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Selective Mutism

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Handbook of Child and Adolescent Anxiety Disorders

Abstract

Selective mutism is a persistent and debilitating condition in which a child fails to speak in public situations where speaking is expected. Children with selective mutism often speak well in familiar situations such as home but do not speak to people in public situations such as parks, shopping malls, restaurants, and school. Failure to speak must last at least 1 month. A diagnosis of selective mutism does not generally apply to youths with a communication disorder such as stuttering or to youths who lack comfort or knowledge with the primary language spoken in public situations (American Psychiatric Association, 2000). Selective mutism thus does not generally apply to new immigrants or to youths whose parents are non-English speakers, though prevalence of selective mutism among established immigrants may be elevated compared with the general population (Elizur & Perednik, 2003; Krysanski, 2003; Vecchio & Kearney, 2007).

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References

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed. text revision). Washington: Author.

    Google Scholar 

  • Anstendig, K. D. (1999). Is selective mutism an anxiety disorder? Rethinking its DSM-IV classification. Journal of Anxiety Disorders, 13, 417–434.

    Article  PubMed  Google Scholar 

  • Arie, M., Henkin, Y., Lamy, D., Tetin-Schneider, S., Apter, A., Sadeh, A., et al. (2007). Reduced auditory processing capacity during vocalization in children with selective mutism. Biological Psychiatry, 61, 419–421.

    Article  PubMed  Google Scholar 

  • Baskind, S. (2007). A behavioural intervention for selective mutism in an eight-year-old boy. Educational and Child Psychology, 24, 87–94.

    Google Scholar 

  • Beare, P., Torgerson, C., & Creviston, C. (2008). Increasing verbal behavior of a student who is selectively mute. Journal of Emotional and Behavioral Disorders, 16, 248–255.

    Article  Google Scholar 

  • Bergman, R. L., Piacentini, J., & McCracken, J. T. (2002). Prevalence and description of selective mutism in a school-based study. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 938–946.

    Article  PubMed  Google Scholar 

  • Black, B., & Uhde, T. W. (1994). Treatment of elective mutism with fluoxetine: A double-blind, placebo-controlled study. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 1000–1006.

    Article  PubMed  Google Scholar 

  • Blum, N. J., Kell, R. S., Starr, L., Lender, W. L., Bradley-Klug, K. L., Osborne, M. L., et al. (1998). Case study: Audio feedforward treatment of selective mutism. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 40–43.

    Article  PubMed  Google Scholar 

  • Carlson, J. S., Kratochwill, T. R., & Johnston, H. F. (1994). Prevalence and treatment of selective mutism: A survey of child psychiatrists. Journal of Child and Adolescent Psychopharmacology, 4, 281–291.

    Article  Google Scholar 

  • Carlson, J. S., Mitchell, A. D., & Segool, N. (2008). The current state of empirical support for the pharmacological treatment of selective mutism. School Psychology Quarterly, 23, 354–372.

    Article  Google Scholar 

  • Chavira, D. A., Stein, M. B., Bailey, K., & Stein, M. T. (2004). Child anxiety in primary care: Prevalent but untreated. Depression and Anxiety, 20, 155–164.

    Article  PubMed  Google Scholar 

  • Cohan, S. L., Chavira, D. A., Shipon-Blum, E., Hitchcock, C., Roesch, S. C., & Stein, M. B. (2008). Refining the classification of children with selective mutism: A latent profile analysis. Journal of Clinical Child and Adolescent Psychology, 37, 770–784.

    Article  PubMed  Google Scholar 

  • Cohan, S. L., Chavira, D. A., & Stein, M. B. (2006). Practitioner review: Psychosocial interventions for children with selective mutism: A critical evaluation of the literature from 1990-2005. Journal of Child Psychology and Psychiatry, 47, 1085–1097.

    Article  PubMed  Google Scholar 

  • Cohan, S. L., Price, J. M., & Stein, M. B. (2006). Suffering in silence: Why a developmental psychopathology perspective on selective mutism is needed. Journal of Developmental and Behavioral Pediatrics, 27, 341–355.

    Article  PubMed  Google Scholar 

  • Cunningham, C. E., Cataldo, M. F., Mallion, C., & Keyes, J. B. (1983). A review and controlled single case evaluation of behavioral approaches to the management of elective mutism. Child and Family Behavior Therapy, 5, 25–49.

    Article  Google Scholar 

  • Cunningham, C. E., McHolm, A. E., & Boyle, M. H. (2006). Social phobia, anxiety, oppositional behavior, social skills, and self-concept in children with specific selective mutism, generalized selective mutism, and community controls. European Child and Adolescent Psychiatry, 15, 245–255.

