Silent suffering: understanding and treating children with selective mutism

  title={Silent suffering: understanding and treating children with selective mutism},
  author={Katharina Manassis},
  journal={Expert Review of Neurotherapeutics},
  pages={235 - 243}
  • K. Manassis
  • Published 1 February 2009
  • Psychology
  • Expert Review of Neurotherapeutics
Children with selective mutism (SM) restrict speech in some social environments, often resulting in substantial academic and social impairment. Although SM is considered rare, one or more children with SM can be found in most elementary schools. Assessment is performed to confirm the diagnosis, rule out psychological and medical factors that may account for the mutism, ascertain comorbid and exacerbating conditions needing treatment, and develop an intervention plan. Interventions are often… 
Treatment of selective mutism based on cognitive behavioural therapy, psychopharmacology and combination therapy – a systematic review
Pharmacologic treatment and especially CBT showed promising results supported by some degree of evidence, which combination treatment lacks, yet small numbers, few RCTs, heterogeneous study designs, lack of consistent measures, short treatment and follow-up periods, generally limits the evidence.
Symptoms of Selective Mutism in Non-clinical 3- to 6-Year-Old Children: Relations With Social Anxiety, Autistic Features, and Behavioral Inhibition
It can be concluded that while the involvement of social anxiety is unambiguous in SM, autism-related problems are also implicated and behavioral inhibition seems to play a key role in the non-speaking behavior of non-clinical young children.
A randomized controlled trial of a home and school-based intervention for selective mutism - defocused communication and behavioural techniques.
Greater improvement in the younger age group highlights the importance of an early intervention in selective mutism and significantly improved speech.
Application of a web-based cognitive-behavioural therapy programme for the treatment of selective mutism in Singapore: a case series study.
Findings from the present study provide support for the use of a web-based CBT programme in improving speech and decreasing the severity of SM among affected children.
The Cochrane Library and the treatment of childhood and adolescent anxiety disorders: an overview of reviews
There is a body of literature in the CDSR to support evidence-based treatment decisions for pediatric anxiety disorders; however, as this is a field that is rapidly expanding its knowledge base, efforts must be made to ensure the most recent evidence is consistently incorporated.
Ties of silence - Family lived experience of selective mutism in identical twins
In the interview, the children conveyed experiences that even the parents were unaware of and revealed examples of daily life-traumas for which they were unable to obtain support and help, and the whole family was trapped in the silence.
Web-based CBT for the Treatment of Selective Mutism: Results from a Pilot Randomized Controlled Trial in Singapore
Introduction: Cognitive behavioral therapy (CBT) approaches have shown promise for some children with Selective Mutism (SM), but to date there are limited published randomized controlled trials (RCT)
Feasibility trial of virtual reality exposure therapy for selective mutism
Significant improvement in overall functioning were found at post-treatment and follow-up measures, but there were no significant changes in parent-rated speech frequency and anxiety measures, which support the acceptability of VRET as an adjunct modality of CBT in SM treatment.
Basics of Related Medical Disciplines
Owing to novel high-throughput technologies of DNA sequencing, most patients now can get a genetic diagnosis for several reasons, in the routine workup after failed newborn hearing screening but also in cases of hearing loss manifesting later in life.
Title Application of a web-based cognitive-behavioural therapy programme for the treatment of selective mutism in Singapore : a case series study
Application of a web-based cognitive-behavioural therapy programme for the treatment of selective mutism in Singapore : a case series study. or electronic copy may be made for personal use only.


Comparing Interventions for Selective Mutism: A Pilot Study
  • K. Manassis, R. Tannock
  • Medicine, Psychology
    Canadian journal of psychiatry. Revue canadienne de psychiatrie
  • 2008
The findings suggest the potential benefit of SSRI treatment in severe SM, but randomized comparative treatment studies are indicated.
Helping Your Child with Selective Mutism: Practical Steps to Overcome a Fear of Speaking
This book offers a broad overview of the condition and reviews the diagnostic criteria for the disorder, and explains the steps you can take on your own to encourage your child to speak comfortably in school and in his or her peer group.
When silence is not golden: an integrated approach to selective mutism.
There is a critical need for cross-disciplinary research from the fields of speech-language pathology, psychiatry, and clinical psychology to develop protocols for assessing language and cognitive functioning in children with SM and developing interventions that address psychiatric, communicative, and social aspects of this disorder.
Selective Mutism: Are Primary Care Physicians Missing the Silence?
Behavior modification, pharmacotherapy with SSRIs, and early intervention are viable treatment options for children with selective mutism.
Elective mutism: an analysis of 100 cases.
  • H. Steinhausen, C. Juzi
  • Psychology, Medicine
    Journal of the American Academy of Child and Adolescent Psychiatry
  • 1996
This large series of affected children has identified the most typical features of EM and thereby extends the limited knowledge of this rare disorder of childhood.
Narrative skills in children with selective mutism: an exploratory study.
The findings suggest that SM may involve subtle expressive language deficits that may influence academic performance and raise additional questions for further research.
Fluoxetine treatment of children with selective mutism: an open trial.
Persistent selective mutism presenting with comorbid anxiety disorders may respond to fluoxetine treatment, and improvement at week 9 was inversely correlated with age.
Selective mutism: more than social anxiety?
Findings that children with SM do not report greater social anxiety than other children with a SP diagnosis are replicated and it is suggested that oppositional behaviors may be part of the clinical presentation of a subset of children withSM.
Prevalence and description of selective mutism in immigrant and native families: a controlled study.
In this sample, the disorder appeared to be associated with a combination of a specific diathesis (SAP) with intrinsic (NDD) and/or environmental (family immigration) vulnerabilities and Marital discord appeared toBe a general risk factor for SM.
The sounds of silence: language, cognition, and anxiety in selective mutism.
Social anxiety and language deficits are evident in SM, may predict mutism severity, and should be evaluated in clinical assessment.