The Selective Mutism Clinic’s ‘Online’ or ‘Outreach’ service has been successfully provided to children and their families throughout Australia for over 15 years, including Melbourne, Canberra, Brisbane, Adelaide, Perth, Darwin, Hobart, as well as rural and remote areas.

Following the assessment, the child and their parent(s) receive ongoing video consultations to learn strategies to build their communication with the clinician, generalise their communication to other adults and children, learn to communicate more effectively in the community, and learn strategies to manage their anxiety and other emotions. The cost of these 50-minute consultations are $260.

We have developed highly effective online strategies to help children start talking to their therapist and to generalise their talking to other adults and children. The clinician implements an ‘online’ adaptation of the Gold-standard ‘Sliding In’ treatment for Selective Mutism. This involves the parent playing a talking game with their child at home, and the therapist (who is on a laptop or other portable device) is placed in a different room in the house to the child, and then gradually moved closer to the child/parent until the therapist can overhear the child talking. The therapist starts directing comments towards the child and gradually joins in the game until the child is talking to the therapist alone.

Many children respond to this online version of ‘Sliding In’ even faster than our traditional face-to-face strategies as they are in a more comfortable space in their own house (it can be daunting for a child with Selective Mutism to come to a clinic to meet someone new!). During online sessions, children are able to use their own games (which they usually love showing us!) or similar games to what we would use in the therapy room, as well as reward charts and other incentives to help increase motivation to gradually face their fear of communicating. The games are so engaging and fun they keep children of all ages engaged and excited to return to their next session. When children are having fun, their anxiety reduces, and talking becomes easier. Once the child trusts the therapist and can talk to them well, they feel ready to practice talking to other people.

These online strategies for Selective Mutism can be effective for children as young as 2 years of age, as well as adolescents and adults. Some adolescents have a strong preference for face-to-face sessions over the video sessions, in which case we encourage the adolescent to come into the clinic. If this is not possible due to distance, then we can work with the parents alone over video.

Once the child is talking fairly comfortably with their therapist online, we use highly developed techniques to help the child then generalise their communication to other adults online (who are brought into the Zoom session). We also hold online group sessions to help children with Selective Mutism slowly build their comfort with talking to other children around their age.

An added advantage of online treatment is that it often allows both parents to be present in the session as parents who are at work can join the Zoom from their workplace for the duration of the session.