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About the Provider
Name: Kelly Melhorn
Disciplines/credentials: Behavior Analyst, M.A.
Modalities: Safe and Sound Protocol (SSP), Behavior Analysis
Client Background
Clients: 20 children over a 9-month period
Gender and Age: 16 girls and 4 boys, between 4 and 14 years old
Program Delivered: Safe and Sound Protocol (SSP)
- SSP Core: Hours 1-5
Across her practice, provider Kelly Melhorn treats pediatric clients presenting with selective mutism as their primary diagnosis and primary rationale for initiating listening therapy.
For individuals experiencing selective mutism, specific social environments may trigger overwhelming fear and heightened anxiety, making vocal communication exceptionally difficult or entirely unachievable. While this complex condition typically manifests during early childhood, its clinical impact can persist across the lifespan.
Many of these children had previously engaged in other interventions, including cognitive behavioral therapy (CBT), play therapy, and occupational therapy (OT), without attaining their desired therapeutic milestones. Some families also faced geographic barriers and lacked treating professionals in their immediate area, prompting them to seek a remote, accessible modality to support their child in overcoming selective mutism.
Kelly specializes in supporting clients with selective mutism, drawing from both professional clinical experience and personal experience navigating a diagnosis with her own child. The primary clinical goals for these clients were to help shift the children away from chronic sympathetic nervous system activation and increase parasympathetic regulation, thereby creating greater opportunity to work through various communication goals.
Implementation of the Safe and Sound Protocol (SSP)
Parents were thoroughly trained on how to facilitate the listening therapy in the home environment. Under Kelly’s guidance, the children completed 10-minute daily listening sessions of SSP Core, five days a week. Before each listening session, the parents and children engaged in designated “heart-connection exercises” to foster co-regulation. During each session, parents delivered passive rhythmic movements to support their child’s regulation.
Throughout the SSP, parents met virtually or in person with Kelly once per week to discuss changes in their child’s behavior and collaborate on small, manageable steps to support the child’s communication goals.
Response
After completing the SSP, parents reported noticeable shifts in emotional regulation, increased independence, reduced reactivity to environmental changes, and a higher inclination to communicate outside the home. Caregivers frequently noted that their children appeared distinctly happier, manifesting as increased smiling and laughing, enhanced conversational engagement with primary caregivers, and greater ease of co-regulation when distressed.
The vast majority of clients successfully began using their vocal communication with individuals other than their primary caregivers in public and community settings, including schools, places of worship, and restaurants. Older children in the cohort (ages 12-14) demonstrated heightened agency, actively expressing a desire to participate in family activities and independently selecting preferred outings rather than passively adhering to others’ plans.
Discussion
In reflection, Kelly observed that the therapeutic benefits extended directly to the caregiving unit and made it easier for parents to console the child when they became upset.
“I feel that not only did the children feel more calm and relaxed, [but] so did the parents,” Kelly shared. “The parents were now able to have conversations with their children about how they want to be supported through their selective mutism. This took a lot of stress off the parents, and they were feeling more at ease with their child’s progress and less overwhelmed. When the parents are feeling more calm and grounded, the child becomes likely to stay calm and grounded with them or return there easier. Parents no longer felt like they had to ‘walk on eggshells’ around their children.”
Kelly emphasized that the SSP “works because it strengthens the child from the inside. It gives them a sense of safety that other treatment modalities aren’t able to reach.”
By shifting out of persistent fight, flight, or freeze states, children can begin to view social interactions as opportunities for connection. Traditional behavioral laddering, often used to treat selective mutism, requires active practice to advance communication skills. However, a child in a chronic shutdown state is unable to even attempt these practices. By using the SSP to help establish inner calm, children gain the opportunity to engage in communication practice and feel proud of what they accomplish.
“They see others as people to connect with instead of people to fear,” Kelly added. “When there is an inner sense of calm, there are greater opportunities for them to engage in and explore.”
“When we feel safe, our nervous systems and entire bodies undergo a massive physiological shift that primes us to be healthier, happier, and smarter; to be better learners and problem solvers; to have more fun; to heal faster; and generally feel more alive.”
— Dr. Stephen Porges and Seth Porges, from Our Polyvagal World
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