Stimulus fading can also be used in problematic situations that occur outside of school (e.g., talking to grandparents, ordering in restaurants). Gradually, other students are introduced into the group until the child is able to speak in the presence of a large group of peers.
For example, the child may first be rewarded for speaking to a classmate with whom they already speak outside of school. Stimulus fading interventions build on the success of contingency management and shaping reinforcement strategies by gradually increasing the number of people and places in which speech is rewarded.
A reinforcement menu containing the types of rewards the child wants to earn and for which behaviors should be first developed in collaboration with the child. Shaping reinforcement is provided for approximations of the target verbal behaviors (e.g., mouthing words, whispering, talking on the telephone) and later for normal speech.Contingency management uses positive reinforcement to reward verbal behavior, which may include initial reinforcement of nonverbal communication like pointing and whispering.There are several behavioral strategies that when used together are most effective in supporting a child’s improvement in speaking, including: Behavioral strategies refer to coming up with a step-by-step plan where the child gradually performs increasingly difficult speaking-type behaviors coupled with positive reinforcement whenever the child accomplishes those behaviors. These are the most widely supported psychological treatments for selective mutism. Behavioral and Cognitive-Behavioral (CBT) Strategies In psychotherapy, a psychologist or other professional will use some of the following approaches, depending on the individual child. Some children with selective mutism also benefit from speech-language therapy and other interventions recommended by the main treatment provider(s). Treatment for selective mutism (SM) can include psychotherapy and medication to address the anxiety that underlies the person’s inability to speak in certain situations. Treating Selective Mutism How to Treat SM: Effective Research-Based Treatments for Selective Mutism Selective Mutism Treatment Options
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