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Clinical Perspectives on the Treatment of Selective Mutism

Author(s): Robert L. Schum, Ph.D

Journal: Journal of Speech and Language Pathology and Applied Behavior Analysis
ISSN 1932-4731

Volume: 1;
Issue: 2;
Start page: 66;
Date: 2006;
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Keywords: Selective Mutism | Operant Conditioning | Cognitive Behavior Therapy | Communication Hierarchy | Talking Scale | Talking Map | Parent Counseling | Collaboration.

Selective mutism is a childhood disorder characterized by a failure to speak in some but not all of the contexts where speaking is normally expected. It is commonly associated with co-occurring anxiety, both on the part of the child and on the part of one or more family members. The prevailing opinion on treatment recommends medication, cognitive-behavioral therapy (CBT) and family counseling. However, treatment efficacy research is extremely limited. Further, since selective mutism is often first identified during the preschool years, CBT must be modified to match a child’s developmental level. This paper summarizes the nature and prevalence of selective mutism, techniques used to treat this disorder, and issues in need of research. The discussion of behavioral treatment techniques is based on the literature and on the author’s clinical experience.

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