Exploring Online Behavioral Parent Training for Selective Mutism

SM-BPT, a nine-session online behavioral parent training program, demonstrated high engagement and early symptom reductions for children with school-based selective mutism, offering a scalable, parent-mediated pathway to reach children where specialist care is scarce.

Limited access to selective mutism specialists delays timely intervention in many regions; a parent-delivered online model directly addresses that service gap. Within a behavioral parent training framework, the program taught exposure hierarchies, environmental modification, and reinforcement strategies to caregivers, positioning its format and content as a practical, scalable delivery option for underserved areas.

Feasibility metrics were strong: session attendance averaged 93.5% and homework completion averaged 73.5%, indicating high acceptability and sustained caregiver engagement across the nine-session pilot. These engagement data support progression to larger controlled trials and early implementation planning.

Effectiveness analyses showed statistically significant reductions in school-based selective mutism symptoms (p = .04) and in measured anxiety (p = .03). Clinically, participating children demonstrated improved speaking and reduced anxiety in school settings — preliminary but meaningful signals that require controlled replication.

Parents reported improved mental health (GHQ-30 decreased, p < .01) and substantial reductions in negative parenting behaviors (p < .001). The single-group pilot design, small analyzed sample, and reliance on parent-report limit causal inference and generalizability.

Next steps should prioritize larger randomized trials, longer follow-up, and evaluation of equitable access and durability before broader implementation.

Key Takeaways:

• SM-BPT produced high parent engagement and early reductions in school-based mutism and anxiety, suggesting promise for parent‑mediated online care; consider piloting in local programs.
• Young children with school‑based selective mutism and their caregivers — especially in regions with limited specialist access — may benefit from an accessible parent-focused option; prioritize evaluation in underserved settings.
• Findings support progression to larger randomized trials and implementation studies to assess durability, equity, and integration with local services; prioritize controlled evaluation before wide adoption.