Materiały źródłowe

• #1 Selective Mutism | Fact Sheet – ABCT – Association for Behavioral and Cognitive Therapies

  https://www.abct.org/fact-sheets/selective-mutism/

  Selective mutism causes significant impairment in daily functioning, academic performance, and/or social relationships. Due to the fear of speaking, children are unable to ask to use the bathroom or communicate when they are in pain, or fully participate in school or social activities. The duration of SM can last several months or persist for years, and, if left untreated, it can have many short-term and long-term negative consequences on a child’s life. These include depression, risk of developing other anxiety disorders, social isolation or withdrawal, poor academic performance or school refusal, and risk of substance abuse. […] The most research-supported treatment for selective mutism is behavioral and cognitive behavioral therapy. Behavioral therapy approaches, including gradual exposures, contingency management, successive approximations/ shaping, and stimulus fading, are successful in the treatment of childhood anxiety.

• #2 How to Treat Selective Mutism: Best Practices and Effective Treatments    :: The Baker Center For Children and Families

  https://www.bakercenter.org/selective-mutism2

  Kids with selective mutism are most often diagnosed between the ages of 3 and 8 years old. Identifying selective mutism and intervening at an early age provides the child with more opportunities for successful treatment and it can help them avoid a long and challenging future of potential academic, social, and emotional repercussions. Early intervention is key, and beginning interventions at the time that the symptoms appear has been shown to be the most effective timing for treatment success. Beginning treatment early can minimize the amount of time that the child is experiencing reinforcements and accommodations for their mutism. […] Many treatments for selective mutism, and other anxiety disorders, encourage brave behaviors and the use of an approach model. In these treatments, clinicians and caregivers use skills to help the child approach situations that make them anxious, which in turn will teach the child that its not so bad after all.

• #3 Selective mutism – NHS

  https://www.nhs.uk/mental-health/conditions/selective-mutism/

  With appropriate handling and treatment, most children are able to overcome selective mutism. But the older they are when the condition is diagnosed, the longer it will take. […] Treatment does not focus on the speaking itself, but reducing the anxiety associated with speaking. […] This means: not letting the child know you’re anxious, reassuring them that they’ll be able to speak when they’re ready, concentrating on having fun, praising all efforts the child makes to join in and interact with others, such as passing and taking toys, nodding and pointing, not showing surprise when the child speaks, but responding warmly as you would to any other child. […] Cognitive behavioural therapy (CBT) helps a person focus on how they think about themselves, the world and other people, and how their perception of these things affects their thoughts and feelings. CBT also challenges fears and preconceptions through graded exposure.

• #4 Treatment of selective mutism: a 5-year follow-up study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6060963/

  Selective mutism (SM) has been defined as an anxiety disorder in the diagnostic and statistical manual of mental disorders (DSM-5). Cognitive behavioral therapy (CBT) is the recommended approach for SM, but prospective long-term outcome studies are lacking. […] We have developed a school-based CBT intervention previously found to increase speech in a pilot efficacy study and a randomized controlled treatment study. […] Treatment gains were maintained on the teacher- and parent questionnaires. […] These results point to the long-term effectiveness of CBT for SM, but also highlight the need to develop more effective interventions for the subset of children with persistent symptoms. […] SM has over the years been considered difficult to treat, and both medication and psychosocial treatment have been tried. […] A comprehensive practitioner review from 2006 provided support for the use of behavioral- and cognitive behavioral therapy (CBT) for SM. […] In recent years, CBT interventions especially adapted for children with SM have been elaborated. […] Consequently, in 2013 researchers developed an integrated behavioral therapy for SM to be conducted at the clinic with parental participation using graduated exposure tasks to the feared stimuli/situation (e.g., verbal communication).

• #5 Orlando CBT Therapy For Selective Mutism for Children

  https://www.groundworkcounseling.com/services/child-counseling/selective-mutism-why-wont-my-child-talk-in-public/

  GroundWork in Orlando specializes providing evidence-based therapy for children, and teens (ages 6+) with selective mutism and social anxiety disorder. […] Our approach combines cognitive behavioral therapy, and exposure therapy to reduce selective mutism symptoms and improve social communication. […] CBT (Cognitive Behavioral Therapy) and ERP (exposure and response prevention) are two of the most common methods used to treat selective mutism. […] It teaches strategies for managing selective mutism by examining unhelpful patterns of thinking that may be preventing effective communication. […] With the guidance of a qualified clinician, selective mutism sufferers can learn to confront their fears and anxieties, overcome their selective mutism, and interact more comfortably with their peers.

• #6 Treatment of selective mutism: a 5-year follow-up study – PubMed

  https://pubmed.ncbi.nlm.nih.gov/29357099/

  Selective mutism (SM) has been defined as an anxiety disorder in the diagnostic and statistical manual of mental disorders (DSM-5). Cognitive behavioral therapy (CBT) is the recommended approach for SM, but prospective long-term outcome studies are lacking. […] We have developed a school-based CBT intervention previously found to increase speech in a pilot efficacy study and a randomized controlled treatment study. […] In the present study, we provide 5-year outcome data for 30 of these 32 children with SM who completed the same CBT for mean 21 weeks (sd 5, range 8-24) at mean age 6 years (10 boys). […] At the 5-year follow-up, 21 children were in full remission, five were in partial remission and four fulfilled diagnostic criteria for SM. […] Treatment gains were maintained on the teacher- and parent questionnaires. […] These results point to the long-term effectiveness of CBT for SM, but also highlight the need to develop more effective interventions for the subset of children with persistent symptoms.

• #7 Selective Mutism | Fact Sheet – ABCT – Association for Behavioral and Cognitive Therapies

  https://www.abct.org/fact-sheets/selective-mutism/

  Selective mutism causes significant impairment in daily functioning, academic performance, and/or social relationships. Due to the fear of speaking, children are unable to ask to use the bathroom or communicate when they are in pain, or fully participate in school or social activities. The duration of SM can last several months or persist for years, and, if left untreated, it can have many short-term and long-term negative consequences on a child’s life. These include depression, risk of developing other anxiety disorders, social isolation or withdrawal, poor academic performance or school refusal, and risk of substance abuse. […] The most research-supported treatment for selective mutism is behavioral and cognitive behavioral therapy. Behavioral therapy approaches, including gradual exposures, contingency management, successive approximations/ shaping, and stimulus fading, are successful in the treatment of childhood anxiety.

