be anxious about or what to avoid (Carpenter et
al., 2014). Children who have anxiety disorders are taught to resist the “worry bully” that is
trying to trick them (Carpenter et al., 2014). Parents and therapists work with young children
with the use of puppets as a form of early intervention. Many times, parents of anxious children
are reported to have strained relationships with their children over the child’s symptoms.
Early diagnosis and intervention are extremely important no matter what treatment is
used. Research suggests that treatment for selective mutism is effective when it begins as soon
as symptoms are reported (Camposano, 2011). The child will respond to treatment at a faster
rate the younger they are. Shipon-Blume (2006) warms that if selective mutism is left untreated,
there will be academic, social, and emotional repercussions. As children get older, selective
mutism can lead to other health issues such as cardiac, immune, or respiratory problems.
Family Therapy
Research has shown that anxiety disorders run in families, with one or both parents
exhibiting moderate to severe anxiety (Camposano, 2011). Pediatricians do not usually diagnose
anxiety unless parents bring up the symptoms. Even then, many pediatricians are not familiar
with the symptoms and the assumptions by the pediatricians are that the child will outgrow the
excessive shyness. Unless the parents bring up family history, the diagnosis can be delayed by
more than one year. The symptoms are typically present in the child around age three, however

26
the disorder is not usually identified until the child enters school where there is an expectation of
speech (Camposano, 2011).
Therapists should not look for a single cause of the mutism or assume that the cause was
trauma or abuse (Sloan, 2007). Recent research indicates that the development of selective
mutism is associated with the child’s temperament and is also hereditary. By involving the
family in therapy, a therapist can address the needs of the family, the needs of the child, and
other needs such as school. The environment is extremely important as well because there has to
be mutual respect and trust among the family and the therapist. Sloan (2007) conducted a case
study of a female Hispanic kindergartner. Parents reported the regression in her social capacity,
but parents still deemed the behavior as shy. The mother of the girl reported having extreme
anxiety as an adult due to being the victim of sexual abuse as a child. The therapist gave the
parents the role of being co-therapists. The parents were then tasked to help their daughter feel
comfortable speaking somewhere in the school building, with the therapist’s office being the first
obstacle.
Creating a comfortable environment with familiar people is the first step to decreasing
anxiety in other settings. The girl began to play a game in the office of the therapist with the
door closed. Next steps included the door being open, to the therapist being in view of the girl
and then finally in the room. Eventually, she was able to speak with the therapist in the room.
Treatment Approaches in the School Setting
Shipon-Blume (2006) attempts to identify key ideas for teachers of students with
selective mutism. The ideas presented in her article are important however, no evidence-based
research strategies are provided to assist teachers. As a reminder to teachers, she states that the
student is not being defiant on purpose or trying to control the situation on purpose. The
expectation of speech is causing the anxiety. It is important to note that children with selective

27
mutism should not be in special education classes because of the anxiety. She devotes a small
paragraph to a ‘process’. She acknowledges that there is no overnight miracle for selective
mutism, but refers to the guidance of a professional, parents and teacher team that will help the
child build coping skills for the anxiety. This can be provided through content knowledge to
teachers through effective Professional development workshops for early childhood educators
(Harwood & Bork, 2011).
Identification
Entrance into the school environment appears to be a salient and definitive landmark for
children with selective mutism (Camposano, 2011). Typically, a first school setting is the first
time a selectively mute child is identified. Those who naturally warm up after a few weeks and
those acquiring a new language begin speaking (Giddan, Ross, Sechler, & Becker, 1997). The
public-school speech and language pathologist is typically the first one consulted when a child in
not talking in school. There is no research involving private schools as to who is first consulted,
as the resources at private schools are limited. Many public-school teachers who have taught
immigrant populations have had experience with children who have difficulty speaking at the
beginning of the school year. Selective mutism cannot be diagnosed in a student where there is
an absence of the language.
Since evidence of Selective mutism is not identified until a student enters a structured
school setting, teachers are the ones who make the referral, yet they do not have the expertise to
deal with the disorder alone (Camposano, 2011). These children present a unique challenge for
the teacher. They must help these children overcome their fear of being heard in the classroom
setting. Since selective mutism is a complex anxiety related disorder, parents, educators, and
some health professionals misdiagnose selective mutism as shy behavior (Harwood & Bork,
2011). Much of the research has focused on cognitive behavior strategies and pharmacological

28
interventions. There is a lack of research to show teachers how to workday in and day out with
these selectively mute children. Research shows that the symptoms of selective mutism will first
appear with a child’s first exposure to a structured school setting. Given this information,
preschool and kindergarten teachers must be given the resources to be equipped with sufficient
knowledge to identify, refer, and treat selective mutism in the class setting (Harwood & Bork,
2011).
Teacher Professional Development Workshops
Most teachers engage in professional development on a voluntary basis as most consider
themselves to be lifelong learners. Professional development can be effective when it impacts
student learning and development. Selective mutism is not a standard topic for school
professional development. In order to address teacher concerns regarding students with selective
mutism, a teacher had to independently search for workshops. Due to the lack of research in this
area, Harwood and Bork (2011) researched and examined the effects of targeted professional
development workshop on selective mutism. They provided content knowledge about the
selective mutism disorder, explained the relationship between the professional develop and the
teacher outcomes, and engaged in active learning and play based pedagogy. The importance of
early educators and their ability to identify, assist, and address children with selective mutism
with proper mechanics was explained. Participants were also given levels of speaking hierarchy,
which were categorized and described with various levels of anxiousness. They were also given
examples of what each level looked likes in terms of anxiety for the child and what would be
considered ‘safe’ for the child with selective mutism.
In addition, teachers were given strategies which included lists of ‘Do’s and Don’ts, ways
of fostering communication through other areas, such as art or music, seating arrangements, and
visual cueing systems to use with the students (Harwood & Bork, 2011). The workshops

29
included activities to engage the teachers in discussions about students with selective mutism and
how to create an inclusive classroom. They had to use alternate means of communication such
as body language, and they had to reconstruct common teaching practices like ‘calendar time’, to
minimize talking.
The teachers who participated in this workshop completed a pre and post questionnaire
on selective mutism. Listed on the post questionnaire were strategies learned during the
workshop. Simple strategies listed included using less eye contact with student, using audio
equipment, using more pictures or photos, private space, use of puppets, respect their fear,
parental participation. More complex strategies learned and listed were tracking and
documenting for assessments, knowing how to desensitize selectively mute children into either
verbal or non-verbal situations, observing and noting the location, people, and activities that
affect the silent behavior (Harwood & Bork, 2011).
Role of Elementary Classroom Teacher
Teachers need to be aware of selective mutism and must be ready to respond
appropriately with early referrals and interventions. Selective Mutism is typically notice by
educators in the primary grades, typically a child’s first exposure to a structured school setting.
Parents are not the first to recognize selective mutism because the child speaks freely at home
(Crundwell, 2006). As selective mutism persists over time, it becomes more resistant to
treatment the longer it progresses. To prevent additional problems, such as academic difficulty,
recognition is key. Selective mutism reduces social opportunities in children. Due to their
silence and reluctance to speak, it has been reported that they have been the victims of bullies
and rejected by peers (Crundwell, 2006).
Elementary classroom teachers cannot make a formal diagnosis; professionals such as
psychologists, physicians, and psychiatrists are the ones to make the formal diagnosis. The

30
formal diagnosis comes after many assessments are completed with input from the teacher. By
documenting a child’s behavior, the useful information can inform those making the formal
diagnosis (Crundwell, 2006). Teachers are very important in the identification of problems,
referrals for assessments, and providing valuable data. There are many assessments that can be
used to assess expressive and receptive language skills.
Social functioning within school. There are mixed results within current research.
Some studies have selectively mute children struggling in school and overall functioning,
unwillingness to join groups or invite friends over to their house (Bergman, Piacentini, &
McCracken, 2002). A different research study done by Cunningham, McHolm, Boyle, and Patel
(2004) found that selectively mute children were not victimized or bullies by peers. These
children presented assertive, less disruptive characteristics that allowed them to participate in
sports, recreational activities, and after-school activities with peers. The study acknowledged
that there are social deficits in selectively mute children, however stressed that teachers should
be aware that children with selective mutism are not unsociable.
Multidisciplinary Interventions
In the school setting, it is imperative that interventions be put in place as soon as possible
in order to have the best prognosis for eliminating the mutism. Several research studies point to
not just one intervention, but a combination of interventions appears to be the best strategy as
well as established rapport with a therapist or teacher. Group therapy allows a school to treat not
only selectively mute children but also others with anxiety disorders (Busse & Downey, 2011).
Teaching of social strategies, contingency management, along with stimulus fading and self-
modeling, combined with cognitive behavior therapy can be utilized by teachers and staff to
lower anxiety (Busse & Downey, 2011). Interventions such as anxiety screening and whole class
techniques for anxiety may minimize the need for individual treatment, and peers may be used to

31
decrease anxiety (Busse & Downey, 2011). When implementing interventions, the key factor is
the child’s response to the interventions. Once selectively mute children overcome their anxiety
within one setting, their anxiety is decreased in that setting. The anxiety is context specific, not
like children who have shy temperaments. Selectively mute children the context is typically
related to the identity of the people present in the setting, compiled with the anxiety of being
overheard by others.
Speech therapy. A case study by Giddan et al. (1997) looked at a selectively mute 2
nd

grade female. She was a 2
nd
grade repeater and had not spoken in regular public-school classes
for three years. Ways of communication included writing notes and limited gestures. She was a
special case because she also had significant syntactic and phonological error patterns. She had
difficulty with the sounds of /l/ and /r/ in addition to omitting /s/ with plurals, possessive and
present tense verbs. The team assembled to assist this student included a speech pathologist, a
psychologist, and her teacher. She would have two sessions per week with the speech therapist
and one session per week with the psychologist. The team worked together to develop a plan
and then worked to create goals that were achievable. The team also met weekly to discuss
progress and next steps. Once progress was made in one setting, for example, whispering with
the psychologist, then the teacher and speech pathologist knew they could expect her to whisper
to them. Rewards were provided to the student; she received dyno dollars money, which was
part of the class token economy system. When whispering in all three settings became
predictable, then the speech pathologist was able to begin syntactic and articulation interventions
(Giddan, et al., 1997).
The coordinated efforts helped this student increase verbalizations at school. The team
also included her parents who attended quarterly conferences with the rest of the team members.
The approach that made this intervention successful was the therapeutic approach, which

32
involved establishing rapport, gain speech via an avoidance technique (whispering), provide
daily rewards, use multiple sites for the interventions, persistently increase the demands,
maintain an empathic relationship, vary interventions, allow the child to choose behaviors, and
use creative approaches when stalled.
It is important to discuss the teacher’s observations during this case study. The teacher
reported that at first, the student was unintentionally being rewarded for not talking as she
received points for following classroom rules. Her classmates also reinforced the mutism by
doing all the talking for her and telling other adults, that she does not talk or that she is shy.
The speech pathologist saw and began taping her voice; they listened together so the
speech therapist could use this as a teaching tool. Once the whisper was out, she could focus on
correcting her articulation and errors. Rewards were consistently used daily for speaking goals.
Selective mutism was thought to be a communication disorder and these children who did not
speak at school were preferred to the speech pathologist (Giddan, et al., 1997). As their research
evolved, it became apparent to these researchers that selective mutism was a pervasive
psychological disorder that required a comprehensive treatment strategy specifically matched to
each individual student.
Stimulus fading. Speech should be established with the support of a trusted
conversational partner for the selectively mute child. There has to be a period where rapport is
built with one key person who the child feels comfortable with and relaxed enough to
communicate with simple gestures. When conversations take place, there is another familiar
person who comes in and gradually overhears the conversation, without making conversation
with the child. This scenario is repeated so the child speaks with the other person in the room.
Then the environment is changed to another room repeated the same transfer of speech. If a

33
child is already speaking to a key person, the key person is the one constant in the environment
and other people change and the environment changes (Johnson & Wintgens, 2001).
Treatment Considerations
Once assessments have taken place and it is determined that the child does have a
diagnosis of selective mutism, the pressure to speak must be removed to lessen the anxiety. This
may increase the chances of spontaneous utterances, as speech is not expected. The selectively
mute child must also be exposed to the environment that is causing the silence. Johnson and
Wintgens (2001) have defined an approach that can be used to treat selective mutism.
First, they recommend using a behavioral approach that is aimed at reducing anxiety and
enabling the child to communicate in a range of situations. They are rewarded for the desirable
behavior, which is speech and ignored when the desirable behavior is not achieved. Children
should never receive a negative consequence for not speaking. Second, the child should be an
active participant in the treatment program. Next, as treatment progresses, only change one
variable at a time to alleviate any additional anxiety. Let the child set the pace and never let
them struggle to communicate.
Conceptual Framework
The conceptual framework that will guide this research project is Bronfenbrenner’s
Ecological System’s Theory model (1979). The ecological systems theory holds that we
encounter different environments throughout our lifespan that may influence our behavior in
varying degrees. These systems include the micro system, the mesosystem, the exosystem, the
macro system, and the chronosystem. For purposes of this research project and the selectively
mute child, the micro system and the mesosystem will be utilized. Setting is crucial for these
children to feel comfortable speaking. The framework will allow the research study to examine
how the specific settings affect the teacher interactions with the student.

