Follow-Up of Electively Mute Persons

Abstract

The follow-up reports of individuals treated for elective mutism are presented in Table 16.1. The practical constraints on clinical work do not make it easy to include a formal follow-up evaluation. The preparation of the table was complicated because a number of studies did not indicate the method of assessing the status of the client. Reports of the follow-up phases frequently amount to anecdotal reports rather than clearly defined dependent variable measures such as the duration of speaking, and the number or frequency of words spoken. Unfortunately, the majority of the anecdotal reports do not clearly indicate if the client spoke only when asked a question (reluctant speech) or if the person voluntarily contributed to conversations (spontaneous speech). Evidence of advance planning for a systematic follow-up is absent in the majority of the studies. A systematic follow-up should specify the method of obtaining information (telephone or face-to-face interview, questionnaire or direct observation by the investigator) as well as the questions which were employed. It is also advisable to include the same dependent variables in the follow-up assessment that were employed in assessing the internal validity of the intervention. Client satisfaction with treatment is one additional measure of treatment effectiveness but studies rarely address this issue either at the conclusion of treatment or at follow-up.