• #8 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Behavioral-Therapy-for-Selective-Mutism.aspx

  Treatment of selective mutism mainly involves behavioral therapy. Affected children need the help of a multidisciplinary team of health care professionals that includes a pediatrician, child psychologist or psychiatrist, and a speech-language pathologist (SLP). […] Every child’s therapy uses a different strategy or a blend of strategies based on individual needs. The SLP usually creates a behavioral treatment plan that aims to address specific speech and language issues the child faces. […] In behavior therapy, the child is gradually exposed to increasingly tough tasks involving speaking. Therapy starts with easier steps and it becomes progressively harder. […] Over time, children realize that they do not have to avoid a stressful situation in order to cope with the anxiety. They get more comfortable with speaking and feel there is a reduction in their anxiety when there is a demand to speak.

• #9 Selective Mutism | Fact Sheet – ABCT – Association for Behavioral and Cognitive Therapies

  https://www.abct.org/fact-sheets/selective-mutism/

  Cognitive strategies can be useful for older children when they can reflect upon their thoughts. Techniques include recognizing bodily cues of anxiety, identifying and challenging negative thought patterns, and putting together a coping plan for anxiety so that it is less likely to interfere with speaking behavior. […] Medication has been useful in the treatment of children with SM. Medication is recommended for children with more severe difficulties, if the child has had SM for a long time, and/or if the child is not responding well to behavioral therapy. Medication should be used in combination with behavioral therapy to help children participate more actively in treatment. SSRIs (selective serotonin reuptake inhibitors) are recommended as first-line medications because they are effective for anxiety and relatively well tolerated by children.

• #10 SMart Center – Overcome Selective Mutism & Find Your Voice

  https://selectivemutismcenter.org/

  Selective Mutism, Anxiety, Related Disorders Treatment Center (SMart Center) specializes in treating children, teens, and adults with Dr. Elisa Shipon-Blums evidence-based treatment, Social Communication Anxiety Treatment (S-CAT). Implemented only at the SMart Center. […] From her years researching Selective Mutism, Dr. E developed the evidenced-based Social Communication Anxiety Treatment (S-CAT). S-CAT is the concept that SM is more than just the mutism it focuses on the WHOLE person. […] Our most popular and successful approach to treating Selective Mutism. Designed for children, teens, and adults. […] Intensive Group Treatment and Parent Training Support Program to help parents, children, and teens (ages 3-17+) […] A la carte style virtual play-dates and get-togethers for children and teens (6-18) to reinforce strategies. […] School professionals seeking trainings, support and further education on Selective Mutism […] Discover opportunities to learn from the SMart Center via virtual training, treatment groups, webinars, special events.

• #11 Treating Selective Mutism – Selective Mutism Association

  https://www.selectivemutism.org/treating-selective-mutism/

  Several protocols have included a variety of these behavioral components that have been found to be effective in reducing SM behaviors and anxiety across settings. […] A medical doctor such as a psychiatrist or pediatrician may prescribe medications to address the underlying cause of the child being nonverbal in certain situations: anxiety. Medication is most effective when combined with behavioral and/or other psychological strategies above, especially to help the child maintain improvement over time. […] Since speech and language impairments can co-occur with SM, speech-language pathologists (SLPs) may contribute to the treatment benefits of children with selective mutism. Additionally, SLPs are trained to work with children on pragmatic language skills, which can be greatly impacted by selective mutism.

• #12 How to Treat Selective Mutism: Best Practices and Effective Treatments    :: The Baker Center For Children and Families

  https://www.bakercenter.org/selective-mutism2

  The first step to getting effective support is to pursue a thorough evaluation with a mental health professional. With an evidence-based evaluation, your clinician can help you to identify the specific challenges your child is struggling with, determine if a diagnosis is appropriate, and recommend the best treatment pathway for your individual family and child. […] PCIT-SM is a family-based intervention that is based on a two-phase treatment model. The first phase is Child-Directed Interaction (CDI) which includes learning and building skills for positive relationships and reinforcement, and it serves as a base for the second phase of treatment. The second phase is Verbal-Directed Interaction (VDI), which introduces a framework for encouraging and facilitating speech for kids with SM. […] A behavioral approach to selective mutism is highly supported by research. Behavioral treatments will include gradual exposures to the anxiety-inducing stimuli, with less distressing situations being introduced first.

• #13 Selective mutism – NHS

  https://www.nhs.uk/mental-health/conditions/selective-mutism/

  Behavioural therapy concentrates on helping combat current difficulties using a gradual step-by-step approach to help conquer fears. […] There are several techniques based on CBT and behavioural therapy that are useful in treating selective mutism. […] Medicine is only really appropriate for older children, teenagers and adults whose anxiety has led to depression and other problems. […] Medicine should never be prescribed as an alternative to environmental changes and behavioural approaches. Though some health professionals recommend using a combination of medicine and behavioural therapies in adults with selective mutism.

• #14 Selective mutism treatment – Priory

  https://www.priorygroup.com/mental-health/selective-mutism-treatment

  Therapeutic treatment programmes look to reduce the debilitating symptoms of selective mutism, helping your child to feel comfortable showing off their personality in a variety of social settings. […] Among the most effective methods of treating selective mutism is CBT. […] The child may talk at ease with someone, such as a parent. In stimulus fading, another person is introduced to the situation. […] This method attempts to reduce the fear of certain people hearing the sound of you or your child’s voice. […] With two-way communication among people other than close friends and family being the desired goal, shaping uses techniques which steadily move towards this through activities such as reading aloud or taking part in interactive reading games. […] This involves gradual exposure to scenarios which cause increasing levels of anxiety.

• #15 Treatment for Selective Mutism | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/treatment-selective-mutism

  Selective mutism is an anxiety disorder. Treatment varies based on the needs of your child, and may include: […] Stimulus fading. This is done by slowly introducing a new person into the room when your child is relaxed. […] Shaping. This is done by encouraging your child’s attempts to communicate with gestures and whispers until they speak out loud. […] Self-modeling. This is done by having your child watch a video of themself communicating well at home. […] Speech therapy. This can be done for any underlying speech problems, if needed. […] Family and behavioral therapy. These can help with emotional issues. […] Medicines. Some medicines can be used to lower anxiety. […] Speaking with your child’s teachers. Your child’s teachers can help make communication at school less scary. For example, a teacher may have your child only speak in small groups at first, instead of to the whole class.

