Supporting autonomy and self advocacy in teens and young adults

Begin with the person’s priorities

Ask which situations they want to change and which are acceptable as they are. One person may prioritize answering a medical question; another may want to order food, participate in a seminar, or communicate with a supervisor. Goals can include speech and other methods of direct communication.

Ask before speaking for someone

Caregivers and professionals often answer quickly because they want to keep the interaction moving. Agree in advance on a response sequence. The young person might respond first by speech, writing, or typing; signal for help; or ask the support person to add information after they have contributed.

For urgent situations, use the established safety plan. Autonomy includes having dependable support, not being left without a way to communicate.

Practice self advocacy in multiple formats

A person can rehearse explaining selective mutism aloud, by email, in a prepared note, or through a short script on a phone. Useful statements include: “I may need extra response time,” “I can answer in writing,” “Please ask one question and wait,” and “I will let you know if I need my support person to answer.”

Transfer responsibility gradually

Break complex tasks into parts. A caregiver may initially help draft an accommodation email while the young person sends it. Later, the young person may write the message and copy the caregiver only if wanted. Similar steps can be used for scheduling appointments, checking in at an office, or communicating with school staff.

Respect privacy and changing roles

Discuss who can receive treatment updates, school information, and workplace details. When a person reaches legal adulthood, consent and access rules change even if family support continues. Providers should explain those changes directly and create a communication method that allows the young adult to make choices.

Review whether supports are increasing access and independence. The aim is not to remove help on a schedule; it is to make help responsive to the person’s goals and current skills.

Create scripts that can be adapted

A script can help with the first step of a difficult interaction. For an instructor: “I have selective mutism and may not be able to answer aloud without preparation. I can participate by writing and am working on a plan for oral tasks.” For a medical office: “Please ask me directly and allow time. If I cannot speak, I will type my answer.”

The person should edit the words so they sound accurate and comfortable. The script can be stored on a phone, printed on a card, sent by email, or rehearsed aloud. Over time, the person may use only part of it or communicate the same information spontaneously.

Shift the caregiver role deliberately

Caregivers can move from answering to preparing, waiting, and backing up. Before an interaction, agree on who will start, how long to wait, what signal requests help, and what information the caregiver may add. Afterward, ask the young person what worked before offering an interpretation.

Independence is not measured by whether family support disappears. A more useful question is whether the young person has greater choice and direct control. Support can remain available while the person takes ownership of selected tasks, decisions, and communication.

Putting this into practice

Pick one self advocacy statement and one real setting in which to use it. Decide whether the first use will be written, recorded, rehearsed aloud, or communicated with support. A small successful use can create a script for later situations.

After the interaction, ask whether the person felt heard and whether the requested support was provided. Self advocacy is not complete when a message is sent; the environment also has to respond. Bring recurring barriers back to the relevant school, workplace, medical, or treatment team.

Sources and further reading

• ASHA Practice Portal Selective Mutism

• Systematic review Selective mutism in adolescents and young adults

• Selective Mutism Association Resources

Related Braverly information

Learn about selective mutism care