34
As stated previously, the school is the primary setting in which selective mutism is first
suspected. This is typically a child’s first introduction to a structured school setting where
speech is expected. The environment is new to the child, and it is natural for most children to
express inhibited behaviors upon their first exposure. After a few months, if the child is still
silence, then other factors need to be taken into consideration and a full assessment is warranted.
Bronfenbrenner (1979) looked at a new perspective in human development where he looked at
the interactions between a person’s developments and how those functioned within the
environment. With selective mutism, this theory is very relevant as a specific environment is
where the mutism occurs, and anxiety is manifested as the child develops. The ecological
environment has many moving parts that overlap and intertwine. The ecological transition these
children face when entering school, involves a change in their role, meaning the expectation of
certain behaviors related to certain positions in society (Bronfenbrenner, 1979).
Basic Concepts of the Ecological Theory
An environment can place demands on a person. The ecological environment is made up
of different structures, which encompass each other. As this study will be looking at the teacher’s
role with a selectively mute child, the interconnection between the micro system and meso
system will provide the foundation. He states that different settings create different patterns and
roles, activities, and relationships for people within that setting. When children move from a
familiar environment to non-familiar environments, there is typically a change in behaviors. For
students with selective mutism, the anxiety of a non-familiar setting coupled with the
expectations of speech and interactions within this setting, can cause the silence.
The micro system. Bronfenbrenner states that the micro system's setting is the direct
environment we have in our lives. A child’s family, friends, classmates, teachers, neighbors and
other people who have a direct contact with are included in their micro system. The micro

35
system is the setting in which one has direct social interactions with these social agents. The
theory states that people are not mere recipients of the experiences they have when socializing
with these people in the micro system environment, but they are contributing to the construction
of such environment.
The microsystem is a pattern of activities, roles, and interpersonal relations experienced
by the person in a given setting with specific physical or material characteristics
(Bronfenbrenner, 1979). The setting is where face-to-face interaction takes place. This could be
the school, the home or a childcare center. The activities, roles, and relations are what make up
the microsystem. As we know that selective mutism is an anxiety based disorder, the
experiences are key because the child is the ones who perceives what is happening and the
silence is the result of the experiences in that setting.
The mesosystem. Brofenbrenner also states that the mesosystem involves the
relationships between the microsystems in one's life. This means that a family’s experience may
be related to one’s school experience. For example, if a child is neglected by his parents, he or
she may have a low chance of developing positive attitude towards his or her teachers. Also, this
child may feel awkward in the presence of peers and may resort to withdrawal from a group of
classmates.
The mesosystem is the interrelation between two or more settings the child participates.
This could be a home, school, and neighborhood group. The mesosystem is made up of groups
of microsystems. Children could actively participate in more than one setting, however one can
be a setting in which the child will not participate. Brofenbrenner also states that the
developmental potential of a setting in a mesosystem is enhanced when the person’s initial
transition into that setting is not made alone. An example would be a mother coming to the
school with the child for the first day.

36
CHAPTER THREE: METHODOLOGY
This chapter presents the research design, sample and population, instrumentation, data
collection, and the data analysis process that was used in this research study. The purpose of this
research was to gain an understanding of teachers’ knowledge of and awareness about Selective
Mutism (SM) and their experiences with children who are selectively mute as well as the
strategies used in the classroom. This study also addressed how the elementary teachers learned
about Selective Mutism and to what extent they were educated on the topic. This study was
guided by the conceptual framework presented in Chapter Two and answered the following
research questions:
1. How do general education teachers apply strategies to address the learning of
selectively mute children in the classroom?
2. What strategies do general education teachers employ with selectively mute children
in the classroom?
3. How does working with a selectively mute child impact on a teacher’s thoughts,
feelings and behaviors?
4. How does the setting and support groups affect the strategies used by general
education teachers?
Research Design
A qualitative methods (Creswell, 2014) approach was used for this study. A qualitative
research study includes several characteristics defined by Creswell (2014). These characteristics
are having a natural setting, using the researcher as the key instrument, using multiple sources of
data, using inductive and deductive data analysis, include participants’ meanings, having an
emergent design, using researcher’s reflexivity, and providing a holistic account. This study was
defined as a qualitative study as it contained most of these characteristics. Teachers were

37
contacted and interviewed at their specific school site. The researcher was the one collecting the
data, examining the documents, observing teacher behavior throughout the interview, and
ultimately being responsible for gathering all of the necessary data. The teachers provided
multiple sources of data for the researcher through a series of interview questions, pertinent
documentation of student work samples, and interviews. The researcher looked at the data to
determine if there were any emergent themes or whether additional information was needed.
The researcher kept in mind that the research design held much of the information about the
research questions. There was also a need for flexibility, as the design may have been needed to
change. The researcher acknowledged that there could be certain experiences that may have
shaped the way answers were interpreted and thus may have shaped the outcome of the study.
Finally, this qualitative research study sought to identify the different factors that contributed to a
selectively mute student being successful in the classroom and how the ecological theory of
development played a part.
In addition, qualitative research is an approach for exploring and understanding the
meaning that individuals or groups ascribe to a social or human problem (Creswell, 2014). In
this research study, the social problem was selective mutism and the individuals were the
teachers. As such, the qualitative design that was used in this research study was a combination
of phenomenological (Patton, 2002) whereas the researcher described the thoughts, feelings, and
experiences of teachers of students with selective mutism and grounded theory in which the
researcher discovered the different processes teachers undertook with students who had selective
mutism and how specific interventions within their environment increased or decreased speaking
in the elementary classroom.
Qualitative methods are appropriate when an interest in uncovering the meaning of a
phenomenon of people involved in an experience (Merriam, 2009). A need for understanding

38
how people interpret their experiences and the meaning they give to these experiences is
qualitative research (Merriam, 2009). This study involved teachers of selectively mute students
and the impact teaching these students has on a teacher’s thoughts, feelings and behaviors in the
classroom. This study also addressed the strategies these teachers used to communicate with the
selectively mute student. In order to understand the effect this had on a teacher, a qualitative
approach was necessary in order to understand the experiences of the teachers and the impact
within their classrooms.
The choice of methods that was used in this research study allowed for specific
information to be discovered throughout the research study. (Creswell, 2014). Once the data was
collected through open ended questions, interview data, and document data, the results were
analyzed to determine if there were themes or patterns that emerged from the data or if additional
data was needed.
The researcher also chose not to do observations inside the participants’ classrooms. The
presence of an outsider would have impacted the results of the study. It was not viable to do
observations of selectively mute students as this population already struggled with speaking in a
classroom with a familiar teacher and peers. Interviewing this population as well would have
been challenging as the anxiety of speaking to a stranger would have also affected the results of
the study.
Sample and Population
An important step in the research process is making sure there is a clear purpose
(Creswell, 2014). The purpose of this research study was to understand how teachers effectively
applied specific strategies within the classroom for students with selective mutism, how the
teacher and student interacted with each other, and how it affected a teacher’s thoughts feelings
and behaviors.

39
Merriam (2009) states that a researcher must use purposeful sampling to determine what
selection criteria are essential in choosing the subjects and/or sites that will provide the data
needed for answering the research questions. Purposeful sampling was be used because it could
offer useful manifestations of the phenomenon of selective mutism and how a student functioned
within the ecological setting, while gaining insight about the topic (Patton, 2002). Using Patton
(2002) and Merriam (2009) as guides, the following criteria was be used for determining the
participants.
The criterion-based sampling process that was used in selecting interview respondents
was a referral through colleagues and school psychologists who had knowledge of selectively
mute children in our local district. The colleagues were appropriate to include as they had
knowledge of where these students were located as they were either current or former teachers of
these students. The school psychologists were appropriate to include as they diagnosed some of
the students with selective mutism, knew the severity of the diagnosis, and could provide me
copies of their reports.
Maxwell (2013) states that purposeful selections allow a researcher to observe the typical
settings of individuals, or activities. He also states one can deliberately examine cases that are
critical for the theories you are studying. Lastly, purposeful selections can establish particular
comparisons to illuminate the reasons for differences between setting or individuals.
Teachers needed to be purposely selected by referral, as they were the ones who had
students in their class who met the condition. The interview protocol included basic information
and, when possible, brief history of the student. This was done to ease into the interview
process. Questions regarding the student and patterns of communication with family were also
asked in the beginning, while questions focusing on teachers’ feelings, thoughts and behaviors
were asked next, and lastly questions regarding support given or needed were asked.

40
As the study involved teacher’s behaviors and strategies used to communicate with
students who were selectively mute, I wanted to hear from the teachers how it impacted their
teaching, what their interactions with the student were like, and how the student conveyed his or
her intentions or actions within the classroom with peers and the teacher.
Participant criteria 1. The participating teachers were the roster-carrying teachers in
elementary general education classrooms. The study’s purpose was to investigate how teachers
applied strategies to address the learning needs of selectively mute children in their classroom.
In looking at the application of strategies, no other staff member could have been used as a
participant as the direction of the class fell under the supervision of the teacher. Other research
questions focused on specific strategies and especially how working with the student affected a
teacher’s thoughts, feelings, and behaviors, thus the sample was the roster-carrying teacher in an
elementary general education classroom and not an assistant teacher, special education assistant,
resource teacher, teacher’s assistant, instructional coach, or parent volunteer. For the purposes of
this study, a general education teacher was defined as someone who has earned a credential,
either preliminary or clear, and could be found listed in the California Commission on Teacher
Credentialing website.
Participant criteria 2. The participating teachers taught a student with selective mutism
within the past three years or currently were the teacher of a student with selective mutism. In
order to effectively determine how the environment could affect the strategies used by the
teacher for a student with selective mutism, the teacher needed to know that there was a student
with selective mutism in their class either diagnosed by the school psychologist or by an outside
psychologist or doctor or informed by the parent or guardian.
As the participant criteria was the most important, the secondary criteria to this research
study were the sites. The sites that were used in this study were ones in which the researcher has

41
no vested interest. In order to allow for complete objectivity, the study will not take place at the
researcher’s school site. As the site is secondary, the criteria are listed below.
Site selection criteria 1. This study was conducted at elementary school sites where
students with selective mutism were currently enrolled or previously enrolled in the last three
years. The study’s purpose was to look at how teachers use specific strategies with students with
selective mutism.
Site selection criteria 2. The classroom were general education classroom. In order to
have a better understanding of specific strategies used by general education teachers and how
strategies were implemented within the classroom, it was important that the elementary
classroom be a general education class.
Instrumentation
The primary instrumentation that was used in this research study was interviews. The
participants were given questions in advance to review, which provided the researcher with a
preliminary look at the trends, attitudes, or opinions of the teachers of students with selective
mutism. Interviews were conducted face-to-face with the participants in their natural setting.
The initial interview questions had follow up questions which were based on the responses to the
initial interview. This allowed for more clarification when needed and also allowed for open-
ended questions to elicit personal thoughts and feelings about their experience as a teacher of a
student with selective mutism.
Interviews. According to Patton (2002), we interview people to find out from them the
things we cannot directly observe. As we cannot observe everything, especially a teacher’s
thoughts or feelings, we have to ask the people the questions about the things we cannot observe.
As we interview, we can enter into the other person’s perspective. We seek to find out what is in
and on someone’s mind and to gather their stories. We have to assume in qualitative

42
interviewing that their perspective is meaningful, knowable, and able to be made explicit (Patton,
2002). More importantly, however, Patton (2002) states that the quality of the information
obtained in the interview is largely dependent on the interviewer. As this research study sought
to find what specific strategies were implemented by general education teachers of student with
selective mutism and how they were implemented, it was necessary to interview the teachers as
the participants were not able to be directly observed with their students as this would have
disrupted the ecological system of the student. The participants were able to provide historical
data and this allowed the researcher to control which questions were being asked to obtain the
data needed (Creswell, 2014).
Weiss (1994) addresses the need for interviews within qualitative research. He lists
several reasons why interviews are a preferred method for a qualitative study. Several reasons
interviews were deemed best for this study include integrating multiple perspectives, describing
the process, developing detailed descriptions, and developing a holistic description.
An interview protocol was created to inform the participants about the purpose of the
study, for permission, and to guide the interview to make sure enough data was collected. The
interview questions were constructed based on Patton’s (2002) six types of interview questions:
behaviors, opinions, feelings, knowledge, sensory data, and demographics. As this study sought
to determine any themes among teacher’s thoughts and feelings about teaching students with
selective mutism, it was imperative that the researcher made clear to the participants the
difference between an opinion and a feeling. Included in the protocol were questions that focused
on the cognitive processes of people and questions aimed at eliciting emotions. As this research
study was qualitative, truly open-ended questions were asked of the participants to allow them to
fully respond in whatever directions and using whatever words they wanted.