• #16 Treatment for Selective Mutism | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/treatment-selective-mutism

  Selective mutism is an anxiety disorder. Treatment varies based on the needs of your child, and may include: […] Stimulus fading. This is done by slowly introducing a new person into the room when your child is relaxed. […] Shaping. This is done by encouraging your child’s attempts to communicate with gestures and whispers until they speak out loud. […] Self-modeling. This is done by having your child watch a video of themself communicating well at home. […] Speech therapy. This can be done for any underlying speech problems, if needed. […] Family and behavioral therapy. These can help with emotional issues. […] Medicines. Some medicines can be used to lower anxiety. […] Speaking with your child’s teachers. Your child’s teachers can help make communication at school less scary. For example, a teacher may have your child only speak in small groups at first, instead of to the whole class.

• #17 Treatment for Selective Mutism | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/treatment-selective-mutism

  Selective mutism is an anxiety disorder. Treatment varies based on the needs of your child, and may include: […] Stimulus fading. This is done by slowly introducing a new person into the room when your child is relaxed. […] Shaping. This is done by encouraging your child’s attempts to communicate with gestures and whispers until they speak out loud. […] Self-modeling. This is done by having your child watch a video of themself communicating well at home. […] Speech therapy. This can be done for any underlying speech problems, if needed. […] Family and behavioral therapy. These can help with emotional issues. […] Medicines. Some medicines can be used to lower anxiety. […] Speaking with your child’s teachers. Your child’s teachers can help make communication at school less scary. For example, a teacher may have your child only speak in small groups at first, instead of to the whole class.

• #18 Selective Mutism

  https://www.asha.org/practice-portal/clinical-topics/selective-mutism/?srsltid=AfmBOoob5Ffh24FFdhWMbHIbNCayF3xp1Dg9G-NJgp3SdBnz7Te3gcdK

  ParentChild Interaction Therapy for children with selective mutism aims to increase verbal interactions in social settings and decrease avoidance behaviors. […] Social Communication Anxiety Treatment (S-CAT) uses a multimodal approach to increase the social engagement, verbal communication, and confidence of the person with selective mutism. […] The clinician can incorporate the Ritual Sound Approach into the S-CAT program to systematically increase the child’s comfort with making sounds and words. […] This integrated approach emphasizes participation in social engagement (nonverbal and verbal) at increasingly difficult levels. […] Generalizing spontaneous speech to different settings and communication partners may involve having the individual with selective mutism rate situations and people from most difficult to least difficult in a hierarchy.

• #19 Selective Mutism

  https://www.asha.org/practice-portal/clinical-topics/selective-mutism/?srsltid=AfmBOoob5Ffh24FFdhWMbHIbNCayF3xp1Dg9G-NJgp3SdBnz7Te3gcdK

  The purpose of treatment is to decrease anxiety and increase verbal communication in a variety of settings, incorporating practice and reinforcement for speaking in subtle, nonthreatening ways. […] The treatment options below include approaches that are within the scope of an SLP, may involve an SLP in an interprofessional team, or may require additional training. […] Integrated behavioral therapy for selective mutism, originally developed for children ages 48 years, aims to increase successful speaking behaviors in anxiety-provoking situations, habituate speaking-related anxiety, and positively reinforce speaking. […] Intensive Group Behavioral Treatment focuses on providing a full course of intervention for selective mutism in a condensed period, such as a 1-week summer camp program.

• #20 Guide to Selective Mutism in Children – Child Mind Institute

  https://childmind.org/guide/parents-guide-how-to-help-a-child-with-selective-mutism/

  Children with selective mutism (SM) are talkative at home but unable to speak in more public settings, including school. […] The good news is that selective mutism is very treatable with the right care. Kids with SM respond best to behavioral therapy that is focused on helping them learn to speak in new settings, during new activities and with new people. […] If you are concerned that your child might have SM, you should get a comprehensive evaluation that establishes a diagnosis. […] Children with SM should never be pushed to speak. The pace of treatment should be gradual, and children shouldn’t be asked to do something that is too difficult for them. […] Intensive behavioral treatment, like the Brave Buddies™ program, has proved to be very successful in treating SM. […] For a treatment program to be effective, kids need to learn how to speak in everyday situations — not just in the doctor’s office.

• #21 Selective Mutism Service – Child Mind Institute

  https://childmind.org/care/areas-of-expertise/anxiety-disorders-center/selective-mutism-service/

  We use generalization, which means taking therapy “on the road” – we go to stores and other places in the community to help the child practice. We provide multiple contexts for practicing “brave talking,” including a weekly practice peer group. […] We assign homework so parents can practice out of session and keep momentum going. […] We collaborate with the child’s school, provide staff trainings and offer specific strategies for use in the classroom. […] When medication may be helpful, our team works with board-certified child and adolescent psychiatrists at the Child Mind Institute or collaborates with your physician. […] Brave Buddies® is a group intensive behavioral therapy program to help children with SM ages 3 to 12 speak in school and other public settings. Using a simulated classroom, the program offers children a safe environment to practice “brave talking” with positive feedback.

• #22 Selective Mutism Service | NYU Langone Health

  https://nyulangone.org/locations/child-study-center/selective-mutism-service

  In addition to our traditional weekly therapy sessions for selective mutism, we offer intensive treatment programs which condense a full course of weekly therapy for selective mutism into a one-week-long session. […] Camp Courage is our four-day intensive summer treatment program aimed at helping children ages 4 to 11 communicate verbally in various social situations. […] Through repeated practice and graduated exposure, children begin to conquer their fears about speaking and joining in with others. […] Experts in selective mutism work one-on-one with children to facilitate speech and reward verbal communication. […] We offer individualized intensive treatment programs over multiple, consecutive days for families who are able to travel to New York City from elsewhere in the state or country.

• #23 Selective Mutism Treatment and Therapy — Thriving Minds

  https://www.thrivingmindsbehavioralhealth.com/selective-mutism-treatment

  Children with Selective Mutism struggle to speak in environments like school or extracurricular activities, but can communicate at home with close family. At Thriving Minds, our highly trained therapists specialize in treating this childhood anxiety disorder, helping children build confidence and improve communication in all settings. […] Thriving Minds offers several models of research-supported treatment for Selective Mutism: […] Grow your child’s brave voice through weekly sessions with one of our expert therapists using behaviorally-based intervention techniques. […] Intensive therapy for Selective Mutism is a structured treatment model designed to accelerate progress by providing several hours of therapy per day over a series of consecutive days. […] This concentrated approach allows children to practice communication skills in real-world settings, helping them build confidence faster than traditional weekly sessions, while still using the same evidence-based methods for treating Selective Mutism.

