Selective Mutism

Treatments

Cognitive Behavioral Therapy           

Treatment Summary: The literature in which I reviewed suggests that treating Selective Mutism (SM) is often a multimodal task including cognitive behavioral therapy (CBT), modeling, and reinforcement. Cases should be individualized to meet the needs of the particular child’s speech/development. In the case of “Bruce”, the clinician first had to break down the verbal barrier between the client and the therapist. For the first couple of sessions Bruce would initiate in play therapy with his mother and brother and progressively the therapist would interact (starting with being just outside the room and ending in actual involvement of the game). Once this verbal communication was established, the rest of the sessions (21 total) focused on multiple facets. These aspects included psycho-education, social skills training, and more reinforcement to name a few. At Bruce’s 6 month follow up he no longer met the DSM criteria for Selective Mutism 

• Reference: Reuther, E. T., Davis, T. I., Moree, B. N., & Matson, J. L. (2011). Treating Selective Mutism Using Modular CBT for Child Anxiety: A Case Study. Journal Of Clinical Child & Adolescent Psychology, 40(1), 156-163. doi:10.1080/15374416.2011.533415 

• Submitter: Brittany Campbell 

Video Self-modeling, Fading, and Reinforcement 

Summary of Treatment: Video self-modeling, fading, and reinforcement is a three-tier approach to the treatment of Selective Mutism that has proven to be effective. Video modeling teaches behaviors or skills by using a video recording as a model. The adolescent views a video recording of themselves performing the behavior or skill successfully. Bork and Bennett (2020) incorporated this model in the treatment of three adolescents diagnosed with Selective Mutism.  During the video self-modeling stage, the adolescents answered questions asked by a familiar adult. The same questions were then asked by an unfamiliar adult. The video was edited to give the child the impression that he or she answered the questions asked by the unfamiliar adult. The video was played over and over until the child became desensitized. Stimulus fading involved exposing the child to a stimulus they feared until they no longer feared it. Self- reinforcement was carried out by allowing the child to reward self with a treat when noticing appropriate behavior conducted such as responding to the adult who was not trusted. After 8 weeks of treatment, verbal communicative behavior increased, and scores on both the Selective Mutism Questionnaire (SMQ) and School Speech Questionnaire (SSQ) increased significantly. 

• Reference: Bork, P., & Bennett, S. (2020). Video self-modeling, fading, and reinforcement: An effective treatment package for children with selective mutism. Clinical Child Psychology & Psychiatry, 25(2), 446.  

• Submitted by: Brinetta Rose