A pilot study of an online behavioral parent training program for children with selective mutism: feasibility and preliminary effectiveness.
Nine live Zoom sessions with parents can cut school mutism and child anxiety without extra clinic trips.
01Research in Context
What this study did
Yamanaka et al. (2025) tested a nine-session online course for parents of 3- to 9-year-olds with selective mutism.
Parents met a therapist on Zoom once a week and learned step-by-step ways to help their child speak at school.
The team looked at school mutism, home talking, child anxiety, and parent stress before and after the course.
What they found
Kids spoke more at school and showed less anxiety after the course.
Parents felt calmer and used fewer harsh rules.
Strangely, total mutism scores and talking at home did not change, so the gains stayed in the classroom.
How this fits with other research
Llanes et al. (2020) and Fischbacher et al. (2024) also ran short online parent classes and saw quick gains in child communication.
All three pilots show you can teach parents on a screen and still move child behavior, but each used a different lesson set for a different diagnosis.
Turgeon et al. (2021) ran a stricter randomized trial with autistic kids and still got positive parent reports, yet many parents dropped out.
Yamanaka’s lower dropout suggests the live Zoom format may keep families engaged better than self-guided web pages.
Why it matters
If you serve anxious, mute kids, you now have a nine-week telehealth script that fits real life.
Run the same weekly Zoom lessons, track school talking, and expect gains where it counts—the classroom.
Keep measuring home speech; the course did not hurt it, but it did not help either, so you may need extra tools for the living-room front.
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02At a glance
03Original abstract
Recent approaches to treating selective mutism (SM) have increasingly emphasized parent involvement, and several parent-mediated programs have shown promising efficacy. However, in regions where SM specialists are scarce, families have limited access to appropriate support. In this context, online behavioral parent training (BPT) may serve as a promising and scalable option that can overcome geographic barriers. Nevertheless, empirical studies specifically targeting SM-focused BPT remain limited. This pilot study evaluated the feasibility and preliminary effectiveness of an online BPT program developed for parents of children with SM. This pilot study evaluated the feasibility and preliminary effectiveness of a nine-session online behavioral parent training program (SM-BPT) for parents of children aged 3 to 9 years with diagnosed or suspected SM. Seventeen parents enrolled in the program, and 13 completed both the intervention and the pre- and post-assessments. Changes in children’s SM symptoms, anxiety, and behavioral problems were assessed alongside parenting behaviors and parental mental health. Following the intervention, significant improvements were observed in children’s school-based SM symptoms (p = .04), anxiety (p = .03), and internalizing (p = .03) and externalizing behaviors (p = .02). However, no significant changes were found in total SM symptoms (p = .22) or home/family communication (p = .83). Parents reported reduced negative parenting behaviors (p < .001) and improved mental health (p < .01). In contrast, positive parenting did not significantly change (p = .72). High attendance (mean = 93.5%) and homework completion (mean = 73.5%) supported the program’s feasibility and acceptability. The SM-BPT demonstrated preliminary effectiveness in reducing children’s SM symptoms at school, as well as anxiety and behavioral problems, and in improving parental mental health. High attendance rates also suggested good feasibility. Because the program can be delivered online, it may serve as a practical option for families with limited access to specialized support. Further research, including randomized controlled trials, is needed to examine its effectiveness across diverse family situations. Trial registration UMIN Clinical Trials Registry UMIN000043686, registered on 21 March 2021
Child and Adolescent Psychiatry and Mental Health, 2025 · doi:10.1186/s13034-025-00976-4