• #24 Guide to Selective Mutism in Children – Child Mind Institute

  https://childmind.org/guide/parents-guide-how-to-help-a-child-with-selective-mutism/

  It’s important that everyone in a child’s life be involved with treatment because SM is a disorder that other people tend to adapt to, which can actually make it harder to treat. […] Treatment helps reverse this by giving kids experience speaking in situations where they feel anxious. […] As part of a comprehensive treatment program, it is extremely important to get a child’s school on board with treatment. […] Behavioral treatment is the gold standard for treating selective mutism, but medication can be helpful for kids with the disorder who aren’t making sufficient gains with therapy alone. […] Kids who have had SM for longer will be accustomed to not speaking in public, and their parents, teachers and other caregivers will have adapted to working around their avoidance. […] Selective mutism is more common among children who speak a second language.

• #25 What is Selective Mutism? | Kurtz Psychology

  https://www.kurtzpsychology.com/selective-mutism/what-is-selective-mutism-2/

  Treatment options for SM We treat children with SM in a few different ways. Treatment is always customized to your familys unique situation and we work with you to decide on the best option: […] PCIT-SM is the underlying basis of all of our individual and group SM treatments. We work with you to build a positive, trusting relationship with your child, and then use that relationship to help them develop and practice their brave talking. […] The heart and soul of this treatment is teaching the parents how to be their childs behavior therapist. We systematically teach parents a well-defined set of behavioral Dos and Donts, so they become the experts helping their child learn to talk with others. […] We partner with our parents to provide the necessary information and training to the schools so they can work effectively with their students.

• #26 Treatment Statement | Selective Mutism Association

  https://www.selectivemutism.org/treatment-statement/

  A team approach is crucial to the child’s overall success. […] Treatment should involve helping the child to increase awareness of his or her anxiety in a manner that is developmentally appropriate. […] Medication may or may not be needed. If medication is prescribed, it should be used in combination with a multimodal, team treatment approach as described herein. […] Nutritional therapy supplements and herbal remedies should be used with caution. […] Due to the nature of SM, treatment should include interventions and goals within the school and community settings, not just the treating professional’s office. […] Generally, it is not advised to place children with SM in self-contained or special education classrooms based solely on their selective mutism diagnosis, nor are educational environments with limited opportunities for social interaction advised.

• #27 Selective Mutism Treatment and Therapy — Thriving Minds

  https://www.thrivingmindsbehavioralhealth.com/selective-mutism-treatment

  As treatment progresses, the therapist will set up situations that allow the client to speak and receive rewards for speaking immediately. […] Weekly psychotherapy sessions are incredibly beneficial for reversing the effects of Selective Mutism, but brave practices that occur outside of weekly sessions contribute exponentially to the child’s progress. […] For child with Selective Mutism, school can be an incredibly difficult setting. […] Our therapists, however, regularly offer training and consultation with schools to help create consistent expectations and interventions in all environments. […] For many schools, an Individualized Education Plan (IEP) is needed in order to make accommodations in the classroom. […] Dr. Kotrba offers consultation to professionals and parents about the following topics: Treatment for selective mutism. […] Want to learn more about helping your child, student, or client with Selective Mutism?

• #28 Navigating selective mutism in children – CHOC – Children’s health hub

  https://health.choc.org/navigating-selective-mutism-in-children/

  Learn the signs, symptoms and treatment for selective mutism in children, including myths about the rare childhood anxiety disorder. […] Treatment can really help children with selective mutism. […] Selective mutism responds well to behavioral therapy, which focuses on encouraging speech in many different situations. Treatment should slowly move forward, making sure not to push children too far. […] Treatment can help break this pattern by providing opportunities for children to speak in anxiety-inducing situations. […] In a complete treatment plan, it’s important to involve the child’s school. […] For children with selective mutism, an IEP can provide specific accommodations to help them overcome communication issues in the classroom, such as using other forms of communication, gradual exposure tools, and support environments to boost verbal communication.

• #29 Selective Mutism: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/selective-mutism

  With treatment, its possible to reduce the severity and frequency of symptoms. With early diagnosis and treatment, some people may see the symptoms vanish entirely. […] Mental health therapy (especially cognitive behavioral therapy, or CBT) is generally the first option. Its also the most likely to help. Behavioral therapy helps you understand and cope with anxiety and other distressing feelings that cause SM symptoms. It can also help with modifying tantrums or other disruptive behaviors that can happen with SM. […] Speech therapy involves working with a speech therapist or another specialized healthcare professional. It can be particularly helpful when SM happens with speech disorders. […] Medications can be part of treatment for SM, especially if mental health or speech therapy arent effective on their own. […] The outlook for SM is good overall, especially with early diagnosis and treatment. When diagnosed and treated in early childhood, most people with SM can overcome or learn to cope with it, so it doesnt affect their lives as much (or at all).

• #30 Selective Mutism

  https://www.asha.org/practice-portal/clinical-topics/selective-mutism/?srsltid=AfmBOoob5Ffh24FFdhWMbHIbNCayF3xp1Dg9G-NJgp3SdBnz7Te3gcdK

  Selective mutism is a complex anxiety disorder that affects pragmatic language. […] Speech-language pathologists are integral members of an interprofessional team and often collaborate with school-based teams (e.g., teachers, guidance counselor, school staff) and behavioral health professionals (e.g., school or clinical psychologist, psychiatrist, school social worker). Collaboration between the speech-language pathologist and assigned team members is particularly important for appropriate assessment and treatment because selective mutism is an anxiety-based disorder that can significantly impact the ability to access speech and language skills. […] Speech-language pathologists (SLPs) play an integral role in the screening, assessment, diagnosis, and treatment of individuals with selective mutism.

• #31 Selective Mutism | Therapies For Kids

  https://therapiesforkids.com.au/blog/selective-mutism/

  A child with selective mutism should be seen by a speech-language pathologist (SLP), in addition to a paediatrician and a psychologist or psychiatrist. These professionals will work as a team with teachers, family, and your child. […] Once assessment is complete our speech and language Pathologist will offer intervention. This may be a combination of strategies including; creating a behavioural treatment program, focusing on specific speech and language problems, working in the child’s classroom with teachers. […] A behavioral treatment program may include the following: Stimulus fading: involve the child in a relaxed situation with someone they talk to freely, and then very gradually introduce a new person into the room; Shaping: use a structured approach to reinforce all efforts by the child to communicate, (e.g., gestures, mouthing or whispering) until audible speech is achieved; Self-modeling technique: have child watch videotapes of himself or herself performing the desired behavior (e.g., communicating effectively at home) to facilitate self-confidence and carry over this behavior into the classroom or setting where mutism occurs.