43
Surveys. Using Patton’s (2002) interview guide, a brief demographic survey was
constructed to gather general demographic information about the participants. These questions
focused on demographic data as it allowed the same basic information to be gathered from all
participants. Demographic data included years of general education teaching experience,
credentials, general teacher training, training specific to selective mutism, and any other training
they engaged in on their own. These types of general demographic survey questions were
analyzed to determine if there were any themes or patterns among the participants education and
experience levels and if so, did these themes or patterns affect the responses in the interviews.
Table 1
Matrix of Research Questions to Instrument and Element of Conceptual Framework
Research Question Theoretical Framework Data Instrumentation
How do general education teachers
apply strategies to address the
learning of selectively mute
children in the classroom?
Ecological Systems Theory Interview 9 & 18
What strategies do general
education teachers employ with
selectively mute children in the
classroom?
Ecological Systems Theory Interview 16 & 17
How does working with a
selectively mute child impact on a
teacher’s thoughts, feelings and
behaviors?
Ecological Systems Theory Interview 4, 13-15, 20
How does the setting and support
groups affect the strategies used by
general education teachers?
Ecological Systems Theory Interview 7, 9a-12, 19, 21-23
Demographic questions Interview 1-3, 5-6, 8, & 24-25

Data Collection
The topic of my research dictated that my sampling strategy needed to be criterion based
and therefore, I had to seek out teachers of selectively mute children. In order to have access to
teachers, I connected with colleagues within my local district who had knowledge of the location
of the students with their diagnoses. I also looked at student work and heard additional

44
comments about experiences, successes and some failures with the students. During the
interview, I audiotaped it in its entirety. I wrote notes as well in my local district issued
MacBook to purposely show that I was in the same ranks as a teacher with my interviewees. The
notes were then transferred onto the researcher’s password protected home computer with an
encrypted flash drive.
Data Analysis
The approach that was used for analyzing the interviews and data for this research project
was the generic approach. The responses from the interviewees were collected and analyzed for
common themes. Harding’s (2013) outline for analyzing qualitative data was used. At first, the
responses to each question were compared among the participants. The researcher summarized
each response into phrases for each question and identified categories for each response. Codes
were then identified within each transcription. After identifying the specific codes, the
transcripts were reviewed along with the codes and the categories into more broad categories to
determine which ones needed to appear in which category. Responses from multiples questions
were identified as fitting into themes.
Trustworthiness and Credibility
According to Miles, Huberman, and Saldana (2014), they have identified 13 tactics that
can be used by a researcher to ensure the quality of the data and thus make it more credible and
trustworthy. The following methods were used while collecting data for this research project.
The researcher interviewed those who met the criteria; non representatives were not be included
in the sample. The researcher had no effect on the environment as there were not any direct
observations of students. The data sources and the methods were used to corroborate each other
and increase the trustworthiness of the interviews.

45
Corbin and Strauss (2008) discuss drawing upon personal experiences in order to share
them with the participants. They are not talking about using the personal data in the research
itself, but to draw upon the experiences to bring about a new way of thinking to a participant
conceptually. The researcher does have a personal experience with the research topic, however,
the researcher chose not to share with the participants as the researcher felt the responses would
not be as candid by the interviewees if the researcher shared.
According to Patton (2002), this research study included the elements required of a study
to be credible. Rigorous methods were employed, which included the interviews of those
involved in the specific field. The researcher was credible as the researcher had training and
experience in the field of selective mutism prior to the study. Lastly, the researcher valued the
qualitative inquiry process which included the personal interviews.
The researcher is also in the field of special education and is an advocate of students with
various educational needs. The researcher hold a multiple subject credential and an education
specialist credential.
Ethics. Each participant was given a consent form which explained the research project.
It also states that they can opt out and choose not to be audio recorded. It stated how long and
where the data will be kept. The participants were not be given any form of monetary
compensation. The names of the teachers were not used nor were the actual names of the
schools they taught at identified in the research project to protect their privacy and the privacy of
the selectively mute students. Glesne (2011) discussed reciprocity in terms of ethics. She stated
that although researchers do not wittingly assume the role of therapist, they nonetheless fashion
an interview process that can be strikingly therapeutic. The interview questions that were used
for this research project asked the participants to name an emotion that described an experience.

46
This way was therapeutic for the participants because they were able to identify both highs and
lows.
Conclusion
This chapter presented the research design methodology that was utilized for this study.
Included as well was a description of the sample and population that participated in this study.
The instrumentation that was utilized was described in detail to ensure proper data collection.
The chapter included the data once it was collected as well as the data analysis process that was
used. Lastly, the steps to ensure reliability and validity of the findings were discussed.

47
CHAPTER FOUR: FINDINGS
The purpose of this study was to gain an understanding of general education teachers’
knowledge of and awareness about Selective Mutism and their experiences with children who
are selectively mute as well as the strategies used in the classroom. Additionally, the study
investigated how general education teachers applied strategies to address the learning of
selectively mute children in the classroom, and what specific strategies they used. In order to
help understand the impact of having a selectively mute student in the class, teachers were also
questioned as to the effect on each teacher’s thoughts, feelings and behaviors related to the
student. Lastly, I looked to see how the setting and support groups affected the strategies used by
general education teachers.
As previously stated, a qualitative methods (Creswell, 2014) approach was used for this
study. A qualitative research study includes several characteristics defined by Creswell (2014).
These characteristics are defined as having a natural setting, using the researcher as the key
instrument, using multiple sources of data, using inductive and deductive data analysis, include
participants’ meanings, having an emergent design, using researcher’s reflexivity, and providing
a holistic account. This study was defined as a qualitative study as it contained most of these
characteristics.
The participating elementary general education teachers were identified through referrals
through colleagues and school psychologists who had knowledge of selectively mute children in
our local district. Those selected were roster-carrying teachers who had students with Selective
Mutism in their classroom either currently or within the previous two years. A large school
district in the greater Los Angeles area employed all four teachers, and they all met the criteria
defined by the researcher. There were other teacher participants referred to the researcher but

48
they could not be included in the study, as they did not meet the criteria of being a current
teacher or having taught a student within the past two years.
The first three chapters of this dissertation presented the purpose of this study, discussed
the significance of the problem, provided a plethora of research pertaining to effective strategies
that could be employed by teachers who teach students with selective mutism, and explained the
qualitative methodology approach which was to be used. There were four research questions
that were the focus of this study. These four questions aimed to understand how teachers were
affected by having a student with selective mutism in their classroom. In addition, the research
study wanted to focus specifically on effective teaching strategies used that would decrease
anxiety and increase expressive speech. Interview questions were formulated to provide an
understanding of their feelings and were based on these four research questions:
1. How do general education teachers apply strategies to address the learning of selectively
mute children in the classroom?
2. What strategies do general education teachers employ with selectively mute children in
the classroom?
3. How does working with a selectively mute child impact on a teacher’s thoughts, feelings
and behaviors?
4. How does the setting and support groups affect the strategies used by general education
teachers?
These questions were addressed through a qualitative research methodology where the
researcher interviewed, audiotaped and took notes during face to face interviews over the span of
approximately two hours per interviewee, with some clarification taking place via a phone
interview after all four participants had completed their in person interview between December
2017 and January 2018. The data collected from the interviews was analyzed and the findings

49
were first categorized to see what strategies were most effective per teacher, and a general
consensus as to how it affected the teacher. Pseudonyms are being used in order to maintain
confidentiality and to protect the identities of the participants, students, and school sites as
referenced in UP-17-00812. This chapter begins with brief descriptions of the teacher
participants in the next section followed by the findings based on each of the four research
questions.
Description of Teacher Participants
When referred to be a participant for this study Martha was in her sixth year of teaching.
She earned a Bachelor of Arts Degree in Psychology with a Minor in Art, and she earned a
Master of Arts in Education with her Clear Multiple Subject Credential. She did not have any
formal training about Selective Mutism, however she stated that when the student was in her
class, “…she read material on the topic.” It was during her fourth year of teaching that she had
the selective mute student in her class. A colleague referred her to the study. She had taught 1
st
,
2
nd
, and 4
th
grade in her six years of teaching. At the end of her interview when asked to share
something positive about her experience with a selectively mute student, she stated. “It was nice
to see how a joint effort between the parents and the teacher really helped the student succeed
and positively influence her life.”
Similar to Martha in terms of education and experience, Joan was in her 10
th
year of
teaching when she participated in this research study. She taught the selectively mute student in
her 9
th
year of teaching and was now going back to school to earn her Special Education
Credential. Joan already earned her Clear Multiple Subject Credential. She holds a Bachelor of
Arts Degree in Sociology and a Master of Science in Elementary Education. Like the first
participant, Joan did not have any formal training about Selective Mutism in her Multiple
Subject Credential Program. Joan stated, “I was given a book by the student’s parents to read

50
about Selective Mutism.” She also looked for articles about the topic on her own. A former
colleague referred her to the study. She had taught 7
th
grade and had been in 3
rd
grade after that.
When asked at the end of the interview to provide a positive outcome of teaching the student, she
said, “I had the training to academically teach him but was not too informed on students with
disabilities. The student made me want to continue my education and he is why I am working on
my Education Specialist Credential.”
Just as the other participants did not have formal training, neither had Jennifer. She had
been teaching for fourteen years when she participated in this research study. She earned her
Clear Multiple Subject Credential and a Master of Science in Technology, Master of Science in
Elementary Education, and Master of Arts in School Leadership and Administration. Just like the
other participants, Jennifer did not receive any formal training about Selective Mutism. She did
not attend any specialized trainings but remarked that the student had an off-site psychologist
who would brief her every week with strategies. A friend of one of her colleagues referred her.
She was a computer class teacher for 8 years, then moved to 3
rd
grade for the last 6 years. At the
end of the interview when asked to provide a positive take away, she stated,
I had not been exposed to a selectively mute student before, so it was a learning
experience for me. I learned not to pressure my student for any kind of verbal response. I
learned more about children who are selective mutes and how to interact with them in a
way that fosters trust.
Having had the most years of teaching experience, Daisy had been teaching for 20 years
before she had a selective mute in her class. She holds a Clear Multiple Subject Credential, an
Administrative Credential, a Cross-cultural, Language, and Academic Development (CLAD)
certificate, and National Board Certification. Daisy said, “I did receive some background
information throughout my career regarding special education, but not specifically Selective

51
Mutism.” She did not have any formal training. A colleague who knew the researcher referred
her to the study. She has taught multiple grades over her 20-year career. She has been in 2
nd
, 3
rd
,
and most recently 5
th
grade. When asked to provide a positive impact at the end of the interview,
Daisy stated,
I could relate to my student very well because I myself am on the quiet side, so for me it
was a bit eye opening. I tried to empathize with my student and not force her to speak if
she was uncomfortable.
Table 2 is a brief overall summary of the demographic survey that describes each
participating teacher, their years of teaching experience, education levels, and the grade of the
selectively mute student.
Table 2
Description of Participating Teachers
Participating
Teacher
Years of Teaching
Experience Education of Teacher Grade of Student
Martha 6 yrs
BA - Psychology, MA -
Education, & Multiple Subject
Credential 2nd
Joan 10 yrs
BA - Sociology, MA - Education,
& Multiple Subject Credential 3rd
Jennifer 14 yrs
BA - Liberal Studies, MA -
Education, MA - Technology, MA
- Education, & Multiple Subject
Credential 1st
Daisy 20 yrs
BA - Liberal Studies, Multiple
Subject Credential, CLAD, &
NBCT 5th

Research Question 1: How do general education teachers apply strategies to address the
learning of selectively mute children in the classroom?
The main purpose for this research question was to understand how general education
teachers applied effective learning strategies with students with Selective Mutism. This research

52
question was connected to the conceptual framework that was presented in this study as the
interactions between student and teacher and the effects of the student’s micro system and the
meso system impacted how the teachers approached their students. This area posed some
difficulty with the participants as 3 out of the 4 stated that they did not seek out professional
development to assist them in learning new learning strategies for their students. Their
professional development pertained to social and emotional needs of students. I was still able to
connect the actions of the teachers in regard to the student’s meso system to the five key steps to
school interventions. These five key steps relate to the levels of anxiety a student has and how to
deal with each level of anxiety one at a time. The five steps involve bringing in someone outside
of school to speak with the student in school, then transferring these conversations to peers and
classroom activities, providing a reward, increase in school conversations, and finally monitor
the progress (Crundwell, 2006).
School Environmental Support
Martha stated that she attended several conferences over the course of a few months at
the beginning of the school year “…in the hopes of learning more tips, strategies, and curriculum
that would help this particular student as well as the rest of the class.” The professional
development she attended addressed social emotional supplementary curriculum, such as Second
Step, classroom management, and English Language Arts curriculum, but did not specifically
address selectively mute students. Follow up questions addressed social emotional curriculum
used in the classroom. Second Step, Growth Mindset, Go Noodle, Brain Pop, relaxation and
breathing techniques, and Class Dojo were mentioned by all the participants as programs used
for social emotional support. Participants were asked how adaptations were made within these
programs to decrease the anxiety and focus more on the learning strategies. Martha stated,

