Selective Mutism: How to Spot It, Support Your Child, and Find Evidence-Based Help (with Dr. Melissa Giglio)

Dawn Friedman welcomes Dr. Melissa Giglio, a CBT therapist and director of Central Health Partners Child Development in Hong Kong, to discuss selective mutism (SM). Giglio explains SM as an anxiety disorder in which children who speak fluently at home are persistently unable to speak in specific settings, often mistaken for stubbornness, and distinguishes shyness from social anxiety and SM using persistence and functional impairment. They emphasize collaborating with schools, using gradual exposure without “rescuing,” helping children habituate, and coaching parents to stay calm, supportive, and non-accommodating while building distress tolerance and confidence. The conversation addresses anxious parents, concerns about traumatizing exposure, demand avoidance and providing perceived control with continued expectations, common comorbidities (including ADHD), when medication may help, and the need for evidence-based, systemic treatment involving parents and schools. Giglio shares resources (Bravery Grows book, a six-month journal) and intensive one-to-one camps in Hong Kong and Maine, plus outcomes when SM is untreated.00:00 Podcast Welcome00:17 Meet Dr Giglio01:47 What Is Selective Mutism02:44 Why The Name Changed03:37 Misconceptions And Oppositionality04:22 How Parents First Notice05:23 Shy Vs Social Anxiety06:53 When Anxiety Becomes Persistent09:43 Supporting Exposure Without Rescue11:55 Handling Meltdowns And Tiny Steps13:27 Anxious Parents And Trauma Fears16:12 PDA And Demand Avoidance Nuance20:00 Comorbidity And Medication Questions22:23 Overlearning Through Exposure22:54 Finding Proper SM Treatment23:47 Parents As Co Therapists27:08 Coaching Without Accommodating28:15 Books And Journals Tools31:25 Intensive Exposure Camps33:37 Wins And Progress Stories35:16 Risks Of Late Identification37:23 Let Kids Do Hard ThingsWorking with Dr. Giglio at Main Child Therapy CenterGrab her book, Bravery GrowsFollow her on InstagramMentioned in this episode:TELL ME IT WILL BE OK: The PracticeI invite you to check out TELL ME IT WILL BE OK: The Practice, a guided reflective journaling podcast for parents raising anxious kids in a worried world. This is not a list of things you’re doing wrong. This is not a bunch of one size fits all parenting advice. This is a place to remember what you already know. (And to learn some new stuff along the way.) Each session is approximately 30 minutes. I help us get grounded; share resources, inspiration, and information; and then using thoughtful prompts we journal together to move you forward in your understanding. It also includes access to our own private community. You can sign up for a free sample practice at my site: OpenBookParenting.com