• #32 Treating Selective Mutism – Selective Mutism Association

  https://www.selectivemutism.org/treating-selective-mutism/

  Several protocols have included a variety of these behavioral components that have been found to be effective in reducing SM behaviors and anxiety across settings. […] A medical doctor such as a psychiatrist or pediatrician may prescribe medications to address the underlying cause of the child being nonverbal in certain situations: anxiety. Medication is most effective when combined with behavioral and/or other psychological strategies above, especially to help the child maintain improvement over time. […] Since speech and language impairments can co-occur with SM, speech-language pathologists (SLPs) may contribute to the treatment benefits of children with selective mutism. Additionally, SLPs are trained to work with children on pragmatic language skills, which can be greatly impacted by selective mutism.

• #33 Selective Mutism

  https://www.asha.org/practice-portal/clinical-topics/selective-mutism/?srsltid=AfmBOoob5Ffh24FFdhWMbHIbNCayF3xp1Dg9G-NJgp3SdBnz7Te3gcdK

  ParentChild Interaction Therapy for children with selective mutism aims to increase verbal interactions in social settings and decrease avoidance behaviors. […] Social Communication Anxiety Treatment (S-CAT) uses a multimodal approach to increase the social engagement, verbal communication, and confidence of the person with selective mutism. […] The clinician can incorporate the Ritual Sound Approach into the S-CAT program to systematically increase the child’s comfort with making sounds and words. […] This integrated approach emphasizes participation in social engagement (nonverbal and verbal) at increasingly difficult levels. […] Generalizing spontaneous speech to different settings and communication partners may involve having the individual with selective mutism rate situations and people from most difficult to least difficult in a hierarchy.

• #34 Selective Mutism: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/selective-mutism

  With treatment, its possible to reduce the severity and frequency of symptoms. With early diagnosis and treatment, some people may see the symptoms vanish entirely. […] Mental health therapy (especially cognitive behavioral therapy, or CBT) is generally the first option. Its also the most likely to help. Behavioral therapy helps you understand and cope with anxiety and other distressing feelings that cause SM symptoms. It can also help with modifying tantrums or other disruptive behaviors that can happen with SM. […] Speech therapy involves working with a speech therapist or another specialized healthcare professional. It can be particularly helpful when SM happens with speech disorders. […] Medications can be part of treatment for SM, especially if mental health or speech therapy arent effective on their own. […] The outlook for SM is good overall, especially with early diagnosis and treatment. When diagnosed and treated in early childhood, most people with SM can overcome or learn to cope with it, so it doesnt affect their lives as much (or at all).

• #35 Selective Mutism | Fact Sheet – ABCT – Association for Behavioral and Cognitive Therapies

  https://www.abct.org/fact-sheets/selective-mutism/

  Cognitive strategies can be useful for older children when they can reflect upon their thoughts. Techniques include recognizing bodily cues of anxiety, identifying and challenging negative thought patterns, and putting together a coping plan for anxiety so that it is less likely to interfere with speaking behavior. […] Medication has been useful in the treatment of children with SM. Medication is recommended for children with more severe difficulties, if the child has had SM for a long time, and/or if the child is not responding well to behavioral therapy. Medication should be used in combination with behavioral therapy to help children participate more actively in treatment. SSRIs (selective serotonin reuptake inhibitors) are recommended as first-line medications because they are effective for anxiety and relatively well tolerated by children.

• #36 Selective mutism – NHS

  https://www.nhs.uk/mental-health/conditions/selective-mutism/

  Behavioural therapy concentrates on helping combat current difficulties using a gradual step-by-step approach to help conquer fears. […] There are several techniques based on CBT and behavioural therapy that are useful in treating selective mutism. […] Medicine is only really appropriate for older children, teenagers and adults whose anxiety has led to depression and other problems. […] Medicine should never be prescribed as an alternative to environmental changes and behavioural approaches. Though some health professionals recommend using a combination of medicine and behavioural therapies in adults with selective mutism.

• #37 Treatment Statement | Selective Mutism Association

  https://www.selectivemutism.org/treatment-statement/

  A team approach is crucial to the child’s overall success. […] Treatment should involve helping the child to increase awareness of his or her anxiety in a manner that is developmentally appropriate. […] Medication may or may not be needed. If medication is prescribed, it should be used in combination with a multimodal, team treatment approach as described herein. […] Nutritional therapy supplements and herbal remedies should be used with caution. […] Due to the nature of SM, treatment should include interventions and goals within the school and community settings, not just the treating professional’s office. […] Generally, it is not advised to place children with SM in self-contained or special education classrooms based solely on their selective mutism diagnosis, nor are educational environments with limited opportunities for social interaction advised.

• #38 How to Treat Selective Mutism: Best Practices and Effective Treatments    :: The Baker Center For Children and Families

  https://www.bakercenter.org/selective-mutism2

  Medication for selective mutism has been used in combination with therapy if the child has severe difficulties, if they have not been respondent to behavioral approaches, or if they have been struggling with selective mutism for a long time. The goal of medication for these kids is to help reduce high levels of distress so that they can better engage with behavioral therapy skills.

• #39 Selective Mutism: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/selective-mutism

  With treatment, its possible to reduce the severity and frequency of symptoms. With early diagnosis and treatment, some people may see the symptoms vanish entirely. […] Mental health therapy (especially cognitive behavioral therapy, or CBT) is generally the first option. Its also the most likely to help. Behavioral therapy helps you understand and cope with anxiety and other distressing feelings that cause SM symptoms. It can also help with modifying tantrums or other disruptive behaviors that can happen with SM. […] Speech therapy involves working with a speech therapist or another specialized healthcare professional. It can be particularly helpful when SM happens with speech disorders. […] Medications can be part of treatment for SM, especially if mental health or speech therapy arent effective on their own. […] The outlook for SM is good overall, especially with early diagnosis and treatment. When diagnosed and treated in early childhood, most people with SM can overcome or learn to cope with it, so it doesnt affect their lives as much (or at all).

• #40 Treatment of selective mutism: a 5-year follow-up study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6060963/

  This is the first prospective follow-up study conducted 5 years after the end of a cognitive behavioral treatment for children with SM, in a reasonably large sample. Clinical gains were largely maintained at follow-up, as rated by both a child psychiatrist, teachers, and parents. A significant reduction of comorbid anxiety disorders was found, and the children reported good quality of life. However, half of the children still described it as somewhat challenging to talk at school/outside home, although the majority did speak. Several children had persistent SM symptoms, speaking to the need for the study of additional interventions to help such individuals.

