How Myofunctional Therapy Can Be Connected to Selective Mutism

Many children with selective mutism also have underlying oral-motor, breathing, or sensory challenges that make speaking feel physically difficult or uncomfortable. When a child is already anxious, these extra layers of effort can make verbal communication feel overwhelming.

This is where myofunctional therapy can play a valuable role.

1. When Talking Feels Physically Hard, Anxiety Gets Stronger

Some children with selective mutism have:

• Low oral muscle tone

• Difficulty coordinating breathing and speech

• Tongue-tie or restricted oral movements

• Mouth breathing habits

• Tension in the jaw, tongue, or lips

If a child feels like speech takes “extra work,” they may avoid speaking in stressful settings. Myofunctional therapy helps improve:

• Nasal breathing

• Oral rest posture

• Tongue and lip coordination

• Muscle strength for speech clarity
  These improvements can make talking feel easier, which can reduce the physical component of stress around speaking.

2. Myofunctional Concerns Can Overlap With Sensory Sensitivities

Many children with selective mutism also experience sensory processing differences. They may be sensitive to:

• Facial touch

• Vibrations or sound

• Oral-motor movement inside the mouth

Myofunctional therapists often use gradual, play-based strategies to increase oral awareness and comfort. This can help build tolerance and decrease the sensory overload that can happen when trying to speak in new environments.

3. Mouth Breathing Can Activate the Stress Response

Chronic mouth breathing affects far more than oral posture — it influences the nervous system. Mouth breathing can:

• Keep the body in a more “fight-or-flight” state

• Increase feelings of restlessness or tension

• Reduce the ability to coordinate breath for speech

Myofunctional therapy supports healthy nasal breathing patterns, which can help the body shift toward a calmer baseline. When children feel physiologically calmer, they are better able to access speech in challenging settings.

4. Improved Confidence in the Body Supports Confidence in Communication

Children with selective mutism often fear making sounds or being “heard.” If a child isn’t confident in how their body feels or how their speech will sound, this fear can grow.

As myofunctional therapy strengthens the oral muscles, improves breathing, and increases body awareness, many families notice:

• Better willingness to make sounds during play

• More comfortable participation in speech therapy

• Increased confidence with communication attempts

• Lower frustration during speaking tasks

These gains support — not replace — the child’s work with a mental health provider or selective mutism specialist.

5. Myofunctional Therapy Is a Complement, Not a Cure

It’s important for families to know:

• Myofunctional therapy does not treat the anxiety component of selective mutism.

• But it can remove physical barriers that make talking harder.

• When combined with behavioral or cognitive-behavioral therapy, gains can happen more easily.

Think of it like this:
If anxiety is the locked door, oral-motor and breathing challenges are the heavy furniture in front of the door. Myofunctional therapy helps move the furniture so the child has a clearer path as they work on opening the door.

Selective mutism is complex, and every child’s needs are different. For some children, addressing oral-motor, breathing, and sensory factors can reduce the physical strain around speaking — allowing behavioral interventions to be more effective.

Myofunctional therapy offers a supportive, body-based approach that can help children feel more comfortable in their mouths, their breathing, and their ability to communicate.