53
“Having the students participate in a low stakes non-academic task daily helped them all to have
fun and relax.”
Daisy used Class Dojo and used positive/growth mindset icons. She stated, “I added
perseverance, empathy, gratitude, mindfulness, and growth mindset and I also provided
consistent reinforcement in addition to academic and work habits icons.” Daisy noticed that as
she added more positive or social emotional icons, her class had improved behavior, improved
attention, fewer disruptions, and increased learning overall: “I found that the students responded
well to the new icons used as it created a better atmosphere for my students.” She felt that it
indirectly helped her student because “the classroom environment was not loud and it made my
student feel calm.”
Both Martha and Jennifer stated that they would frequently “stay after school with their
student.” This dedicated time with their student was when they would assess the student and
engage in conversation when no one else was present. These situations reflect the intersection of
the two environments. They said they did not place academic pressure at all. Martha’s student
would “speak non-stop after school.” She also noted that her student “enjoyed the cleaning the
board and doing other classroom tasks.” Jennifer stated that her student “would talk to her but
when other people would come into the classroom to speak to me, my student would stop.”
Joan stated, “The student’s therapist gave me the strategies to use with the student in the
classroom. They were ones she practiced weekly in her private sessions with the student.” She
would “provide a report to the therapist once a week” and after her student met with the
therapist, “the therapist would tell me what to do for the following week based on her session.”
Joan also made some adaptations within the classroom to test her student. She stated, “I allowed
him to use an iPad to record at home so I could listen to the student’s speech.” She allowed
reports to be done this way instead of oral presentations in front of the class. She stated that the

54
book that was given to her by the parent was “very helpful.” She would “read parts of the book
when she was having a difficult time implementing what the therapist suggested.” Joan stated
that there were times when she would ask her student to stay for a few extra minutes before
nutrition and this was “most productive” because she would use this time to informally assess
her student by just asking questions in a non-threatening manner. She said, “I would try to make
myself look busy, shuffling papers on my desk or walking around, and I would get a response
every time I looked like I wasn’t paying attention.” Joan was using the stimulus fading strategy.
All 4 participants felt that their teacher training did not adequately prepare them to help a
student with Selective Mutism. However, all four agreed that by focusing on the student’s social
emotional state, essentially the microsystem, they felt that the students displayed a heightened
interest in learning and performed better on tests. All four participants also gave out a weekly
report. Progress was always mentioned, whether academic or social, and all 4 provided positive
reinforcement either with an economy system, sticker chart, line leader, or treasure box. Another
important detail to mention is that there were no academic concerns with any of the students. All
teachers stated that their students were able to access the curriculum. The obvious standard
where the students demonstrated a weakness was speaking. Martha and Jennifer were able to
assess their students speaking skills based on their conversations after school.
Increased Personal Interactions
The teachers did not directly address the academic learning aspect of these students
within the meso system of the school classroom as many of the strategies employed addressed
behavior therapy and the manipulation of the environment. Their observations of the learning
taking place occurred within personal interactions with the student.
There were many reported instances of increased personal attention with the selective
mute students. With these increased opportunities of personal attention, the students would

55
respond to the teacher. All four teachers stated that academic progress was not a major concern.
The consensus was that their biggest concern was facilitating conversations in the classroom
(meso system) and monitoring the progress of these conversations periodically of their students.
Martha’s strategy was to first “have the sibling of her student help me push the chairs in at the
end of the day.” The student and sibling spoke to each other outside of school at home. Martha
said,
My student began to speak to the sibling in my classroom after a few weeks. I did not ask
any questions to my student during this time, I just observed the siblings speaking and I
would ask my questions to the sibling.
Eventually, the selectively mute student began to answer her when she asked the sibling a
question. The first few times this happened, “I was so excited, on the inside, but I didn’t want to
bring attention to the fact that my student just spoke out loud!” She said that her student “began
to help the sibling push the chairs in and I began asking for my student to repeat the words I said
every time a chair was pushed in. I made it a game.”
Martha would ask for rhyming words as well. “I would ask what does chair rhyme with,
hair and bear or chalk and choose. Every question was answered correctly.” When they were
done with the chairs, she would ask her student to begin the homework. “I had them read out
loud the directions first and then write their answers on the board so they would be working
together and focused on speaking to each other, not me.” She said that at first it was difficult
because she had to build rapport with the student.
Neither child knew me well, but they engaged with each other in my presence. I would
spend more time in conversation with the sibling, but I think these conversations helped
my student because then I wasn’t someone to be afraid of.

56
Even though much of the talking was done by Martha and the sibling, my student became more
comfortable.
My first conversation was about trains. I knew they were a preferred item. I just asked if
they had ever ridden Amtrak. Their eyes got so big and I saw them smile at each other.
I said to them that I loved going on trains too.
She said as the conversations became more voluntary for the selective mute student, she began to
ask some questions related to the learning:
I always started questions with something fun, like what did you have for dinner the night
before, or lunch. But I did place an emphasis on the academics. I always said that we
were going to build math fluency facts or practice our reading skills.
Jennifer stated she employed a strategy that was like Martha. She made herself “available
both before school and after school to decrease the anxiety of a full classroom.” She was more
focused on the learning after school:
I would ask her to sit at the round table and ask her to read to me, even if it was just a
whisper or something where I could at least observe that she was comprehending the text
or whatever I gave her to read.
She also echoed Martha’s experience in that the environment needed to be somewhat
controlled “without any others present.” Jennifer said, “If there were other students or parents or
just anyone, they went silent. Nothing would come out verbally.” She also stated that the student
had to be given a reward for staying after school. These rewards were her form of positive
reinforcement to engage the student in speaking:
After we were done, I would bring out my treasure chest. I had a whole bunch of stickers
and pencils, and anything that my students would be interested in. I used these as

57
reinforcements so at the end, she knew she was going to get something for following
along with what I asked.
Jennifer said that afterschool, she would go to the student computer lab with her student
so her student could play games and participate in a non-academic and low-anxiety setting.
I was fortunate in a way because the computer games had settings where I could use the
results of the games to determine the math level and reading too of my student, such as
how many words were read within one minute and which math facts the student knew.
She used this data to complement written work produced in the classroom environment. “In the
beginning, I needed a parent to be present because the student would not go to the lab with me
without the mom.” She was surprised to hear the student’s voice right away when the student
was engaged in a conversation with the parent. “The parent tried to get the student to speak to
me in the that first day, but it wasn’t going to happen.” Jennifer said it took “a good two weeks”
before the student began talking to her after school when the mother was present. After
consistent speaking after school, she asked the student if there “was a classmate that he would
want to join them afterschool.” The student nodded and gave her a name:
I knew how important this was to increase the verbal communication so I asked the other
student’s parents to get permission. Once I explained the situation, they were very
supportive as well and were happy their child was going to get extra computer time.
The two began going to the computer lab after school for 30 minutes. “It took about 5-7 days to
have full sentence conversations between the two students.” At first, there were yes/no
responses, which when those happened, Jennifer facilitated the conversations. She had them play
the same educational math games to help their conversations. “When they were playing the same
game, they could see each other on their monitors, so it was very useful because they had
something already to talk about.” Jennifer was startled, but she said not surprised when she saw

58
that her student in grade one was “completing math puzzles at a sixth-grade level.” She could
see that her student was very intelligent and wondered if the “high level of intellect caused some
of the anxiety.”
Joan used the student’s verbal recordings as her basis for making sure her student was
learning. She also “relied on the student’s psychologist to assist her in the school environment.”
She provided feedback to the student when the recordings were heard after school. She
“provided positive praise for the responses, not for the speaking, which is what the student’s
psychologist told me to do.” For instance, a good example Joan provided was when her student
was reading aloud, “I would praise the student for reading the difficult words or for using
intonation, rather than telling the student great job for speaking. I took the focus away from the
speaking and focused on the task.” Joan’s student would get weekly visits by the school
psychologist. The psychologist would “take her student out of the room with one other student
to play a game.” The two games she used were ‘Trouble’ and ‘Guess Who’ specifically because
in order to play those games, the student had to explain the rules to the classmate if they wanted
to play. The reward was playing the game for her student. As her student began having
conversations with peers in a one on one setting, “the psychologist would ask me to change the
seating arrangements to manipulate the setting or to make small groups with those the student
had played games with and spoken to.”
Most students who suffer from anxiety will not speak to peers or their teachers within the
school setting. Although the students spoke to their teachers in a relatively short amount of time,
the students still were not fully conversational with peers, in the classroom setting, except for
Daisy’s student.

59
Summary of Findings for Research Question 1
The goal of the first research questions was to find out how general education teachers
apply strategies to address the learning of selectively mute children in the classroom. The
common theme that was prevalent and clear among all participants was the level of personal
interaction with their student. The personal approach appeared to cross from the meso system to
the micro system and provided the students with an effective support system at school. From a
behavioral view, the mutism is a coping mechanism for the anxiety, so the reinforcement
happens when the expected behavior is observed, thus the more effective the communication is
between the teacher and student, the more reinforcement will occur (Camposano, 2011). These
findings are in accordance with Crundwell’s (2006) recommendations for school-based
interventions and Beare, Torgerson, and Creviston’s (2008) statement on increasing verbal
behaviors. Common practices employed were bringing in what Crundwell called ‘conversation
visits’, which was the practice of bring in a person the student spoke to outside of school and
bring them to the school. The next step to decreasing the anxiety was to have the ‘conversation
visits’ move closer to the classroom or with peers. The third step was to offer a reinforcement
with fading prompts taking into consideration the level of anxiety a student displayed. The
fourth step was to increase in school conversations such as group activities, or special seating
arrangements. The last step was to monitor and evaluate all interventions. Progress with
selectively mute children can be tedious and slow, so all interventions need to be tracked so they
can be easily observed and counted.
Research Question 2: What strategies do general education teachers employ with
selectively mute children in the classroom?
The main purpose of this second research question was to assist the researcher in
determining other strategies teacher use with selectively mute students in the classroom when not

60
related to an academic task. In accordance with the conceptual framework for this study, the
micro and meso systems are very closely related as the teacher can affect the student’s
microsystem when the student is at school in the mesosystem (Bronfenbrenner, 1979). The
participating teachers employed various strategies to increase verbal output by the selectively
mute student. The professional development training they attended mostly focused on social and
emotional support. It was evident that the participating teachers were able to transfer the growth
mindset strategies and apply them to this new situation of having a selectively mute student in
their classroom.
Focus on the Student
In discussing with the research participants, the difference between addressing strategies
addressing the learning and strategies for specifically addressing selectively mute students, the
participants were more focused on the student’s microsystem. Specifically, how to make the
student less anxious and how the teachers could change the student’s environment.
Joan stated, “I was very strategic in the student’s placement in groups and where to put
them in the seating chart.” She also noticed that the student would engage in conversation with
certain peers, and only when they were seated at the back of the classroom:
After observing my student and any preferences visible to me, once I saw the preference
for certain classmates and the placement of my classroom, in the back, where they
definitely would not be the center of attention with the rest of the kids, I just started to
move certain students weekly.
She stated rewards were given when speaking occurred to positively reinforce the expected
behavior. “I would always make point to reinforce the speaking, and the reward was one of the
preferred rewards which was playing a board game with a preferred peer.” Joan adapted her
techniques and strategies over time. “Once we made the rounds more or less, with all the other

61
students, I was able to stretch out the rewards. The more comfort level I saw in the student, the
less rewards I had to give.” She was able to change the seat location as the student developed
increased speaking skills. She stated, “As I added the strategies from the therapist, and the
speaking increased in the classroom setting, the therapist was needed less in the classroom.”
Joan taught in a self-contained classroom. She used the same strategies throughout the day.
During assemblies, she would allow her student to sit with a preferred peer.
Martha used a different approach. Her student would stay after school where they would
have spontaneous conversations:
I created a talking contract with the student. I placed pictures of trains, which was a
preferred toy, on the floor to increase the student’s motivation. Each train had a certain
number of stars (points) associated with it. The student had to collect a certain number of
stars to get a prize. The student would earn fewer stars when if the speaking took place
closer in relation to my desk. If the student spoke at a greater distance away from her
desk, the student received more stars.
Non-verbal signals were also used during class: “There were non-verbal signals for bathroom,
pencil, and water. I used these signals to create a classroom environment in which the student
was able to communicate.” Martha said she allowed her student to “select preferred partners and
groups when needed.”
Martha adapted her strategies over time as her student began to speak to more peers and
needed less rewards for speaking. She also asked her student to increase the volume of speech
with rewards, which she was able to fade after time. Allowances were made for her student to
select a preferred peer, and then she would assign a non-preferred peer to a group. She said,
When it was usually the first time, I put new group members together, the student would
not speak as loud or as much, and sometimes would ignore the non-preferred peer.