• #41 Treatment of selective mutism: a 5-year follow-up study – PubMed

  https://pubmed.ncbi.nlm.nih.gov/29357099/

  Selective mutism (SM) has been defined as an anxiety disorder in the diagnostic and statistical manual of mental disorders (DSM-5). Cognitive behavioral therapy (CBT) is the recommended approach for SM, but prospective long-term outcome studies are lacking. […] We have developed a school-based CBT intervention previously found to increase speech in a pilot efficacy study and a randomized controlled treatment study. […] In the present study, we provide 5-year outcome data for 30 of these 32 children with SM who completed the same CBT for mean 21 weeks (sd 5, range 8-24) at mean age 6 years (10 boys). […] At the 5-year follow-up, 21 children were in full remission, five were in partial remission and four fulfilled diagnostic criteria for SM. […] Treatment gains were maintained on the teacher- and parent questionnaires. […] These results point to the long-term effectiveness of CBT for SM, but also highlight the need to develop more effective interventions for the subset of children with persistent symptoms.

• #42 Selective Mutism: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/selective-mutism

  With treatment, its possible to reduce the severity and frequency of symptoms. With early diagnosis and treatment, some people may see the symptoms vanish entirely. […] Mental health therapy (especially cognitive behavioral therapy, or CBT) is generally the first option. Its also the most likely to help. Behavioral therapy helps you understand and cope with anxiety and other distressing feelings that cause SM symptoms. It can also help with modifying tantrums or other disruptive behaviors that can happen with SM. […] Speech therapy involves working with a speech therapist or another specialized healthcare professional. It can be particularly helpful when SM happens with speech disorders. […] Medications can be part of treatment for SM, especially if mental health or speech therapy arent effective on their own. […] The outlook for SM is good overall, especially with early diagnosis and treatment. When diagnosed and treated in early childhood, most people with SM can overcome or learn to cope with it, so it doesnt affect their lives as much (or at all).

• #43 Selective mutism – NHS

  https://www.nhs.uk/mental-health/conditions/selective-mutism/

  With appropriate handling and treatment, most children are able to overcome selective mutism. But the older they are when the condition is diagnosed, the longer it will take. […] Treatment does not focus on the speaking itself, but reducing the anxiety associated with speaking. […] This means: not letting the child know you’re anxious, reassuring them that they’ll be able to speak when they’re ready, concentrating on having fun, praising all efforts the child makes to join in and interact with others, such as passing and taking toys, nodding and pointing, not showing surprise when the child speaks, but responding warmly as you would to any other child. […] Cognitive behavioural therapy (CBT) helps a person focus on how they think about themselves, the world and other people, and how their perception of these things affects their thoughts and feelings. CBT also challenges fears and preconceptions through graded exposure.

• #44 Adult Selective Mutism: Causes and How to Handle It

  https://www.healthline.com/health/anxiety/adult-selective-mutism

  Selective mutism generally doesn’t go away on its own, Scharfstein says, and this makes it important to address your symptoms in a way that feels right for you. […] According to Scharfstein, treatment can significantly improve your symptoms and quality of life, often within a matter of months. […] Treatment for selective mutism usually involves one or more of the following: cognitive behavioral therapy (CBT), an approach that focuses on changing negative thought patterns about yourself, other people, and the world around you. […] Speech therapy, an approach that your care team may recommend when a speech disorder or other communication difficulties play a part in selective mutism. […] Exposure therapy, an approach that uses a gradual step-by-step process to help you conquer fears in a safe environment.

• #45 Adult Selective Mutism: Causes and How to Handle It

  https://www.healthline.com/health/anxiety/adult-selective-mutism

  Selective mutism generally doesn’t go away on its own, Scharfstein says, and this makes it important to address your symptoms in a way that feels right for you. […] According to Scharfstein, treatment can significantly improve your symptoms and quality of life, often within a matter of months. […] Treatment for selective mutism usually involves one or more of the following: cognitive behavioral therapy (CBT), an approach that focuses on changing negative thought patterns about yourself, other people, and the world around you. […] Speech therapy, an approach that your care team may recommend when a speech disorder or other communication difficulties play a part in selective mutism. […] Exposure therapy, an approach that uses a gradual step-by-step process to help you conquer fears in a safe environment.

• #46 Adult Selective Mutism: Causes and How to Handle It

  https://www.healthline.com/health/anxiety/adult-selective-mutism

  Selective mutism generally doesn’t go away on its own, Scharfstein says, and this makes it important to address your symptoms in a way that feels right for you. […] According to Scharfstein, treatment can significantly improve your symptoms and quality of life, often within a matter of months. […] Treatment for selective mutism usually involves one or more of the following: cognitive behavioral therapy (CBT), an approach that focuses on changing negative thought patterns about yourself, other people, and the world around you. […] Speech therapy, an approach that your care team may recommend when a speech disorder or other communication difficulties play a part in selective mutism. […] Exposure therapy, an approach that uses a gradual step-by-step process to help you conquer fears in a safe environment.

• #47 Adult Selective Mutism: Causes and How to Handle It

  https://www.healthline.com/health/anxiety/adult-selective-mutism

  Your care team may also recommend anti-anxiety or antidepressant medications as a supplement to therapy if you receive a co-diagnosis of anxiety or depression, Boger says. […] A support group typically consists of other people who experience the same or similar symptoms as you. […] While selective mutism usually shows up in childhood, this condition can also affect adults. […] Selective mutism goes beyond shyness or a dislike of public speaking. If you live with this condition, you don’t make a choice not to talk. Rather, you may find it impossible to speak around people you don’t know. […] It’s possible to feel more comfortable speaking by gradually exposing yourself to talking in social situations. If this feels challenging to do on your own, a therapist can offer more support by helping you address the root causes and triggers of selective mutism and explore strategies that can make a difference.

• #48 Adult Selective Mutism: Causes and How to Handle It

  https://www.healthline.com/health/anxiety/adult-selective-mutism

  Your care team may also recommend anti-anxiety or antidepressant medications as a supplement to therapy if you receive a co-diagnosis of anxiety or depression, Boger says. […] A support group typically consists of other people who experience the same or similar symptoms as you. […] While selective mutism usually shows up in childhood, this condition can also affect adults. […] Selective mutism goes beyond shyness or a dislike of public speaking. If you live with this condition, you don’t make a choice not to talk. Rather, you may find it impossible to speak around people you don’t know. […] It’s possible to feel more comfortable speaking by gradually exposing yourself to talking in social situations. If this feels challenging to do on your own, a therapist can offer more support by helping you address the root causes and triggers of selective mutism and explore strategies that can make a difference.

