This paper presents a case study of successful intervention with a boy (in fourth grade at the time of the intervention) who would not speak in the school environment. Intervention involved medication with Fluoxetine to relieve anxiety, parental involvement, and a six-step behavioral therapy plan of gradually increasing speech demands in the school situation with associated rewards and consequences. The therapy plan involved having the boy converse or read with his mother in a school room, then converse with his mother and one of his friends in a school room, and so on, up to the last step which involved having the boy speak to his classmates. (DB)