62
Watching the interaction was surreal. The non-preferred peer was being completely
ignored.
Group and peer preferences also changed over time. When the student would speak in groups
with a non-preferred peer, he would get a reward:
My goal was to still have the student speak in a small group, even if the student did not
direct the speech to the non-preferred peer. As soon as I observed speaking taking place
between the selectively mute student and the non-preferred peer, I would award him stars
on his daily chart and write a brief description. At the end of each day, I would go over
the chart and focus on only the behaviors I wanted him to continue to work on.
She said she would explicit statements such as “here is a star because you spoke in your group to
student. I gave you this star because you spoke to student that I put in your group.” She wanted
her student to know exactly why he was getting rewards. She said she learned these techniques
and strategies from one of the Professional Development classes she went to for decreasing
student misbehavior. Martha’s strategies of behavior implementation support the claims within
the literature that certain techniques such as modeling, fading, and contingency rewards are
effective to decrease anxiety in students with selective mutism.
Martha also taught in a self-contained classroom. Her strategies remained the same
throughout the day across all subject areas. She would work with her student afterschool to
practice with “poem recitation and memorization.” She began using the trains on the floor after
school before asking her student to follow the trains during class time. “I did not want to
introduce something completely new during class time with the other students present. I was
able to show the trains and explain the reward system.”
Jennifer stated that she was very aware of not calling on her student during whole class
instruction, as she did not want to put the student “on the spot.” She said, “I was always looking

63
to see their facial expressions so I could tell whether or not it would be a good day for active
participation.” She said she was able to determine if her student understood the instructions and
give a questioning nod to the student. When her student nodded yes, she knew instructions
would be followed. If there was no nod, instructions were not clear, then she would go over and
explain what needed to be done. The interactions between teacher and student were more
“gestural because I could get more information that way rather than speaking.” She said she also
allowed her student to get up and ask her questions during class time. “There were a few times
when their hand was raised and when I acknowledged the hand, the student would walk to my
desk, which I completely supported so I could answer the question.” She said that when they
would talk after school, she would let her student know that it was acceptable to raise their hand
and come up to her desk or to just get up from their desk to ask her a question. She was also able
to prep her student during these after school sessions since the student would speak and answer
her at this time. “These conversations after school were vital to the success in the classroom. I
was able to prompt, and practice redirection so that during class time, it would happen with little
to no prompting from me.” She would go over homework and had to provide little support in
terms of academics. Jennifer also taught in a self-contained classroom. The strategies remained
the same across subjects.
Other successful strategies used involved being able to carefully craft the question to first
get a response from the student that was not anxiety ridden, and second, to be able to allow the
student to be an active participant. Daisy learned that this 5
th
grade student would respond to yes
or no questions. Her student did not respond with any full sentences, nor was there much eye
contact. Daisy said,

64
I had to learn how to rephrase all of my questions so my student could answer me. This
took a lot of effort on my part to be able to switch in my mind, the rigor of my
questioning, to a basic yes or no question.
As the school year progressed, the student did not attempt to answer in full sentences when
pressed. Eye contact did not increase either. Daisy found that it was “difficult to establish a
reward system” for her student. When asked the reason, she stated that the student had been at
her school since first grade. “There were missed opportunities to help her in term of her
communication. Yes, she is gifted, but that identification won’t help her with speaking in the
class.” She felt that her student was not motivated to speak because it was not enforced in earlier
grades. Daisy taught the gifted cluster, and her selectively mute student was gifted. Her writing
was exemplary, as well as her math and science skills. Daisy did state, “I was able to empathize
with her because I am a reserved and quiet person too, but I am adult and she is 11 years old.”
She felt that her student was able to communicate her needs within the classroom. She did not
place “any extra speaking demands” on her student.
Daisy’s class had a lab day once a week. It consisted of science, computers, and library
time. In these different settings, her student would still respond to yes or no questions when
prompted by the teacher. When working in groups during science, the student would go along
with the group and blend in, typically doing the writing for the group.
Summary of Findings for Research Question 2
The second research question focused on what other strategies teachers used in their
general education classroom for students with selective mutism to help their student be
successful interacting with peers. The findings from the interviews indicate that teachers
employed approaches that involved rewards for the student. Also, the themes from this data
indicated that teachers used highly motivating rewards that were specific to each student as well

65
as nonverbal signals to indicate understanding to provide support to the student. The data also
indicated that repetition of key questions and statements were needed to communicate as well as
rephrasing them in a certain way to elicit a response. The participating teachers all indicated that
they were aware that these special circumstances required a higher level of empathy from them
toward their students.
Research Question 3: How does working with a selectively mute child impact on a teacher’s
thoughts, feelings and behaviors?
Teachers have had more responsibilities placed on them in the last few years due to
budget constraints as well as a shortage of nurses and psychologists. Elementary teachers also
must certify Physical Education minutes and teach computer and digital technology skills in
addition to administering high stakes tests. Teachers also must get breakfast ready every day.
These factors alone can impact a teacher’s thought, feelings, and behaviors. Adding a student to
your class who needs specialized attention that is not like academic intervention or
differentiation can cause additional stress on a teacher. The way a teacher responds to a student
impacts how much success that selectively mute student will have.
When reviewing the findings for this research question, it was clear that the participants
were crossing back and forth between the microsystem and the mesosystem with regards to how
they interacted with the students. All the participants wanted to create an environment in which
the selectively mute student felt comfortable and could learn. Each participant had their own
views as to how they would foster this nurturing learning environment. Some employed positive
reinforcement, and some relied on non-verbal signals. In determining how working with a
selectively mute student affected their feelings, these questions relate to the teacher’s
microsystem. The participating teachers used descriptive words such as nervous, worried,
challenging, frustrated, patient, motivating, self-aware, eager, positive, and protective.

66
Processing Emotions
Joan previously worked as an intake coordinator for families with various education and
mental health issues. “I learned about so many other disorders but I did not work directly with
the families. I was the one who referred the family members to the services they needed.” When
she first started teaching the selectively mute student, she was “nervous” and wondered how she
could “create a positive relationship with the student.” In the beginning, the student did not
speak, so she was unsure “how to handle discipline and provide corrective feedback to the
student without jeopardizing his chances of spontaneous speech.”
When asked what her thoughts were as to why he was diagnosed with selective mutism,
she thought that perhaps there had been some “trauma associated with the school setting for child
to not speak during school hours.” She stated that the student did have “some negative physical
encounters with other peers.” She said it was hard to find out the whole story since the
selectively mute student would not speak during school hours. To her, it was evident that the
student could not orally express frustrations that resulted in a few physical altercations. She said
at times, she “felt disconnected to the student during discussions because the student would only
sit and listen.” The student’s only participation was “the physical presence.”
Joan stated that the positive relationship she had with the parents contributed to
“decreasing the anxiety she felt because the parents informed her daily how the student was
feeling and what the student’s needs and wants were.” Her outlook and thoughts began to
“change for the better” because the student’s therapist would come and support Joan and the
student as well as the rest of the class. “I learned a lot from the therapist in terms of meeting the
needs of my student. I noticed that as I became less anxious, I began to see more progress with
the student as well as gaining trust.” When asked what she thought about the function of the

67
student’s mutism was, she “thought the student did not want to be given any attention or called
on, so by being silent or mute, it would prevent any attention being given.”
Joan said, “In addition to anxiety, I felt nervous because I did not know if my actions or
behaviors were going to affect the student in a negative way.” As her student became more
verbal, her feelings changed. “With the increased talking, I felt at ease because I was able to
create a positive working environment for my student as well as a positive relationship with the
student.” A time when she felt the happiest came when she had been working with the student
for almost three months. “The student came to my desk without any type of prompting at all
whatsoever, and just whispered to me in my ear.” She said it was a simple phrase, but it made
her “feel extremely happy because I had finally made a connection with the student.” She said
that the student had to feel comfortable enough with her to be able to tell her “I want to read a
book.” She took this as a positive because if she was going to see any verbal communication
between the two of them or the whole class, this was “a positive steppingstone.” She said she felt
“very happy and accomplished” because the student was making progress over time and the
parents told her that the student’s medication for anxiety was being decreased.
Joan stated that working with a selective mute made her “more patient and sensitive to
students with disabilities.” Her experience with this student motivated her to return to school to
earn a special education credential. In terms of the delivery of curriculum, “I learned to use
diverse ways to communicate with all my students, such as using gestures, hand signals, and eye
contact.”
In terms of Joan’s role identify, she stated that she would be a stronger special education
teacher because this student forced her to work with alternative teaching strategies than what she
was used to. She is “more aware of specialized needs” with her students.

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Martha did not have any experience working with students who had selective mutism or
anxiety. When she first started working with her student, her main concern was reading.:
I was mainly concerned with reading. In first grade, students continue to develop their
reading skills and build fluency, and with a selectively mute student, how could they
practice these skills if they would not speak aloud? In the end, I was able to work with
one-on-one with the student at my desk, but a lot of the reading skills had to be practiced
after-school and at home.
When asked why she thought the student was selectively mute, she also responded in a
similar fashion to Joan. She thought the student may have had a “negative interaction at school”
since the student refused to talk in front of peers or on the school premises. Even though the
student had this “traumatic experience” she felt that she needed to provide the student with an
extremely positive environment that would make the student feel safe and comfortable. When
asked about the function the mutism provided for the student, she responded that she thought it
gave him protection. “I think the silence allowed the student to be guarded so as not get hurt
emotionally or possibly physically.”
At the beginning of the school year, Martha felt “worried.” She felt she did not have
much teaching experience since this was the first time, she would have a selectively mute student
in her classroom. “Over time, I became less worried because my student was making progress in
all academic areas and for all of the speaking milestones that were met.” She stated that her
biggest concern was when “A guest teacher or visitor who was not aware of her student’s
condition, would come to class, call on the student, expect an answer, and reprimand the student
for not responding. This made me worry, if I wasn’t there what would happen?” To prevent that
from happening, “I did not miss a day of school.” She felt a range of emotions just like any new

69
experience, but overall, “I felt proud and happy for my student for reaching so many speaking
milestones.”
By having this student in her classroom, Martha had to come up with different classroom
participation strategies in order to ensure that her student was engaged and productive in class:
I didn’t have to do much in terms of differentiation of curriculum because the student was
able to access the curriculum, but the differentiation I provided revolved around
classroom participation strategies and materials to ensure that all my students were
involved.
Martha said,
My big takeaway in all of this and having a student in my classroom who was a selective
mute, is the realization that we as teachers could positively or negatively affect the
success of our students. We have to be aware of the type of environment we provide no
matter what the grade.
She had a better understanding that she and all teachers should strive to provide students with a
classroom environment that is “safe and caring.” In terms of her role identify, “I want to focus
on being that teacher who provided that safe nurturing environment and the one where the
students know it.”
Jennifer also did not have any exposure to students with selective mutism or anxiety. She
said, “This was a definite learning experience for me.” She said she learned early on, not to
pressure her student for any kind of verbal response. She learned more about students who are
selectively mute and “how to interact with them in a way that fosters trust.” She knew
the student had some anxiety and I could take a guess that an incident happened at school
to cause the student so much anxiety that the student did not want or could not verbally
communicate with anyone else at school.

70
When asked about the function the mutism played for the student, she thought it somehow
“reduced his anxiety.” She said, “If he was not verbally communicating with others, then
whoever or whatever caused the anxiety did not have to be addressed.”
When asked about her feelings when she first started working with the selectively mute
student, she said, “I wanted to help as I knew the student was very smart and kind to other from
what I had seen.” She wanted to do anything she could to make his school day easier:
The emotion I would use to describe the situation would be frustration, but not frustration
directed toward the student; I think it is more directed towards other teachers and adults
who think the student is just being stubborn or defiant, when I know that is not the case.
She said she was also “upset with the other adults who didn’t take the diagnosis of selective
mutism seriously.” The emotion she used with the student was “protective.” She said, “I felt
protective of the student because I know the student is capable of speaking, since we spoke to
each other after school.”
Working with this student did affect the way she worked. “I was more attentive with my
interactions with the student because I didn’t want to cause any further anxiety.” She would not
call on the student during class but would tell the student throughout the day what was coming
next so the student could prepare emotionally for a possible response. She also said that having a
selectively mute student in her classroom did not affect the way she delivered the curriculum.
She did not need to differentiate the curriculum for this student; she just needed “to give him
warnings of what was coming next because that seemed to decrease his anxiety.”
When asked about how teaching a selectively mute student impacted her role identity,
Jennifer once again said, “I felt protective of my student.” She wanted to have a good rapport
with the student. She was the only adult the student spoke to on campus. It was not during

71
school, it was in the morning, nutrition, and after school. She felt that the more time she spent
with the student in non-threatening speaking situations; the student would feel more relaxed.
Having the most years of teaching experience, Daisy said in her 20 years of teaching, she
had not had a selectively mute student in her own classroom. She stated that there had been
selectively mute students at some of her school sites, but she did not interact with those teachers
on a regular basis to know enough about it.
When Daisy first started teaching her student, she said, “I feel frustrated because this
student is already in the 5
th
grade.” She felt that intervention earlier with the student would have
contributed to increased communication skills at school. She also said, “I spoke to the teacher
who had this student the prior year. She confirmed with me that the student was very intelligent
and that her written expression was above average.” Once again, Daisy said,
I was still frustrated because I could not get the student to participate as she was not
trying and she did not put any effort in trying to participate, it’s like she gave up on trying
to speak at school.
Once she was able to get some student work samples of her writing, she understood what the
previous teacher meant. The student’s writing was always at grade level or above, even her math
responses:
Once I realized that academically she was okay, I sort of accepted the fact that there was
going to be little that I could do for her. I accepting the fact that the student was not
going to be very verbal, so I found some strategies to encourage communication.
She found that when she put her student in a group with one other student of the same gender,
communication about the academic task always occurred. She realized that in the gifted cluster,
many of the students move together year after year. Daisy found out through observations which
peers would be best in a pair. “As the year progressed, I increased the group to four girls.”