    Article  PubMed  Google Scholar 

  • Cunningham, C. E., McHolm, A., Boyle, M. H., & Patel, S. (2004). Behavioral and emotional adjustment, family functioning, academic performance, and social relationships in children with selective mutism. Journal of Child Psychology and Psychiatry, 45, 1363–1372.

    Article  PubMed  Google Scholar 

  • Dow, S. P., Sonies, B. C., Scheib, D., Moss, S. E., & Leonard, H. L. (1995). Practical guidelines for the assessment and treatment of selective mutism. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 836–846.

    Article  PubMed  Google Scholar 

  • Dummit, E. S., Klein, R. G., Tancer, N. K., Asche, B., & Martin, J. (1996). Fluoxetine treatment of children with selective mutism: An open trial. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 615–621.

    Article  PubMed  Google Scholar 

  • Elizur, Y., & Perednik, R. (2003). Prevalence and description of selective mutism in immigrant and native families: A controlled study. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 1451–1459.

    Article  PubMed  Google Scholar 

  • Facon, B., Sahiri, S., & Riviere, V. (2008). A controlled single-case treatment of severe long-term selective mutism in a child with mental retardation. Behavior Therapy, 39, 313–321.

    Article  PubMed  Google Scholar 

  • Fisak, B. J., Oliveros, A., & Ehrenreich, J. T. (2006). Assessment and behavioral treatment of selective mutism. Clinical Case Studies, 5, 382–402.

    Article  Google Scholar 

  • Fung, D. S. S., Manassis, K., Kenny, A., & Fiksenbaum, L. (2002). Web-based CBT for selective mutism. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 112–113.

    Article  PubMed  Google Scholar 

  • Garcia-Lopez, L.-J., Olivares, J., Beidel, D., Albano, A. M., Turner, S., & Rosa, A. I. (2006). Efficacy of three treatment protocols for adolescents with social anxiety disorder: A 5-year follow-up assessment. Journal of Anxiety Disorders, 20, 175–191.

    Article  PubMed  Google Scholar 

  • Jackson, M. F., Allen, R. S., Boothe, A. B., Nava, M. L., & Coates, A. (2005). Innovative analyses and interventions in the treatment of selective mutism. Clinical Case Studies, 4, 81–112.

    Article  Google Scholar 

  • Kearney, C.A. (2010). Helping children with selective mutism and reluctance to speak: A guide for school-based professionals. New York: Oxford University Press.

    Google Scholar 

  • Kearney, C. A., & Vecchio, J. L. (2007). When a child won’t speak. Journal of Family Practice, 56, 917–921.

    PubMed  Google Scholar 

  • Kearney, C. A., Wechsler, A., Kaur, H., & Lemos-Miller, A. (2010). Posttraumatic stress disorder in maltreated youth: A synopsis of contemporary research and thought. Clinical Child and Family Psychology Review, 13(1), 46–76.

    Article  PubMed  Google Scholar 

  • Keen, D. V., Fonseca, S., & Wintgens, A. (2008). Selective mutism: A consensus based care pathway of good practice. Archives of Disease in Childhood, 93, 838–844.

    Article  PubMed  Google Scholar 

  • Kehle, T. J., Madaus, M. R., Baratta, V. S., & Bray, M. A. (1998). Augmented self-modeling as a treatment for children with selective mutism. Journal of School Psychology, 36, 247–260.

    Article  Google Scholar 

  • Kristensen, H. (2000). Selective mutism and comorbidity with developmental disorder/delay, anxiety disorder, and elimination disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 249–256.

    Article  PubMed  Google Scholar 

  • Kristensen, H., & Oerbeck, B. (2006). Is selective mutism associated with deficits in memory span and visual memory? An exploratory case-control study. Depression and Anxiety, 23, 71–76.

    Article  PubMed  Google Scholar 

  • Krysanski, V. (2003). A brief review of selective mutism literature. Journal of Psychology, 137, 29–40.

    Article  PubMed  Google Scholar 

  • Kumpulainen, K. (2002). Phenomenology and treatment of selective mutism. CNS Drugs, 16, 175–180.

    Article  PubMed  Google Scholar 

  • Manassis, K. (2009). Silent suffering: Understanding and treating children with selective mutism. Expert Review of Neurotherapeutics, 9, 235–243.

    Article  PubMed  Google Scholar 

  • Manassis, K., Fung, D., Tannock, R., Sloman, L., Fiksenbaum, L., & McInnes, A. (2003). Characterizing selective mutism: Is it more than social anxiety? Depression and Anxiety, 18, 153–161.

