ETS Domain: Treatment

Praxis 5331 Selective Mutism Questions

Selective mutism items on the Praxis 5331 test whether you understand this as an anxiety disorder rather than a language disorder. Expect scenarios about a preschooler who talks freely at home but never at school and questions about the SLP's role on a multidisciplinary team.

Why this topic matters

Selective mutism is often misclassified as a language disorder — the Praxis directly tests that distinction.
ETS wants you to know the anxiety-based mechanism and the team-based treatment model.
This topic appears in both the assessment and ethics/scope areas.

High-yield concepts

Selective mutism is classified as an anxiety disorder in the DSM.
Children speak in some settings (usually home) but consistently do not speak in specific social settings (usually school).
The child HAS language — the diagnosis requires that speech ability be intact in the comfortable setting.
Treatment uses stimulus fading, shaping, and gradual exposure — often SLP with psychology collaboration.
SLPs assess language to rule out co-occurring language disorder before treatment planning.

Sample practice questions

Try answering before revealing the rationale — mark misses to retry later.

Q1.A 5-year-old speaks freely at home and with her sibling but has not spoken at preschool for 4 months. Language testing at home shows age-appropriate skills. The most likely diagnosis is:

A.Developmental language disorder
B.Selective mutism
C.Autism spectrum disorder
D.Auditory processing disorder

Show answer & rationale

Correct: B. Consistent failure to speak in specific social settings despite normal speech in comfortable settings is the hallmark of selective mutism, an anxiety disorder — not a language disorder.

Q2.The most evidence-based approach for selective mutism combines:

A.Insistence on immediate speaking in the school setting
B.Stimulus fading, shaping, and gradual exposure delivered by an interdisciplinary team
C.Speech-only pull-out therapy
D.Punishment for silence

Show answer & rationale

Correct: B. Behavioral techniques — stimulus fading, shaping, exposure — delivered with psychology and school-team collaboration have the strongest evidence base. Coercion is contraindicated and unethical.

Q3.The SLP's role in a selective mutism case includes:

A.Diagnosing the anxiety disorder alone
B.Assessing language and speech to rule out co-occurring disorders and supporting communication in intervention
C.Providing individual psychotherapy
D.Prescribing anti-anxiety medication

Show answer & rationale

Correct: B. SLPs assess language/speech, rule out co-occurring communication disorders, and support the child's communication within a team plan. Diagnosis of the anxiety disorder is made by a mental-health professional.

Common wrong-answer traps

Diagnosing a language disorder based on school observation alone.
Pressuring the child to speak immediately.
Ignoring the anxiety basis and treating as a behavioral 'refusal.'

Study moves this week

Chart selective mutism vs language disorder differences across five features.
Learn the terms stimulus fading, shaping, and gradual exposure and one example of each.
Draft a two-sentence explanation for teachers about why coercion is harmful.

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FAQ

Do children with selective mutism ever outgrow it?

Many improve significantly with early behavioral intervention. Untreated cases can persist and lead to broader anxiety and social difficulties.

Is medication used for selective mutism?

SSRIs are sometimes prescribed by mental-health providers as an adjunct to behavioral therapy for moderate-to-severe cases.

Should the SLP work individually with the child?

SLPs often work individually to build initial verbal responses, then generalize to small groups, then to school settings, using structured exposure.

Praxis 5331 Selective Mutism Questions

Why this topic matters

High-yield concepts

Sample practice questions

Common wrong-answer traps

Study moves this week

Want 400+ scenario questions with rationales?

FAQ

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