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When asked what emotion came to mind about her student, Daisy said “eagerness and
curiosity.” She was curious as to her history and was eager to manipulate the student’s
environment to increase her engagement and participation in academic conversations. One other
comment brought up by Daisy had to do with her social emotional well-being. “I don’t think the
selective mutism would affect her too much because she is intelligent, but I wonder how is she
going to be a successful adult if she doesn’t have adequate communication skills.”
Daisy said this did “affect her classroom delivery because she had to be purposeful in
restructuring groups.” She said she had to use “more verbal cues, sentence stems, and cues for
speaking in front of several pairs.” Daisy also mentioned that her role identify was impacted
because she could relate to her student as she herself was on the quiet side. She said,
We have many teachers at my school site who are outgoing with strong personalities and
I wonder what would have happened this year if my student was placed in a different
class. I think that other teachers would have a different opinion of my student and I think
that would be detrimental.
She could understand that her student probably felt the same way.
Summary of Findings for Research Question 3
The primary purpose of the third research question was for the researcher to discover how
a teacher’s thoughts, feelings, and behaviors are impacted when there is a selectively mute
student in their classroom. The data indicated that at the onset of the school year, the
participating teachers felt emotions that could be described as negative such as worry and
frustration. As the relationship and comfortability increased, the emotions changed to feelings
such as protective and eager. When there was progress, the feelings changed to a more positive
tone such as motivating and patient. The analyses of the data indicated that the participating
teachers’ feelings were on a trajectory similar to their selectively mute students.

73
Research Question 4: How does the setting and support groups affect the strategies used by
general education teachers?
Knowing how setting and environment affects a student is key to be able to provide the
specific strategies to use within each setting with students who have anxiety. Each participating
teacher taught in a different grade level and the specific strategies they used to provide support
varied based on grade level as well as severity of the selective mutism. Setting and support
groups also varied. The classrooms were all self-contained and within each classroom, small
group instruction took place as well as peer buddy time. Support groups ranged from the student
who had a psychologist visit every week to preferred peer time. The data indicated that the
presence of family members at the school site contributed in a positive manner as spontaneous
conversation was more likely to occur in the presence of a familiar community. The data also
indicated that when communication was frequent between the teacher and student, the student’s
rate of progress in speaking was greater.
Supplemental Supports Within the School/Family Setting
When asked if she was aware of any other conditions or diagnoses regarding her
selectively mute student, Joan stated that her student took medication for anxiety. When asked
to describe the student’s means of communication Joan replied that the student had “little to no
means of communication with peers inside the classroom.” The student would use facial
expressions and hand gestures. The selectively mute student would speak to one other student on
the play yard, but it was whispering in the ear. She recalled that over time, “As the student
started to positively progress, the student would begin to speak to only certain select students in
small group exclusive settings such as afterschool when others were not around.” Joan
remembers that as the school year progressed, the student began to answer her questions at first

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with one word, then one sentence. By the end of the school year, the student was fully
participating in the classroom.
With adults, the situation was similar. At the beginning of the school year, the student
did not speak to any adults; facial signs, gestures, and body movements were used to
communicate any needs. As the student became more comfortable in the class setting, the student
would whisper answers into her ears if there were folders covering the student’s face. “As the
student progressed more and more throughout the year, the student began speaking to me during
nutrition and lunch, but only if other students were not nearby.” By the end of the year, the
student was “fully engaged and speaking with all staff members at school.” When asked about
the contact she had with the selectively mute child’s parents and how this changed over time
Joan stated,
The parents were extremely informative about sharing the student’s needs with me. The
contact I had with the child’s parent was a positive relationship. I spoke with the parent
on a daily basis, to discuss challenges, progress, and strategies on how to best support
their child. The parent also got me in contact with child’s therapist so that we could
discuss best supports in the classroom.
Based on the observations of Joan’s student, sibling relationships were also of interest in
terms of student progress with expressive speech as Joan observed many situations in which her
student and the sibling would engage in play and in conversation in her presence. From her
observations, they had a normal sibling relationship; the sibling was younger. The student would
speak to the sibling when no one else was close by. She said they appeared to have positive
communication patterns.
After this experience, Joan felt that if she were ever to have another selectively mute
student in her classroom, she would “be better equipped to guide the student.” She said that

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having an understanding of the disorder as well as knowing that “progress will take time,” she
would try to get as much information about the student from the parents as soon as possible.
Also, if the student had any other providers of services, Joan would make sure she contacted
them in order “to build a team that would support the student in the classroom.” She said the
biggest helpful support to her with this student was having both the parent and the therapist work
with her. “It would have been helpful to me or interesting at least, to have seen the student in a
previous class and also outside the classroom with other students.” Lastly, when asked about a
child psychologist as an additional support, Joan stated that “it would have been great if there
had been an on-site school psychologist who could have worked with her on how to best support
the student emotionally and in the classroom.”
Martha was not aware of any other condition or diagnoses of her student. She was the
only teacher who sought out professional development. Her trainings covered social emotional
supplementary curriculum, classroom management, but did not specifically address selective
mutism as she could not find training that specifically addressed it. In the beginning, Martha
said,
The student was reluctant to participate in the classroom and would not speak to peers
regardless of the location on campus. However, over time, the student progressed from
using hand gestures to whispering yes and no in preferred peer’s ears, and later, to talking
to a small group (consisting of mixed preferred and non-preferred students) in and
outside the classroom.
With adults, it was somewhat similar. At the beginning of the school year; her student would not
speak to any adult on campus even if a variety of accommodations were used. “Some
accommodations that we used on campus were to have the student be the last in the lunch line to
answer in the cafeteria and rewards, such as table points, would be given.” If the student needed

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to express himself in the classroom, there was a “reliance on the use drawings and gestures.”
Over time, the student “progressed from whispering yes and no in my ear behind books, to
talking in a quiet voice at my desk, and later, speaking openly to me after school.”
The contact Martha had with the selectively mute child’s parents included a daily log that
was sent home highlighting positive situations. The discussions with the parents began with an
introduction of selective mutism and what they were doing at home. Over time, they began to
come up with strategies together to use at school, which would be reinforced at home. She said,
“I truly believe that the teamwork attitude helped my student to give the foundations the student
needed to be successful in the classroom.”
Martha was aware that there were younger siblings, but she only saw them interact once
when the siblings came to her classroom with the parents after school. Her student spoke to the
siblings in a conversational manner. There were no other students in the classroom. After seeing
her student speak in what she called “a controlled setting,” she thought that “peers affected the
speech of her student.” She said, “This experience provided me with the background knowledge
I didn’t have. I now know what behaviors I can anticipate from a selectively mute student and I
will now be better equipped with how to support that student.” At the end of her interview,
Martha remarked,
It would have been great had the school had access to a psychologist who could have
educated her and the other teachers on how to help this student. A child psychologist
would be able to help me understand why a student might be a selective mute and help
me develop strategies on how best to teach my student.
When asked about her student’s means of communication with peers in school and if
these changed over time, Jennifer stated that in the beginning of the school year, her student
“spoke very little and very quietly with select peers.” At some point her student stopped verbally

77
communicating with them a few weeks into the school year. With adults, it was the same
scenario; the student also stopped speaking to adults during the first month. Jennifer said, “My
student would continue to talk to me but only if no one else was around.” Outside of school there
were no issues verbally communicating with others, peers and adults, per parents.
Jennifer described the contact she had with the selectively mute child’s parents as a close
relationship. She was able to establish a rapport with her student so it “would be comfortable.”
At the end of the school year, she became very good friends with the student’s mother.
Jennifer’s student had a sister, and they appeared to have no problem communicating
with each other. Her interpretation of this was that her student was not anxious around her, and
they had a close sibling relationship.
Based on her experience, Jennifer stated that she had developed and employed several
strategies in her classroom to decrease anxiety and increase success for all her students. At the
end of her interview, Jennifer stated,
I think a child psychologist could have helped me develop strategies and procedures to
use within the classroom in order for the student to feel more at ease. The psychologist
may also be able to determine the cause of the behavior and can better help the child cope
with the experiences.
Daisy was not aware of any other condition or diagnoses for her student. With her
student being a 5
th
grader, there was not as much parental support as the other three teachers.
Daisy said that her student “did not really communicate at all with peers.” Her student was
always doing work independently. When given the chance to interact with peers, her student
would only talk to her tablemate, who at the time of this study was a boy. Her student would,
however, work alongside peers, but would avoid eye contact. Daisy said her student always had
their head down and would only talk in a room where others were not present. On one occasion,

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there was a science project that was presented. The project had great content, and the
information was above and beyond any peers’ work. “The student would not look at anyone in
the class, but she was standing with her back to the class. Her voice was monotone, and the
PowerPoint was read word for word.”
Daisy’s student was “an only child, so there were no opportunities to observe her with
siblings.” The most important detail that Daisy mentioned was, “I should have reached out to the
parents in the beginning of the year instead of speaking to the student’s previous teacher.” She
felt that if she had more information about the history of her student, she could have come up
with “more specific strategies to help her student.” She did not have any outside support to assist
her student. The counseling that could have been provided by the school was not offered
because the student was not a Title 1 student. Daisy stressed, “Counseling should be made more
readily available to all students, not just those who have an IEP. I think because she got good
grades and had good test scores, previous teachers just easily ignored her.” If there was access to
a psychologist, Daisy could have been told which specific strategies to use to decrease the
student’s anxiety. Daisy stated that it was trial and error when she implemented strategies to
assist her student. Daisy closed the interview stating, “A psychologist could have given me
more of a diagnosis or opinion to see what really was the root of my student’s issues… it is their
area of expertise.”
Summary Findings for Research Question 4
The primary purpose of the fourth research question was for the researcher to learn about
other supports that were used with the selectively mute students and how specific settings also
affected the students. The data indicated that when family support was prevalent in the school
setting such as a sibling, parent or someone the selectively mute student spoke to outside of
school, the probability that the student would engage in conversation increased. Additional

79
outside, professional support such as a psychologist also increased the probability of speaking.
Communication between parent and teacher also contributed to a more positive setting for the
student.
Summary
This chapter provided a description of strategies that general education teachers used with
student who are selectively mute when it involved learning and in general to decrease anxiety
and discussed the study’s findings by each of the research questions. The results from the first
research question indicated that the common theme that was prevalent and clear among all
participants was the level of personal interaction with their student. The personal approach
appeared to cross from the meso system to the micro system and provided the students with an
effective support system at school. All participating teachers indicated some level of personal
interaction with their student. Examples of the personal interactions included time with the
selectively mute student and teacher after school.
Results from the second research question revealed that the interviews indicated that
teachers employed approaches that involved rewards for the student. Also, the themes from this
data indicated that teachers used highly motivating rewards that were specific to each student as
well as nonverbal signals to indicate understanding to provide support to the student. Behavior
interventions encompass many different approaches to treating selective mutism. In addition, the
data indicated that they specific way a question was asked to a selectively mute student would
result in a response, either nonverbal gesture or a one-word response.
The data from the third research question indicated that at the onset of the school year,
the participating teachers felt emotions that could be described as negative such as worry and
frustration. As the relationship and comfortability increased, the emotions changed to feelings
such as protective and eager. When there was progress, the feelings changed to a more positive

80
tone such as motivating and patient. In addition to the range of emotions felt by the teachers,
other research indicated that after some periods of success, sensitivity and understanding along
with willingness on behalf of the teacher contributed to the even more success of the student.
Lastly, the fourth research question showed that when there was frequent communication
between the teacher and parent, the selectively mute student fared better because the
environment was positive. The data indicated that when family support was prevalent in the
school setting such as a sibling, parent or someone the selectively mute student spoke to outside
of school, the probability that the student would engage in conversation increased. Teacher and
parent communication enhanced the verbal outcome when the selectively mute student witnessed
the parent and teacher interactions. When the parent feels comfortable with the teacher, the
student recognizes it, and feels safe, thus the parent is now a vital, trusted, and contributing
member of the treatment team. The implications of these findings are for informative purposes.
Chapter 5 will look at the implications of these results and provide suggestions for any future
research in the field of study.

