By Dr. Elisa Shipon Blum

For children and teens with Selective Mutism, every question can feel like a pop quiz. It can be unpredictable, anxiety-provoking, and filled with pressure to respond quickly and correctly. What if there were a way to make communication easier and more predictable, like handing them a “cheat sheet”?

That is exactly what Choice Questions with the Right Answer Second provide.

This strategy, part of Dr. Elisa Shipon-Blum’s Social Communication Anxiety Treatment (S-CAT®) approach, is a powerful way to lower anxiety, reduce processing load, and create consistent success. When paired with preparation and visuals through the PVC method (Prepare, Visuals, Choice), children and teens can anticipate what is coming, feel more in control, and respond with growing confidence. Over time, this helps them speak louder, respond faster, and move naturally across the Social Communication Bridge®.

🧠 Why This Strategy Works: A Cheat Sheet for the Brain

When anxiety rises, the brain shifts into survival mode. Thinking, recalling, and formulating responses become difficult. A simple question such as “What do you want to drink?” can feel overwhelming.

Choice Questions with the Right Answer Second act as a built-in prompt, a communication “cheat sheet” that helps the anxious brain recall information quickly. By hearing the correct answer second, the child does not have to search for it or formulate it on their own. The brain hears it, recognizes it, and can respond with less effort and less anxiety. Adding preparation and visuals takes this even further. When children know what to expect (Prepare) and can see the options (Visuals) before hearing them aloud, the cognitive and emotional load decreases dramatically. The child’s brain begins to process the interaction in advance, lowering anxiety and improving success once the question is actually asked.

When an individual with Selective Mutism has underlying WHYs such as speech and language delays, learning or processing challenges, or sensory difficulties, this strategy becomes even more impactful. These children may struggle not only with social anxiety but also with retrieving language, understanding directions, or tolerating sensory input. By reducing the need to think, recall, and process under pressure, Choice Questions with the Right Answer Second provide an essential bridge that supports both comfort and competence. When paired with visuals and repetition, it allows for more accessible communication and meaningful success across different settings.

✨ How It Helps

  1. Reduces the need to think or process
  2. Speeds up response time
  3. Lowers anxiety through predictability and visuals
  4. Reinforces memory and motor patterns
  5. Encourages progress across the Social Communication Bridge®

💬 When You Know the Answer vs. When You Do Not

This strategy works best when you know what the child or teen’s answer is likely to be. In those moments, you can confidently place the correct answer second to help set them up for success. For example, if you know a child always prefers pizza to chicken nuggets, asking “Do you want chicken nuggets or pizza?” allows the child to hear the answer, recognize it, and respond more easily.

However, you will not always know the answer. In those cases, it is important to bridge down, and that is perfectly fine. Rather than providing the answer, offer multiple choices and allow for more response time. You may need to repeat the choices, and if the child is able to write their response, that can also help. The goal is to make communication achievable while respecting the child’s pace and comfort level.

The less sure a child feels, the more they may naturally bridge down to an earlier stage on the Social Communication Bridge. This is a healthy part of the process and not a setback. It simply reflects their current level of comfort in that setting or with that person. The goal is to meet them where they are and provide repeated, predictable experiences that allow them to bridge up again over time.

This is why repetitive and visually supported tasks are so valuable. Examples include using visual menus in restaurants, picture-based scavenger hunts in stores, or familiar visual games and routines during therapy or group play. The more consistent and recognizable the visuals and tasks become, the more the brain can anticipate, process faster, and move toward verbal communication.

🏫 Using Choice Questions in the School Setting

Choice Questions with the Right Answer Second can be easily incorporated throughout the school day by teachers, aides, and peers. When combined with the PVC method, the child becomes more prepared, visual cues clarify expectations, and choice questions create safe opportunities for success.

🌍 Using Choice Questions in the Community

Choice Questions with the Right Answer Second are also ideal for community exposures, where unpredictability can heighten anxiety. When children are prepared in advance and supported with visuals, they are more likely to respond successfully.

📓 The Power of Preparation, Visuals, and Repetition

Choice Questions with the Right Answer Second are most effective when they are part of a predictable system. Preparation allows the child to anticipate the interaction. Visuals give a tangible anchor to reference. Repetition strengthens memory and comfort.

Each time a child hears and answers a familiar question, the process becomes faster and easier. At first, responses may be nonverbal through pointing or nodding. After several repetitions, the same question elicits a whispered response. With continued exposure, responses become louder, more confident, and eventually spontaneous.

When children are prepared in advance, supported by visuals, and guided through choice questions repeatedly across school, home, and community settings, the communication process becomes automatic. What begins as a cheat sheet transforms into fluent, confident communication.

🎯 Practical Tips for Parents, Teachers, and Clinicians

  1. Prepare the child before exposures by reviewing upcoming settings and likely questions.
  2. Use visuals such as photos, drawings, or word cards to preview and practice the choices.
  3. Present the question naturally with the correct answer second, keeping tone calm and supportive.
  4. When you are unsure of the answer, bridge down by providing multiple choices, allowing extra time, and repeating the options. Encourage the child to write or circle their choice if possible.
  5. Reinforce every response, whether pointing, writing, whispering, or speaking, with positive feedback.
  6. Repeat the same questions frequently across settings to build automatic recall and confidence.
  7. Gradually fade the support as comfort grows, moving from choices to more open-ended questions.

💡 In Summary

Choice Questions with the Right Answer Second are a simple yet powerful way to support communication for children and teens with Selective Mutism. When paired with the PVC method of preparing, using visuals, and providing choices, this strategy becomes a reliable cheat sheet for success.

It minimizes the need to think and process, reduces anxiety, and allows the brain to respond more quickly and confidently. When you know the child’s answer, this strategy provides an easy path to success. When you do not, offering multiple choices, repeating them, and giving time for writing or nonverbal responses keeps communication flowing and builds confidence.

Each repetition builds comfort and fluency, helping the individual move naturally across the Social Communication Bridge. Through preparation, visuals, and consistent choice opportunities, children learn that communication can be predictable, safe, and rewarding. Over time, these experiences transform hesitation into participation and silence into confident self-expression.