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Selective Mutism Treatment

(Also Known As: Selective Mute Treatment, Mutism Treatment, Elective Mutism Treatment)

(Reviewed by: Paul Peterson, Licensed Therapist)

What are the available treatment for Selective Mutism?

Psychotherapy: Current treatment applies a multimodal approach using individual, cognitive-behavioral, behavioral, family participation, and school involvement.

  • Preschool children may also benefit from a therapeutic nursery.
  • School-age children are recommended to have individual cognitive-behavioral therapy as a first-line treatment.
  • Family education and cooperation prove beneficial to the development of communication skills of SM children. 13

Pharmacotherapy: Certain medications that address symptoms of anxiety and social phobia (extreme social shyness) have been used safely and successfully.

  • Fluoxetine, the generic version of Prozac is commonly prescribed nowadays for selective mutism. It is usually combined with cognitive or behavioral therapies. Fluoxetine and other antidepressants in the class known as selective serotonin reuptake inhibitors, or (SSRIs), can loosen inhibitions which is a factor in explaining their usefulness for social anxiety. These medications are now an accepted component of treatment when psychosocial interventions are not enough to manage the symptoms. However, this treatment is not equally beneficial for everyone. After starting on antidepressants some children show improvement in social environments but can begin exhibiting inappropriate behaviors, which end when the medication is withdrawn. 14

Selective Mutism can persist from weeks to years. Most parents often think that the child is just refusing to speak, but in a real SM condition, the child is truly unable to speak in certain settings. As the child matures, continued therapy and intervention for shyness and social anxiety into adolescence and adulthood may be required to reduce the inability to speak and thus develop better communication skills. Behavioral and cognitive therapies that rely on reducing sensitivity by gradual exposure to distressing situations, with a lot of positive reinforcement, can also be successful, either on their own or combined with antidepressants.

Clinicians must be certain in their diagnoses of children with SM as having speech or language disorders. Misdiagnoses would mean giving incorrect treatment and thus are unable to deal with psychological problems underlying the failure to speak. The best treatments appear to be behavioral methods executed in a multidisciplinary setting. It is expected that future research will help create a more consistent profile regarding the prevalence of SM which in turn may contribute to improvements in early detection and early treatment of the disorder. 15

Could You Have Selective Mutism?

Selective Mutism Topics

Related Conditions

Anxiety Disorder NOS – Irrational Fears, Anxiety, Phobia, Depression, Stress
Reactive Attachment Disorder – Inappropriate Ways to Relate Socially, Failure to Form Normal Attachment to Caregivers During Childhood
Separation Anxiety Disorder – Anxiety From Separation to a Care Giver, Strong Emotional Attachment
Social Anxiety Disorder – Social Phobia, Distressed, Depression, Anxious, Chronic Fear, Panic Attack, Intense Fear and Anxiety