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CHAPTER FIVE: DISCUSSION, IMPLICATIONS, AND RECOMMENDATIONS
Research indicates that selective mutism is a rare disorder that has reported prevalence
rates between 0.3 and 7.1 per 1,000 children (Sharkey & McNicholas, 2008). There is limited
literature and evidence and the number also varies between studies depending on the population
sampled and the community (Sharkey & McNicholas, 2008). Research indicates that successful
programs for selectively mute students involve slow and deliberate behavioral changes with
rewards (Roberts, 2002). Additional research also indicates that the majority of successful
treatments in addition to behavior therapy include family therapy and pharmacotherapy
(Krysanski, 2003). Studies indicate that the teacher’s primary responsibility consists of reducing
the feelings of anxiety within the child and rewarding success no matter how large or small
(Ponzurick, 2012). Other studies offer various treatment courses for selective mutism. Parent
and teacher questionnaires, behavioral observations and logs are collected in order to determine
how to implement exposure-based practices involving a gradual process in which the selectively
mute student moves from their environment to more difficult environments (Kearney & Vecchio,
2006). Research indicate that strategies that teachers can employ involve separating the class
into small groups with supportive peers and the allowing of alternate means of communication
such as gestures (Dow, Sonies, Scheib, Moss, & Leonard, 1995). Research also indicates that
when teachers participate in professional development that is centered on understanding
Selective Mutism, those who participate can increase in their knowledge in identifying and
providing early Bork intervention (Harwood & Bork, 2011). The evidence indicates that
professional development tailored to selective mutism seems to be an effective first step in
increasing teacher knowledge and confidence (Harwood & Bork, 2011). Given that the number
of students identified as having selective mutism is quite rare, it is imperative that general
education teachers are given the tools and knowledge they need in order to provide the ease of

82
transitioning from a student’s micro system to the meso system at school. With more training,
teachers will be able to support students to provide the personal interactions that are needed to
decrease anxiety.
Purpose of the Study
Selective Mutism is a childhood disorder characterized by a persistent failure to speak in
certain social settings in which speech is typically expected (e.g., at school), despite speaking in
other Considering that the school environment is the primary setting for the onset,
identification, and the continued manifestation of Selective Mutism, there is a lack of evidence
based research studies that are focused on successful interventions that teachers and school staff
can use in the elementary setting for students who have Selective Mutism. This deficiency
contributes to a lack of referrals, treatment procedures, and implementation of strategies to use in
the school setting. School Psychologists can assist students and work with teachers, parents and
support staff to provide school-based interventions that can decrease the severity of the Selective
Mutism and the impact it has on students (Busse & Downey, 2011). In order for support to be
provided to the student, the teacher needs to be able to recognize the symptoms and understand
that excessive shyness could also be Selective Mutism (Harwood & Bork, 2011). Interactions
with children who seem to be stubborn, defiant, unsociable, or extremely shy must be responded
to in an appropriate manner, otherwise inappropriate reactions with adults may contribute to a
stronger case of Selective Mutism (Harwood & Bork, 2011). Children with Selective Mutism
typically engage in social conversation with parents and siblings at home, however not in the
school environment. This study sought to look at what strategies general education teachers used
in their classrooms in that were effective in addressing the learning of these students and other
general strategies used to decrease anxiety. Another objective of this study was to determine how
working with selective mute students impacts a teacher’s thought, feelings and behavior. The last

83
objective of this study was to look at how setting and support groups affect the selectively mute
student. The amount of literature available about the subject of selective mutism is scarce as this
is a rare anxiety disorder (Sharkey & McNicholas, 2008). Research studies cannot be conducted
on a large scale as the time it takes for selectively mute students to be successful in expressive
speech can take a great deal of time (Roberts, 2002). The following research questions guided
this study:
1. How do general education teachers apply strategies to address the learning of selectively
mute children in the classroom?
2. What strategies do general education teachers employ with selectively mute children in
the classroom?
3. How does working with a selectively mute child impact on a teacher’s thoughts, feelings
and behaviors?
4. How does the setting and support groups affect the strategies used by general education
teachers?
A qualitative case study methodology was used for this study (Creswell, 2014). The data
collected was through recorded interviews with follow up questions done via telephone.
Pseudonyms for the participants were used for confidentiality purposes. All data was collected
and coded for analysis based on each research question and grouped by themes.
Summary of Findings
Data was collected through a series of interviews of general education teachers who
implemented specific strategies in order to decrease the anxiety of selectively mute students in
their classroom. The data revealed which strategies were effective with the selectively mute
students and also highlighted the importance of the teacher to student relationship which affected
the success of the student. The results also highlighted how teachers’ feelings impacted the

84
classroom environment with their selectively mute student. Lastly, the findings showed that
support between the meso and micro systems also affected the students positively.
Summary of Findings for Research Question 1
The common theme that was prevalent and clear among all participants was the level of
personal interaction with their student. The interactions took place at non-instructional times in a
low stress setting, typically after school. Some of the participants attended professional
development, however it was not specific to addressing learning needs. Through the interviews
this study showed that a personal approach that spanned the student’s micro system into their
meso system in the classroom provided the selectively mute students with a low anxiety setting
in which they could flourish. These findings are in accordance with Crundwell’s (2006)
recommendations for school-based interventions and Beare et al.’s (2008) statement on
increasing verbal behaviors. Common practices employed were bringing in what Crundwell
called ‘conversation visits’, which was the practice of bring in a person the student spoke to
outside of school and bring them to the school. The next step to decreasing the anxiety was to
have the ‘conversation visits’ move closer to the classroom or with peers. The third step was to
offer a reinforcement with fading prompts taking into consideration the level of anxiety a student
displayed. The fourth step was to increase in school conversations such as group activities, or
special seating arrangements. The last step was to monitor and evaluate all interventions.
Progress with selectively mute children can be tedious and slow, so all interventions need to be
tracked so they can be easily observed and counted. Because the participating teachers employed
this strategy in their classroom, the effect on the student’s learning increased in addition to their
speaking.

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Summary of Findings for Research Question 2
Data from this study showed that the teacher participants used approaches that involved
the selectively mute student receiving a reward for accomplishing a speaking task. Due to the
participating teachers’ personal interactions with the selectively mute students, they were able to
discern what rewards were more favorable than others. Martha used the knowledge she gained
from spending time with her student to devise a highly favorable reward system that involved a
high interest reinforcer for her student, which were train pictures on the floor, coupled with a
reward. Other strategies used included the use of nonverbal signals, strategic placement in the
classroom next to preferred peers as well as asking questions which required either a yes or no
response.
Many of the strategies employed by all of the participating teachers were what could be
identified as ABA (Applied Behavior Analysis) strategies, which are commonly used for
students with behavior needs.
Summary Findings for Research Question 3
The participating teachers all experienced a new situation with the selectively mute
student in their classroom. They disclosed the range of emotions they felt at the beginning of the
school year experience and how they changed as they saw progress with their student. One of the
participating teachers went back to get her special education credential after having this student
in her class. The data indicated that at the onset of the school year, the participating teachers felt
emotions that could be described as negative such as worry and frustration. As the relationship
and comfortability increased, the emotions changed to feelings such as protective and eager.
When success happened, they used emotions such as happy and proud. When there was
progress, the feelings changed to a more positive tone such as motivating and patient. The
analyses of the data indicated that the participating teachers’ feelings were on a trajectory like

86
their selectively mute students. In addition, seeing their student have difficulty speaking just
made the teachers more aware of their personal characteristics, traits, and feelings. The teachers
also disclosed that they began to feel more empathy for all their students and became more open
to alternative strategies for all of their students. The experience also highlighted to the
participating teachers how they as adults and teachers can impact a student’s success positively
or negatively
Summary Findings for Research Question 4
All the participating teachers experienced a new situation with the selectively mute
student. Their training and knowledge on the topic of selective mutism ranged from zero to
scant. These teachers learned about various strategies based on the organic situation that was
developing in their classroom in order to find what worked best for their student. Their
strategies may not have been successful the first time they were implemented, however when
implemented with fidelity, the strategies began to work. Support systems included parents and
siblings as well as a psychologist who provided support to the student and teacher. The data also
indicated that consistent communication between supports in the meso system greatly enhanced
the selectively mute student in the classroom.
Implications for Practice
The findings from this study have implications for teachers, parents, and selectively mute
students. Several recommendations are intended for general education teachers who teach
selectively mute students and for those who are in the position, such as auxiliary staff and
administration, to provide support for the selectively mute students in the classroom. Each
recommendation is based on the responses and experiences of the participating teachers.
Creating a positive and supportive classroom environment in which learning can take place is the
goal of education. However, students enter the classroom at various levels of academic

87
understanding and knowledge about how to regulate their emotions. This can make it difficult
for teachers to devote time to developing emotional regulation if there is outside pressure for
academic rigor. Students, however, cannot be fully focused and engaged in academics if they do
not have the ability to regulate their emotions. If a school places emphasis on developing the
whole child and promotes a culture of teaching students and teachers to have growth mindset,
then it is my belief that we could see lower cases of severe anxiety in early education and
primary grades because students will have the tools to regulate their emotions. My
recommendation is for there to be a system in place to assist teachers and administration in
identifying anxiety and to use the strategies listed to promote communication by the selectively
mute student. Local Education Agencies (LEA) are responsible for finding all children who
have disabilities or who may be entitled to special education services. Many teachers look at eh
academic potential of a student, while not giving enough interest to the social emotional needs of
a child.
Professional development on the topic of selective mutism needs to take place yearly, at
the beginning of each school year to highlight what behaviors to look for with students. There
still exists a lack of knowledge of selective mutism among parents and teachers, as well as those
in the medical field who misdiagnose selective mutism as shyness that will eventually be out-
grown (Harwood, & Bork, 2011). The diagnosis of selective mutism comes from a private
psychologist because of various tests administered and observations of the student in different
settings. Professional development is especially important so students who are entering school
for the first time can receive early intervention as well as for early education and primary
teachers who can provide the interventions. The onset of selective mutism typically occurs
during a student’s first experience in school as it is a new setting. Teachers need to be provided
with enough knowledge about the anxiety disorder, how it manifests in children and what are the

88
best strategies to use for students. Based on this study, there is not one specific strategy that is
better than others, however, this study has shown that multiple strategies can be successful
depending on the selectively mute student and the desire of the teacher to work cooperatively
along with the student and parents. When teachers interact positively with selectively mute
students, the anxiety can decrease so the student will feel more comfortable. Some examples are
providing specific choices, offering options, and giving the student alternative ways to respond.
Strategies need to be implemented at various levels depending on the student as each situation
that involves a student with selective mutism is unique. Sometimes these students will be called
defiant, strong-willed, stubborn, and extremely shy, and it is these types of responses to the
behavior that lead to inappropriate responses by adults who can often exacerbate the selective
mutism.
As there is a lack of literature and knowledge regarding selective mutism, it is difficult
for teachers to ascertain whether a student in their class has selective mutism or not. Many
times, when a student appears to have inhibited behaviors in the classroom with respect to
speaking, teachers who are not familiar with what anxiety looks like, may be forceful with their
interactions with the anxious child and cause the child to internalize more of the anxiety and
reinforce the mutism. Some teachers could display a negative attitude and because they view a
child as defiant because the child will not respond to them. Therefore, training and professional
development on the topic of anxiety in children and specifically selective mutism need to occur
within school districts annually just as other yearly mandatory trainings. School psychologists
will also need to be trained so they can assist general education teachers when they suspect there
is a selective mutism student in their class. Just as schools offer social groups for students with
autism, they can offer communication and speaking groups to students with selective mutism.

89
As more educators become more familiar with the social emotional needs of their
students, we also have to be aware that there could be inappropriate interventions used with
children who have selective mutism. Some inappropriate interventions could lead to negatively
reinforcing silence.
Further recommendations for teachers who teach selectively mute students is to employ a
positive reinforcement plan in the classroom setting. The reinforcement is to promote speaking
not to reinforce the silence. This ties into professional development and knowledge about the
disorder and about the selectively mute student. The more information a teacher has about the
student, the better the plan can be.
Schools have the capacity to provide support for special populations. Many schools offer
academic intervention for students who are having trouble academically. Schools can provide
support groups for student with anxiety and selective mutism. The more support a student
receives and the earlier a student receives support, the better the outcome will be. Once training
is given to those at school sites, they can begin to facilitate support groups. Even though
students who have selective mutism have difficulty communicating within a whole class setting,
selectively mute students can communicate within a group of two or three based on this study.
The participating teachers used the strategy of partnering up their selectively mute student with a
preferred peer. If schools can provide this type of support, preferred peers can be identified, and
these two students can be in a group with a school psychologist.
Within these small support groups, several strategies can occur. If the selectively mutism
is severe, family members or those that they student has spoken to outside of the school
environment can come in to desensitize the student to assist them in speaking in this setting.
Another strategy is to have the psychologist be present in the room while the parent or family
members speak with the selectively mute student. This type of support will focus on making a

90
single space in the school environment a safe place to speak. When the selective mute is
speaking within the room, the circle of participants can be increased.
Specific strategies teachers can employ with these students when asking questions to gain
a verbal or non-verbal response are choosing questions that are either yes/no or a forced choice.
When selective mute students are given a choice of words to use in their response and are given
adequate wait time such as 5 seconds, the selectively mute child will have less anxiety because
they do not have to think of a response on their own. With the decreased anxiety, the selective
mute child will be able to give a response either verbally with a whisper or a non-verbal response
indicating their choice. It is important to make sure the question being asked does not negatively
reinforce the mutism, such as providing a mind reading question such as “it looks like you want
to take this book”, as asking these types of questions will maintain the avoidance of conversation
with the selectively mute student. The amount of emotional support from a teacher will assist
the selective mute in lowering their apprehensiveness when it comes to providing a verbal
response. Instead of supplying a mind reading question, the teacher can use phrases which offer
choices to a student, such as “do you want red pencil or the purple pencil”.
Finally, along with this is the recommendation to provide support for parents. Schools
provide many resources and supports for students, but support for parents is limited to very few
topics. Parents may not have any knowledge about selective mutism as there is not a visible
nationwide platform for selective mutism like there for autism. School districts hold parent
meetings on various topics throughout the year. Schools hold meeting on the topic of gifted and
talented every year. Typical students with selective mutism speak well in certain situations. As
selective mutism does not fall under a developmental delay category, a communication disorder,
or a lack of knowledge of language, most students with selective mutism do well academically

91
(Camposano, 2011). Just as there is a way to parent a gifted student or a student with autism,
there is a way to parent a student with anxiety and selective mutism.
As it has been stated many times, the lack of literature and knowledge about selective
mutism is a disservice to these students and their families. Experts in education and in the
mental health field need to create support programs for parents on a national scale. These types
of programs would offer parents a way to find a solution to helping their child. Mental health is
just as important as physical health. There was a stigma attached to people who suffered from
any mental health disorder as some were not as understood as others. With a national platform,
the students who suffer from selective mutism, can be understood. Not only would this help
parents, it could help adults who do not fully understand their own anxiety. The benefits would
be plenty as parents and teachers would learn from the increased opportunities and knowledge
available in a large-scale platform.
Recommendations for Future Study
The findings from this study proved to be very insightful as to how general education
teachers used effective strategies to support their students with selective mutism both
academically and with general supports. The results also looked at how teachers were affected
personally when they had a selective mute student in their classroom. Some of their initial
feelings affected their approach in a cautious manner, such as not wanting to upset or cause
additional anxiety to their students. However, the results indicated that as the school year
progressed, they learned more about their student and selective mutism, and their feelings
changed to a more positive tone such as eager, hopeful, and happy. Lastly, this study looked at
what types of other support had been available to the teacher or how they gathered outside
support. Several recommendations were based on the findings, however there is still much more
that can happen. This section outlines recommendations for future studies.