• #49 Selective Mutism

  https://www.asha.org/practice-portal/clinical-topics/selective-mutism/?srsltid=AfmBOoob5Ffh24FFdhWMbHIbNCayF3xp1Dg9G-NJgp3SdBnz7Te3gcdK

  Selective mutism is a complex anxiety disorder that affects pragmatic language. […] Speech-language pathologists are integral members of an interprofessional team and often collaborate with school-based teams (e.g., teachers, guidance counselor, school staff) and behavioral health professionals (e.g., school or clinical psychologist, psychiatrist, school social worker). Collaboration between the speech-language pathologist and assigned team members is particularly important for appropriate assessment and treatment because selective mutism is an anxiety-based disorder that can significantly impact the ability to access speech and language skills. […] Speech-language pathologists (SLPs) play an integral role in the screening, assessment, diagnosis, and treatment of individuals with selective mutism.

• #50 Selective Mutism | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions—pediatrics/s/selective-mutism.html

  Treatment varies based on the needs of your child, and may include: […] With treatment, a child is likely to stop having selective mutism. With no treatment, the speaking problems are more likely to continue. […] A pediatrician, speech-language pathologist, and a psychologist may work together to diagnose and treat the condition. […] Your child might need a set of different types of treatment. […] With treatment, most children overcome selective mutism.

• #51 Selective Mutism Service | NYU Langone Health

  https://nyulangone.org/locations/child-study-center/selective-mutism-service

  Some children freely participate in conversations with family and friends, but fall silent when they are in stressful or unfamiliar social situations. This is more than just shynessits selective mutism, a form of social anxiety, in which children struggle to speak consistently. This can affect a childs ability to build relationships, enjoy activities, and excel in school. […] At the Selective Mutism Service at the Child Study Center, part of Hassenfeld Childrens Hospital at NYU Langone, we carefully evaluate your child and determine the treatment options best suited to their needs, including behavior therapy, cognitive behavior therapy, family therapy, medication, and combinations of these methods in an individualized plan. […] Behavior therapy helps children with selective mutism to overcome anxiety by gradually exposing them to speaking in feared social situations and providing high doses of positive reinforcement for meeting speaking goals.

• #52 Treating Selective Mutism – Selective Mutism Association

  https://www.selectivemutism.org/treating-selective-mutism/

  Several protocols have included a variety of these behavioral components that have been found to be effective in reducing SM behaviors and anxiety across settings. […] A medical doctor such as a psychiatrist or pediatrician may prescribe medications to address the underlying cause of the child being nonverbal in certain situations: anxiety. Medication is most effective when combined with behavioral and/or other psychological strategies above, especially to help the child maintain improvement over time. […] Since speech and language impairments can co-occur with SM, speech-language pathologists (SLPs) may contribute to the treatment benefits of children with selective mutism. Additionally, SLPs are trained to work with children on pragmatic language skills, which can be greatly impacted by selective mutism.

• #53 Guide to Selective Mutism in Children – Child Mind Institute

  https://childmind.org/guide/parents-guide-how-to-help-a-child-with-selective-mutism/

  It’s important that everyone in a child’s life be involved with treatment because SM is a disorder that other people tend to adapt to, which can actually make it harder to treat. […] Treatment helps reverse this by giving kids experience speaking in situations where they feel anxious. […] As part of a comprehensive treatment program, it is extremely important to get a child’s school on board with treatment. […] Behavioral treatment is the gold standard for treating selective mutism, but medication can be helpful for kids with the disorder who aren’t making sufficient gains with therapy alone. […] Kids who have had SM for longer will be accustomed to not speaking in public, and their parents, teachers and other caregivers will have adapted to working around their avoidance. […] Selective mutism is more common among children who speak a second language.

• #54 Selective Mutism Service – Child Mind Institute

  https://childmind.org/care/areas-of-expertise/anxiety-disorders-center/selective-mutism-service/

  An innovative program that helps children with SM overcome their symptoms. […] The Child Mind Institute’s Selective Mutism Service is an innovative program that helps children with SM overcome their symptoms using state of the art evidence-based behavioral interventions. […] Treatment uses specialized behavior therapy techniques that prompt speech and then reinforce successful speaking experiences with lots of labeled praise and small incentives. […] We teach parents the skills kids are learning in therapy and help them look for opportunities to reinforce those skills at home. We provide live coaching for parents to make sure they master the skills. […] We guide the child to do “brave talking” by systematically bringing the therapist closer while the parent and child play, then gradually fade the parent out of the room.

• #55 Silent Suffering: Children with Selective Mutism – The Professional Counselor

  https://tpcjournal.nbcc.org/silent-suffering-children-with-selective-mutism/

  Due to the complex nature of this disorder, there exists strong support for treatment programs for selective mutism to be multifaceted, address anxiety in a variety of settings, and involve teachers, peers, parents, and other family members during the treatment process. […] Early, accurate diagnosis and intervention are crucial to overcoming selective mutism regardless of the type of treatment program. Research suggests that treatment for this disorder is most effective if it begins as soon as symptoms of the disorder become apparent, thus minimizing the amount of negative reinforcement for these behaviors. […] School personnel, especially teachers, play crucial roles in the treatment of selective mutism. […] As described in this article, selective mutism is a complex psychological disorder with an unknown origin. There is general agreement that selective mutism is characterized by a child’s inability to speak in certain social settings despite the ability to speak in other situations. Nonetheless, there is disagreement among researchers regarding the most efficient and definitive treatment approach. Treatment has included a variety of psychodynamic, behavioral, cognitive-behavioral, pharmacological, and family systems methods.

• #56 Selective mutism – NHS

  https://www.nhs.uk/mental-health/conditions/selective-mutism/

  With appropriate handling and treatment, most children are able to overcome selective mutism. But the older they are when the condition is diagnosed, the longer it will take. […] Treatment does not focus on the speaking itself, but reducing the anxiety associated with speaking. […] This means: not letting the child know you’re anxious, reassuring them that they’ll be able to speak when they’re ready, concentrating on having fun, praising all efforts the child makes to join in and interact with others, such as passing and taking toys, nodding and pointing, not showing surprise when the child speaks, but responding warmly as you would to any other child. […] Cognitive behavioural therapy (CBT) helps a person focus on how they think about themselves, the world and other people, and how their perception of these things affects their thoughts and feelings. CBT also challenges fears and preconceptions through graded exposure.

• #57 Selective mutism treatment – Priory

  https://www.priorygroup.com/mental-health/selective-mutism-treatment

  Selective mutism usually stems from your child associating talking with a negative experience. […] There is no specific medication to treat selective mutism. However, medication may be appropriate for the treatment of other disorders associated with selective mutism, including anxiety or depression. […] If you think that your child may be showing signs of selective mutism, and if you’re waiting to receive professional support, the following tips may help you to manage this condition: […] Here at Priory, we understand that selective mutism can severely disrupt your child’s development and quality of life. Early diagnosis and treatment can help them overcome these symptoms, allowing them to grow into adolescence and adulthood with increased self-confidence and happiness.

