The wiki link above was broken, however I would go with a more trusted source for information:
http://www.asha.org/public/speech/disorders/selectivemutism.htm

OP, if you can't find a recommendation here for a therapist, you can search ASHA by area and read the areas of practice for each clinician:

http://www.asha.org/proserv/

My child has Generalized Anxiety Disorder with some selective mutism traits. My story is almost exactly like that of 17:01 (I would have thought I had written it except that my son is a little bit younger). I want to add that even as things do improve, with therapy and sometimes medication, it is not an even trajectory. There are always ups and downs, sometimes pretty severe ones. When the downs happen, I always have to back-off and reduce the demands on my child. My child's therapist is very good at reminding me to meet my son at his developmental level. Sometimes, you need to take a step back to notice that a child does not need as much support or just the opposite: that what was easy for a while has become hard again and the child needs more support. Maybe fewer playdates, maybe do nothing for a couple of weeks and then focus on one friend, choose your daughter's absolute favorite activity, preferably one that is low pressure (requires little interaction). The goal is that she have fun and this have an incentive to repeat. Be involved in the playdate yourself to lower the pressure and maybe ensure the enjoyment of the other child. Consider it a success that she simply agrees to go and has enjoys herself. If she does, follow up soon with the same child with another enjoyable activity and little by little require a little more of your child. This is what we did with my child when he would regress. I always had to adjust my expectations and, when I set new ones, I'd find that he could meet them and we'd move from there.

I strongly recommend you find another therapist (or return to the same one, maybe with some incentive for your child). Does the therapist specialize in selective mutism?

Hi OP - I know first hand just enough about Selective Mutism to be dangerous. I think what the other posters are getting at is that S.M. usually does not get better with age, it gets worse and it is imperative that therapy by an expert be commenced immediately. Not talking doctor therapy but an S.M. specialist who can do the types of therapy techniques described in this wikipedia piece. http://en.wikipedia.org/wiki/Selective_mutism. I'm in close contact with a teenager who has it. It's a postively crippling problem to have later in life, especially if you want your child to be able to work in the world, get an apartment, hold down a job, etc. But therapy must start immediate. You need to read up on this and be very aggressive about getting her the treatment she needs before it becomes a life pattern. By adolescence, if the child isn't going to speak to an adult, they won't, which means they will not be able to complete school and function as an adult, which is of course what all SN parents want to see.

DH had selective mutism at school and in public but would speak at home. DS has severe anxiety and, while I wouldn't call it full-out selective mutism, he definitely shuts down verbally when overwhelmed. I really can be debilitating. I agree with the advice to pull back on the playdates. They are clearly not working and you are right that everyone is probably wondering what the point is. I would focus on encouraging your daughter to enjoy activities with you and worry about others later. I agree with the idea of sign language or a picture chart.

I would also highly recommend movement -- we have swings in our basement and a trampoline and it really helps DS. In fact, he was just down there swinging. It soothes him, calms him, gets out excess energy. Not easy to have room for in our city house, but it's worth it. I also know someone who has swings in the living room. I'm sure their friends wonder. I'm no expert so I don't know the physical/mental reason behind it, but it works!

I know how frustrating this can be. DS has trouble in just about every social situation because of the anxiety. When he breaks through the anxiety, he's a beautiful, funny, clever child, but only close friends and family get to see it. Hugs and you are doing the right thing just by recognizing that this is going to be work. I agree to resume therapy, either with the same therapist or another. DS loves therapy with the right person so maybe it is necessary to look for another therapist. GL.

OP,

What did your (former) therapist say about sign language or even using a visual aid--even if it's just a paper of pictures with common things, e.g., food, activities, places?

Is she getting speech therapy? My daughter is in an augmented communication program in kindergarten. There is a little boy with SM in the program and he has made great strides this year. All the kids in the class use assisted speech devices ("talkers") and that has taken a lot of pressure off of him.

Anonymous wrote:1. BIG hugs!

