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 Welcome

00:17 Meet Dr Giglio

01:47 What Is Selective Mutism

02:44 Why The Name Changed

03:37 Misconceptions And Oppositionality

04:22 How Parents First Notice

05:23 Shy Vs Social Anxiety

06:53 When Anxiety Becomes Persistent

09:43 Supporting Exposure Without Rescue

11:55 Handling Meltdowns And Tiny Steps

13:27 Anxious Parents And Trauma Fears

16:12 PDA And Demand Avoidance Nuance

20:00 Comorbidity And Medication Questions

22:23 Overlearning Through Exposure

22:54 Finding Proper SM Treatment

23:47 Parents As Co Therapists

27:08 Coaching Without Accommodating

28:15 Books And Journals Tools

31:25 Intensive Exposure Camps

33:37 Wins And Progress Stories

35:16 Risks Of Late Identification

37:23 Let Kids Do Hard Things

Working with Dr. Giglio at Main Child Therapy Center

Grab her book, Bravery Grows

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