92
First, it would be informative for there to be more research on effective strategies that
early education and primary general education teachers can use to identify selective mutism or
other anxiety disorders during early school experiences. Although this study did highlight
effective strategies, this study did not include the identification process of students with selective
mutism in the school setting. There has been research done abut about selective mutism and how
to make advancements for those afflicted with selective mutism, but there are very few studies
that identify a process that can screen children who may be more susceptible to having anxiety
disorders or selective mutism. Other screeners are available such as autism. But these screeners
are typically given in the medial field. It was not always like that, so I am hopeful that a future
study can incorporate a collaborative process between the medical field and the mental health
field. As more screeners become available, it would be of great benefit to parents and teachers to
learn how to recognize the signs of anxiety in young children. This is important research because
other studies have highlighted genetic and family predispositions after students have been
diagnosed with anxiety disorders or selective mutism (Sloan, 2007). If predispositions are
known, then supports can begin right away.
Second, it would benefit the educational field to conduct more research on students who
have been identified as having behavioral challenges to find out when the challenges began and
what the recommendations were at that time. If a student’s challenge was listed as defiant,
stubborn, or unsociable, it could possibly be traced back to an anxiety disorder. However, little
or any research has been done to find the root causes of these challenges in students. Some of
these students have ended up in special education because of their challenges. It is extremely
important to know the root causes of these challenges. Behavior therapy has been shown to be
one method to decreasing anxiety. It is important to know the impact of these students who have
been labeled as defiant, stubborn, or unsociable if they have not bene diagnosed correctly.

93
Lastly, it is recommended that further research be carried out to investigate how early
intervention can decrease anxiety when genetics show that there is a predisposition to anxiety in
the family. This type of study would need to be conducted by medical professionals, in
conjunction with mental health professionals and early childhood educators. Prior research
states that the disorder is not evident to the family of the child because of the child’s verbal
language use in the home and is only diagnosed upon the child’s entry into school (Anstendig,
384). Most student’s entry into school begins in kindergarten at age 5, however in recent years,
there are more early transitional programs that begin at age 4. Based on this, identification and
intervention can begin at age 4. The facilitation of mindfulness activities, growth mindset
activities, and general mental health activities could indicate which children are more susceptible
to developing anxiety disorders.
Conclusion
This study aimed to learn about strategies that general education teachers used to address
the learning and support of students who have selective mutism. An additional objective of this
study was to learn about how having a student with selective mutism in their classroom impacts a
teacher’s thoughts, feelings, and perceptions. Finally, this study addressed other supports that
were used by the general education teachers to assist them with the selectively mute student.
The findings showed that the more teachers engaged in personal interactions with the selectively
mute student, the more likely the selectively mute student was to engage in responses both non-
verbal and verbal. The participating teachers utilized siblings and family members in the
opportunities to increase interactions. The classroom environment was used to desensitize the
selectively mute student. As indicated in the study, the increased personal interactions with
familiar adults and peers, coupled with access between the selectively mute student and the

94
teacher led to a more collaborative partnership between the student and teacher and the data
showed that the student’s inhibitions decreased and their responses increased.
This study also proved that when there is collaboration between teacher and parent, the
selectively mute student was more likely to respond favorably to the strategies. Parental support
was also important as information provided to the teacher regarding the disorder and about the
student, led to more positive interactions with rewards that increased verbal output. It was
beyond the scope of this study to investigate whether students who had selective mutism were
successful without parental support.
The participating teachers also indicated that there were very few opportunities for
professional development that related to selective mutism. Professional Development that was
attended focused on growth mindset and other social emotional supports for students. The lack
of literature on the topic of selective mutism for teachers led to teachers researching on their own
effective strategies to use with their selectively mute students. Due to the rare nature of this
disorder, the participating teaches needed to rely on learning about the strategies on their own.
There were no physical conferences they could attend. They relied on going to websites and
researching on their own for specific strategies. Some of the participating teachers learned what
they could from parents and therapists working with the selectively mute student.
In conclusion, selective mutism is a rare disorder characterized as an anxiety disorder
(Shriver et al., 2011). Children who are at higher risk have a family history of someone positive
for social phobias, extreme shyness, selective mutism, or anxiety (Sloan, 2007). It is
characterized by a child’s almost complete absence of speaking in certain social setting where
they are expected to speak but adequate speaking at home or with familiar family members
(Moldan, 2005). It is an infrequent phenomenon that is first identified in the school setting
(Giddan et al., 1997). Early childhood anxiety disorders are associated with later emotional

95
disorders (Mian et al., 2011). By working together with medical professionals, mental health
professionals and early education teachers, some of these specific methods such as professional
development, screeners and personal interactions can take with the population in order to address
their specific diagnosis and support the families of the selectively mute child.

96
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101
APPENDIX A
INTERVIEW PROTOCOL
Effective Strategies Used by General Education Teachers to Address the Learning Needs of
Students with Selective Mutism

Interview Protocol: Current Teachers

Interviewer: _____________________________________ Date: ________________

Interviewee: _____________________________________

Job Title: _____________________________________

Phone: _____________________________________

Email: _____________________________________

School Site: _____________________________________

Start Time: ________________ End Time: _________________

1. How long have you been teaching?
2. What were the reasons that led you to be an educator?
3. What teaching credentials do you have?
4. Prior to becoming an educator, have you had any personal experiences with children who
had selective mutism or anxiety disorders?
5. What age was the selectively mute child you taught?
6. How long did you teach the selectively mute child for?
7. Did the selectively mute child have any other conditions or diagnoses?
8. How many years of teaching experience did you have when you first began teaching the
selectively mute child?
a. Did your teacher preparation program adequately prepare you to have the
resources needed to assist the student?
9. Were there any trainings or professional development that you sought out to assist you
with your student?
a. What did the trainings cover?
b. Who sponsored the training?
10. Can you describe the child's means of communication with peers in school and if these
changed over time?
a. Can you describe the child’s means of communication with adults in school and if
these changed over time?

102
11. Can you describe the contact you had with the selectively mute child’s parents and how
this changed over time?
12. Did the selectively mute child have any siblings?
a. If yes, can you describe their patterns of communication?
b. Can you tell me your interpretation of these patterns of communication?
13. Can you tell me about your thoughts when you first started teaching the selectively mute
child and how these changed over time?
a. What were your thoughts about why the child was selectively mute?
b. What function do you think the mute behavior served for the young person?
14. Can you tell me about your feelings when you first started teaching the selectively mute
child and how these changed over time?
a. Can you describe a time when you felt most ____ [name of emotion]?
b. Are there any other feels you had to describe your experience?
15. How did this experience of having a selectively mute child in your class impact on your
work?
a. In particular, how did having a selectively mute child in your class impact on your
pedagogy and delivery of the curriculum?
16. Can you tell me about some of the techniques or strategies you used when working with
the selectively mute child?
a. Did these techniques or strategies change over time?
17. Did the strategies used vary between different subject areas and if so how?
18. To what extent did your training or Professional Development prepare you for working
with this child?
19. If you teach a selectively mute child in the future, would the experiences that you have
had help you? If so, in what way?
20. Can you tell me how teaching a selectively mute child impacted your role identity?
21. What support was helpful to you at the time?
a. What support would have been helpful?
22. Did you have involvement with outside agencies and if so, was this helpful?
a. Did you have involvement with a child psychologist and if so, was this helpful?
23. In your opinion, what additional support do you think a child psychologist could provide
to teachers who are teaching a child with Selective Mutism?
24. Are there any other issues or comments you would like to make about your experiences
of teaching a selectively mute child that have not been covered by my questions so far?
25. Are there any other questions you expected to be asked? If so, what would the answers to
those be?

103
APPENDIX B
INFORMED CONSENT TO PARTICIPATE IN INTERVIEW

University of Southern California
(Rene Gaudet, Doctor of Education Student)

INFORMED CONSENT FOR NON-MEDICAL RESEARCH

Effective Strategies Used by General Education Teachers to Address the Learning Needs of
Students with Selective Mutism

You are invited to participate in a research study conducted by Rene Gaudet at the University of
Southern California, because you are a current or past teacher (within the last two years) of a
student who has a diagnosis of Selective Mutism. Your participation is voluntary. You should
read the information below, and ask questions about anything you do not understand, before
deciding whether to participate. Please take as much time as you need to read the consent form.
You may also decide to discuss participation with your family or friends. If you decide to
participate, you will be asked to sign this form. You will be given a copy of this form.

PURPOSE OF THE STUDY
The purpose of this research will be to gain an understanding of general education teachers’
knowledge of and awareness about Selective Mutism (SM) and their experiences with children
who are selectively mute as well as the strategies used in the classroom.

STUDY PROCEDURES
If you volunteer to participate in this study, you will be interviewed and audio-recorded.
Questions will ask you to describe your thoughts, feelings, and experiences you have with a
selectively mute child. You will be asked questions regarding the impact on your classroom,
strategies used to communicate, and if any training assisted you with this experience. You may
still participate if you decline to be audio-recorded.

POTENTIAL RISKS AND DISCOMFORTS
There are no anticipated risks or discomforts.

POTENTIAL BENEFITS TO PARTICIPANTS AND/OR TO SOCIETY
The potential benefits to participants will be the ability to share their experience with selectively
mute children as well as strategies that are successful. There will also be potential benefits to
society as this diagnosis will receive more attention and increase awareness. Note that as this is a
research study, the benefits are contingent upon the results.

PAYMENT/COMPENSATION FOR PARTICIPATION
You will not be paid for participating in this research study.

104
CONFIDENTIALITY
I will keep your records for this study confidential as far as permitted by law. However, if I am
required to do so by law, I will disclose confidential information about you.
The data will be stored on researcher’s personal computer and in a file cabinet in the home office.
The audio-recordings will also be stored in researcher’s home office. Personal computer includes
a password in which researcher is the only one with the password.

This data will be kept indefinitely.

PARTICIPATION AND WITHDRAWAL
Your participation is voluntary. Your refusal to participate will involve no penalty or loss of
benefits to which you are otherwise entitled. You may withdraw your consent at any time and
discontinue participation without penalty. You are not waiving any legal claims, rights or remedies
because of your participation in this research study.

INVESTIGATOR’S CONTACT INFORMATION
If you have any questions or concerns about the research, please feel free to contact Rene Gaudet
at rgaudet@usc.edu.

SIGNATURE OF RESEARCH PARTICIPANT

I have read the information provided above. I have been given a chance to ask questions. My
questions have been answered to my satisfaction, and I agree to participate in this study. I have
been given a copy of this form.

AUDIO/VIDEO/PHOTOGRAPHS (If this is not applicable to your study and/or if
participants do not have a choice of being audio/video-recorded or photographed, delete this
section.)

□ I agree to be audio-recorded

□ I do not want to be audio-recorded

Name of Participant

Signature of Participant Date

SIGNATURE OF INVESTIGATOR

105
I have explained the research to the participant and answered all of his/her questions. I believe
that he/she understands the information described in this document and freely consents to
participate.

Name of Person Obtaining Consent

Signature of Person Obtaining Consent Date

106
APPENDIX C
BRONFENBRENNER: ECOLOGICAL SYSTEMS THEORY

Abstract (if available)

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Asset Metadata

Creator Gaudet, Rene Irma (author)

Core Title Effective strategies used by general education teachers to address the learning needs of students with selective mutism

School Rossier School of Education

Degree Doctor of Education

Degree Program Education (Leadership)

Publication Date 11/01/2020

Defense Date 10/27/2020

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag anxiety,anxiety disorder,cognitive behavior therapy,effective strategies,environmental system,OAI-PMH Harvest,personal interactions,selective mutism,stimulus fading,teacher perception

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Tobey, Patricia Elaine (committee chair), Combs, Wayne (committee member), Cortez, Nasser (committee member)

Creator Email renegaudet@twc.com,rgaudet@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c89-388576

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Legacy Identifier etd-GaudetRene-9088.pdf

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