2. Get a different therapist ASAP!

3. I'd ease off the play dates for now and focus on things she enjoys. When she's a little more ready, I'd recommend this book:

http://www.amazon.com/Its-Much-Work-Your-Friend/dp/B000WMOFA2/ref=sr_1_1?s=books&ie=UTF8&qid=1367357064&sr=1-1&keywords=it%27s+hard+work+to+be+your+friend

There's a checklist in the back about how to have a successful play date.

Also, I wouldn't worry about an SN program at this point. I've known at least two kids, one in early elementary and one older elementary who went through a selective mutism stage. It will get better.

Thank you, PP! It sounds like the book would be very helpful. I think since we began therapy, there's been a lot of pressure and focus on getting my daughter to talk. I think you're right in shifting the focus to doing things she enjoys. It's just so hard to not push, especially when she's regressing.

PP here. P.S. Not sure if "stage" was the right word and I know it's not a "phase." I don't want to seem insensitive with my word choice.

Anonymous wrote:Is she in a SN preschool program?

No. Doesn't qualify for an IEP either. She is in a Play-based preschool.

1. BIG hugs!

2. Get a different therapist ASAP!

3. I'd ease off the play dates for now and focus on things she enjoys. When she's a little more ready, I'd recommend this book:

http://www.amazon.com/Its-Much-Work-Your-Friend/dp/B000WMOFA2/ref=sr_1_1?s=books&ie=UTF8&qid=1367357064&sr=1-1&keywords=it%27s+hard+work+to+be+your+friend

There's a checklist in the back about how to have a successful play date.

Also, I wouldn't worry about an SN program at this point. I've known at least two kids, one in early elementary and one older elementary who went through a selective mutism stage. It will get better.

Is she in a SN preschool program?

OP here. Thanks for the responses. It feels better just hearing from others. I suspect social anxiety, although we didn't look into that diagnosis when we took her to a psychologist. She worked with a behavioral therapist at school from October to March. We stopped because she said for two months prior that she no longer wanted to see her therapist. It was a difficult choice to stop but she began being resistant to therapy at school and it was getting so expensive.

It was actually the therapist who encouraged play dates to make her feel more comfortable at school. It's not working and I can see how it would cause more anxiety, now that PP pointed it out. Argh!

I'm starting to see a lot of similarities between my daughter and treatment resistant bacteria. LOL.

It's okay. It will get better. But, I think right now you need to ease off the play dates. Selective mutism is anxiety based and I'm sure you can see how playdates could intensify your DD's anxiety. Are you working with a therapist? If not, I strongly encourage you to find one. My DS (now 10) doesn't have selective mutism but he's got severe anxiety. When it was time for him to start K, we weren't sure we were going to be able to get him to cross the threshold of the school. We started OT in the spring before K and that really helped DS a lot. Talk therapy/CBT wasn't effective because, frankly, because the anxiety was so strong he wasn't able to use techniques he learned when he was in the midst of the anxiety producing situation. I'm not recommending this for your 4 yo but I have to say that when we started him on generic Prozac when he was 6 it was the first time we saw a lessening of the anxiety. It was a lifesaver for him. He took it for a couple of years (and was diagnosed with ADHD during that time, the anxiety previously masked it) and has been off of it for a couple of years. He still has GAD but not nearly at the level he was. When it gets bad (right before school starts usually), we put him back on it for a while. HTH.

So she has an underlying anxiety disorder? Is she under the care of a child psychologist or developmental pediatrician? Sorry for all the questions. I really feel for you. Big big hugs.

She's four years old and has selective mutism. She has really regressed lately to using baby talk to me in public when she used to use sentences. What's worse, she's refusing to have anything to do with other kids. I've been setting up play dates with her classmates, and it's upsetting that she refuses To have anything to do with them when we're together. No words, no playing, nothing. If I were the other parent, I'd wonder why the hell we all bothered to get together. And I'd be wondering what was wrong with my child. I know, I know. I'm supposed to keep my happy face on and offer gentle encouragement, but I'm so frustrated right now that I want to cry. I'm beginning to think she'll never get better.

This is mostly a vent but any suggestions to make these play dates less painful and more productive?