• #58 Guide to Selective Mutism in Children – Child Mind Institute

  https://childmind.org/guide/parents-guide-how-to-help-a-child-with-selective-mutism/

  It’s important that everyone in a child’s life be involved with treatment because SM is a disorder that other people tend to adapt to, which can actually make it harder to treat. […] Treatment helps reverse this by giving kids experience speaking in situations where they feel anxious. […] As part of a comprehensive treatment program, it is extremely important to get a child’s school on board with treatment. […] Behavioral treatment is the gold standard for treating selective mutism, but medication can be helpful for kids with the disorder who aren’t making sufficient gains with therapy alone. […] Kids who have had SM for longer will be accustomed to not speaking in public, and their parents, teachers and other caregivers will have adapted to working around their avoidance. […] Selective mutism is more common among children who speak a second language.

• #59 Treatment Tips for Working with Selective Mutism in the School Setting | Plural Publishing

  https://www.pluralpublishing.com/blog/treatment-tips-working-selective-mutism-school-setting?srsltid=AfmBOoqV6u04j77bEbHPK-qNR-k774inqde8zYv6nKe6Rr08jHTb8E47

  Selective mutism (SM) is an anxiety-based childhood disorder that prevents a child from speaking in specific situations […] Research indicates that children diagnosed with SM are more likely to present with underlying speech and/or language deficits […] However, there is hope: research has also shown that children who receive appropriate treatment can and do make communicative gains and can be successful speakers in the school environment […] Selective mutism is a complex disorder that demands involvement from an interdisciplinary team of professionals in order to be treated successfully […] It is critical to establish a key worker in the school setting […] Fading in new communication partners is a critical skill for the key worker to master […] Opportunities for communication must be carefully and intentionally scaffolded in order to balance an appropriate level of challenge for the child with the need to keep success rates high in order to encourage a sense of self-efficacy about the child’s own communication skills and build momentum to keep moving forward

• #60 Treatment Statement | Selective Mutism Association

  https://www.selectivemutism.org/treatment-statement/

  A team approach is crucial to the child’s overall success. […] Treatment should involve helping the child to increase awareness of his or her anxiety in a manner that is developmentally appropriate. […] Medication may or may not be needed. If medication is prescribed, it should be used in combination with a multimodal, team treatment approach as described herein. […] Nutritional therapy supplements and herbal remedies should be used with caution. […] Due to the nature of SM, treatment should include interventions and goals within the school and community settings, not just the treating professional’s office. […] Generally, it is not advised to place children with SM in self-contained or special education classrooms based solely on their selective mutism diagnosis, nor are educational environments with limited opportunities for social interaction advised.

• #61 Treatment of selective mutism: a 5-year follow-up study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6060963/

  Using this school-based CBT, we found a highly favorable treatment outcome in a pilot efficacy study of seven preschool children with longstanding SM. […] We also found a significant treatment effect in an RCT study of 24 children with SM, 39 years of age, with no change in wait-list controls, using this school-based CBT applied by local therapists at community health clinics all over Southern Norway. […] In the present study, we found a significant reduction in comorbid social phobia as this was found to be a negative predictor of outcome in the CAMS study. […] The present study demonstrates that the effect of a school-based CBT for SM is largely upheld 5 years after end of treatment in children with SM aged 39 years at baseline. […] Our study is different from the RCT study using CBT trained therapists, working at one clinic under direct guidance by the principal investigator, or the two uncontrolled studies where all children were treated by one particularly dedicated therapist recruiting patients from private practice.

• #62 Selective Mutism: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/selective-mutism

  With treatment, its possible to reduce the severity and frequency of symptoms. With early diagnosis and treatment, some people may see the symptoms vanish entirely. […] Mental health therapy (especially cognitive behavioral therapy, or CBT) is generally the first option. Its also the most likely to help. Behavioral therapy helps you understand and cope with anxiety and other distressing feelings that cause SM symptoms. It can also help with modifying tantrums or other disruptive behaviors that can happen with SM. […] Speech therapy involves working with a speech therapist or another specialized healthcare professional. It can be particularly helpful when SM happens with speech disorders. […] Medications can be part of treatment for SM, especially if mental health or speech therapy arent effective on their own. […] The outlook for SM is good overall, especially with early diagnosis and treatment. When diagnosed and treated in early childhood, most people with SM can overcome or learn to cope with it, so it doesnt affect their lives as much (or at all).

• #63 How to Treat Selective Mutism: Best Practices and Effective Treatments    :: The Baker Center For Children and Families

  https://www.bakercenter.org/selective-mutism2

  Kids with selective mutism are most often diagnosed between the ages of 3 and 8 years old. Identifying selective mutism and intervening at an early age provides the child with more opportunities for successful treatment and it can help them avoid a long and challenging future of potential academic, social, and emotional repercussions. Early intervention is key, and beginning interventions at the time that the symptoms appear has been shown to be the most effective timing for treatment success. Beginning treatment early can minimize the amount of time that the child is experiencing reinforcements and accommodations for their mutism. […] Many treatments for selective mutism, and other anxiety disorders, encourage brave behaviors and the use of an approach model. In these treatments, clinicians and caregivers use skills to help the child approach situations that make them anxious, which in turn will teach the child that its not so bad after all.

• #64 Treatment of selective mutism: a 5-year follow-up study – PubMed

  https://pubmed.ncbi.nlm.nih.gov/29357099/

  Selective mutism (SM) has been defined as an anxiety disorder in the diagnostic and statistical manual of mental disorders (DSM-5). Cognitive behavioral therapy (CBT) is the recommended approach for SM, but prospective long-term outcome studies are lacking. […] We have developed a school-based CBT intervention previously found to increase speech in a pilot efficacy study and a randomized controlled treatment study. […] In the present study, we provide 5-year outcome data for 30 of these 32 children with SM who completed the same CBT for mean 21 weeks (sd 5, range 8-24) at mean age 6 years (10 boys). […] At the 5-year follow-up, 21 children were in full remission, five were in partial remission and four fulfilled diagnostic criteria for SM. […] Treatment gains were maintained on the teacher- and parent questionnaires. […] These results point to the long-term effectiveness of CBT for SM, but also highlight the need to develop more effective interventions for the subset of children with persistent symptoms.

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