    Article  PubMed  Google Scholar 

  • Manassis, K., & Tannock, R. (2008). Comparing interventions for selective mutism: A pilot study. Canadian Journal of Psychiatry, 53, 700–703.

    Google Scholar 

  • McHolm, A. E., Cunningham, C. E., & Vanier, M. K. (2005). Helping your child with selective mutism: Practical steps to overcome a fear of speaking. Oakland: New Harbinger.

    Google Scholar 

  • Mendlowitz, S. L., & Monga, S. (2007). Unlocking speech where there is none: Practical approaches to treatment of selective mutism. Behavior Therapist, 30, 11–15.

    Google Scholar 

  • O’Reilly, M., McNally, D., Sigafoos, J., Lancioni, G. E., Green, V., Edrisinha, C., et al. (2008). Examination of a social problem-solving intervention to treat selective mutism. Behavior Modification, 32, 182–195.

    Article  PubMed  Google Scholar 

  • Remschmidt, H., Poller, M., Herpertz-Dahlmann, B., Hennighausen, K., & Gutenbrunner, C. (2001). A follow-up study of 45 patients with elective mutism. European Archives of Psychiatry and Clinical Neuroscience, 251, 284–296.

    Article  PubMed  Google Scholar 

  • Rye, M. S., & Ullman, D. (1999). The successful treatment of long-term selective mutism: A case study. Journal of Behavior Therapy and Experimental Psychiatry, 30, 313–323.

    Article  PubMed  Google Scholar 

  • Sharkey, L., & McNicholas, F. (2008). More than 100 years of silence, elective mutism: A review of the literature. European Child and Adolescent Psychiatry, 17, 255–263.

    Article  PubMed  Google Scholar 

  • Sharkey, L., McNicholas, F., Barry, E., Begley, M., & Ahern, S. (2008). Group therapy for selective mutism – A parents’ and children’s treatment group. Journal of Behavior Therapy and Experimental Psychiatry, 39, 538–545.

    Article  PubMed  Google Scholar 

  • Sharp, W. G., Sherman, C., & Gross, A. M. (2007). Selective mutism and anxiety: A review of the current conceptualization of the disorder. Journal of Anxiety Disorders, 21, 568–579.

    Article  PubMed  Google Scholar 

  • Steinhausen, H.-C., & Juzi, C. (1996). Elective mutism: An analysis of 100 cases. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 606–614.

    Article  PubMed  Google Scholar 

  • Steinhausen, H.-C., Wachter, M., Laimbock, K., & Metzke, C. W. (2006). A long-term outcome study of selective mutism in childhood. Journal of Child Psychology and Psychiatry, 47, 751–756.

    Article  PubMed  Google Scholar 

  • Stone, B. P., Kratochwill, T. R., Sladeczek, I., & Serlin, R. C. (2002). Treatment of selective mutism: A best-evidence synthesis. School Psychology Quarterly, 17, 168–190.

    Article  Google Scholar 

  • Suveg, C., Comer, J. S., Furr, J. M., & Kendall, P. C. (2006). Adapting manualized CBT for a cognitively delayed child with multiple anxiety disorders. Clinical Case Studies, 5, 488–510.

    Article  Google Scholar 

  • Vecchio, J. L., & Kearney, C. A. (2005). Selective mutism in children: Comparison to youths with and without anxiety disorders. Journal of Psychopathology and Behavioral Assessment, 27, 31–37.

    Article  Google Scholar 

  • Vecchio, J., & Kearney, C. A. (2007). Assessment and treatment of a Hispanic youth with selective mutism. Clinical Case Studies, 6, 34–43.

    Article  Google Scholar 

  • Vecchio, J., & Kearney, C. A. (2009). Treating youths with selective mutism with an alternating design of exposure-based practice and contingency management. Behavior Therapy, 40(4), 380–392.

    Article  PubMed  Google Scholar 

  • Viana, A. G., Beidel, D. C., & Rabian, B. (2009). Selective mutism: A review and integration of the last 15 years. Clinical Psychology Review, 29, 57–67.

    Article  PubMed  Google Scholar 

  • Yeganeh, R., Beidel, D. C., & Turner, S. M. (2006). Selective mutism: More than social anxiety? Depression and Anxiety, 23, 117–123.

    Article  PubMed  Google Scholar 

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Correspondence to Christopher A. Kearney .

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Kearney, C.A., Haight, C., Day, T.L. (2011). Selective Mutism. In: McKay, D., Storch, E. (eds) Handbook of Child and Adolescent Anxiety Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-7784-7_19

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