By Dr. Elisa Shipon Blum

For teens and young adults with Selective Mutism, if symptoms have persisted since childhood, they will not just disappear in adolescence. It changes form. As children become teens and young adults, their worlds expand and so do the expectations for independence, social participation, and self-advocacy. For those with Selective Mutism, this stage brings both challenges and opportunities.

🌱 Through the Social Communication Anxiety Treatment® (S-CAT®) model, we focus on understanding the “WHYs” behind an individual’s mutism, identifying their baseline stage on the Social Communication Bridge®, and developing structured, real-world goals that promote comfort, connection, confidence, and communication. 💬

Below are common areas of focus for teens and college-aged individuals as they progress through treatment.

💙 🧭 Building Independence and Self-Advocacy

As teens grow, they become more aware of their Selective Mutism and often experience frustration or embarrassment about being unable to speak, barely speak or lack initiation and elaboration in certain settings. Treatment during this phase helps them build understanding, insight, and empowerment. 💪

They learn what Selective Mutism truly is: a social communication anxiety disorder, not a choice or personality trait. They identify the situations, people, and environments that heighten anxiety and practice coping tools such as using the Feeling Chart, relaxation techniques, and bridging down when anxiety rises. 🧘

Self-advocacy becomes a major goal. ✨

College students may meet with disability services to discuss accommodations such as alternative presentation formats or flexible participation expectations. They may also prepare Action Plans before approaching professors, roommates, or supervisors, helping them feel more confident and in control. 🎯

🤝 Strengthening Social Comfort and Peer Relationships

Belonging and acceptance are central during adolescence. For individuals with Selective Mutism, social anxiety can make peer interactions feel daunting, especially in new or unstructured settings. 💞

The goal is to build connection before communication. Teens practice small, planned social experiences that gradually expand their comfort zones. They may arrange weekly social outings such as going to a café, joining a club, or participating in an activity that feels safe but mildly challenging. ☕🎲

Treatment often includes small group or “buddy” activities that foster trust and social engagement. Strategies such as Handover Takeover™ and Frontline™ help increase comfort through nonverbal interaction before speech occurs. 🤗

As confidence grows, teens learn structured ways to initiate and sustain conversations using S-CAT® tools like Preparing, using visual supports, scripting, utilizing Action Plans, Sandwich Questions™, Copy Back, and Common Question Practice. Group programs such as CommuniCamp™ for teens, or treatment groups for adults, provide opportunities to practice in a supportive, understanding environment. 💬

🎓 Academic and Classroom-Based Goals

In school and college, communication is part of participation. Many students with Selective Mutism understand the material but struggle to contribute verbally. The goal is to increase comfort and participation at a manageable pace. 🏫

Teens begin by engaging nonverbally, for example through nodding or handing in work, and then move toward whispering, speaking softly, and finally using direct speech. Educators and students can use the PVC method (Prepare, Visuals, Choice) to structure this process. 📚

Preparation might include knowing what to expect, who will be present, and what support will be available. Visuals such as cue cards, slides, or scripts help make participation predictable. Choice empowers the student to decide how they will communicate, whether by reading, recording, or sharing with a partner. 🗂

Progress is tracked through self-ratings of comfort and anxiety before and after exposures. Over time, these gradual steps lead to independence in class discussions, group projects, and presentations. 🎤

🌍 Expanding Real-World Communication

The teenage and young adult years bring new demands for independence. Treatment helps individuals carry progress from familiar environments into the broader world. 🌎

Goals often include ordering food independently, speaking to cashiers, or making simple social exchanges in stores or restaurants. Teens may take on part-time jobs or internships that involve structured social interactions, using strategies they have practiced such as visual scripts or role-plays. 🍔🛍

Community outings are viewed as communication opportunities. Each one is prepared for using an Action Plan that includes predicting who will be there, what will happen, what might be said, and how the individual can respond or ask questions in return.

🗣 💬 Developing Verbal Initiation and Conversation Skills

Many teens with Selective Mutism can respond but rarely initiate. Treatment focuses on helping them take the first step in conversation and then build momentum. 🚀

They learn to greet others, develop conversation ‘starters’ based on the scenario and task at hand and/or to use “I Am” or “I Just” statements to begin interactions and the Copy Back strategy to keep conversations flowing. For example, if someone says, “How are you” they respond “Good, how are you.” This small shift transforms an exchange into true communication. 🌈

Through Common Question Practice, and creating those conversation Action Plans, they prepare for questions likely to arise in daily life and practice natural, flexible responses. Role-plays and social scripts make these exchanges predictable and less intimidating until they become second nature. 🎭

🧠 Emotional Regulation and Flexibility

Anxiety and perfectionism are common in adolescence. Many teens fear making mistakes or being judged. Treatment therefore includes a focus on emotional awareness and self-regulation. 💗

Teens learn to recognize when anxiety builds and to use calming or grounding techniques. They practice reframing perfectionistic thoughts and develop comfort with gradual progress. Tools such as the Feeling Chart and daily reflection journals build awareness and self-compassion. 🪞📖

When emotional regulation improves, flexibility increases. Teens can adapt to different people and environments more easily, which helps generalize communication gains. ⛅

🎓 College Transition and Adult Life Skills

The transition to college can be both exciting and intimidating. Independence, social connection, and self-advocacy become essential life skills. 🌻

Treatment goals focus on building readiness through real-life exposure and preparation. Examples include speaking with roommates, meeting professors, joining campus activities, and using prepared scripts for introductions or group work. 🏡

Students learn to engage with professors, ask questions in class, and participate in study groups using gradual bridging techniques. They may also practice employment-related skills such as interviews, emails, and workplace communication. 💼

Attention to wellness is equally important. Adequate sleep, nutrition, and exercise play a key role in managing anxiety and supporting communication progress. 🌙🍎

🌟 Progress Over Perfection

For teens and college-aged individuals with Selective Mutism, progress is not measured by the volume of speech but by growth in comfort, connection, and independence. Every small step, a greeting, a question, or a shared laugh, marks meaningful progress across the Social Communication Bridge®. 💞

It is critical that if a teen or young adult is struggling in any of these areas, they work with a therapist experienced in Selective Mutism and their specific needs. A knowledgeable clinician understands how to use the right strategies at the right time and can guide the process safely and effectively. Teens and young adults should be actively involved in their own treatment planning. They collaborate with their therapist to set realistic goals and design personalized Roadmaps and Action Plans that outline the step-by-step path toward success. 💡

Through individualized treatment, teamwork among families, schools, and clinicians, and consistent realworld practice, adolescents and young adults can discover the confidence to communicate authentically and the understanding that their voice matters. 🌈

To learn more about treatment for teens and young adults with Selective Mutism, visit our Teen & Adult Resource page. 💙 We offer both in-person and telehealth treatment as well as coaching/training services. We also offer a variety of school-based services!

Email us for more information or call today at (215) 887 5748!