I started treating Jamie in the summer – she had never spoken to ANYONE outside of her nuclear family, except for two neighbors and best friends, Talia and Lynne. After 7 home therapy sessions (in her living room), she was talking to me in a regular voice and pretty freely! How did it happen? I used a behavioral exposure stepladder; first I faded into the background in her living room, and didn’t interact with her. Once she habituated to my presence and resumed talking in the 2nd session, I became more noticeable, and then in the following session, I joined in a game she was playing with her Mom, and finally, by the 5th session I played with her and her Mom, and spoke directly to Jamie, and Jamie answered me back!! (We played Taboo – Jamie beat me and her Mom hands down!) 2 further sessions increased the ease with which she talked to me. Wow, amazing breakthrough. Now we’re relocating our sessions to the therapy room in Jamie’s school, with the aim of retaking our communicative relationship there, and gradually including peers and teachers; we’ll also incorporate CBT techniques…. I’ll keep you posted!