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Silent suffering: understanding and treating children with selective mutism
1University of Toronto, Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada. katharina.manassis@sickkids.ca
Expert Review of Neurotherapeutics
|February 13, 2009
Summary
Selective mutism (SM) in children causes significant academic and social issues. Behavioral interventions and medications like fluoxetine show promise, but further research is needed for optimal treatment.
Area of Science:
- Pediatric Psychology
- Child Psychiatry
- Speech-Language Pathology
Background:
- Selective mutism (SM) is characterized by consistent speech restriction in specific social settings.
- This condition can lead to considerable academic and social difficulties for affected children.
- While considered rare, SM is present in elementary schools, necessitating effective assessment and intervention.
Purpose of the Study:
- To outline the assessment process for diagnosing SM.
- To identify and describe current intervention strategies for SM.
- To highlight areas for future research in SM treatment.
Main Methods:
- Diagnostic assessment to confirm SM and rule out other conditions.
- Multidisciplinary interventions focusing on anxiety reduction and speech promotion.
- Pharmacological interventions, including selective serotonin-reuptake inhibitors (SSRIs).
Main Results:
- Behavioral interventions and multimodal treatments show symptomatic improvement.
- SSRIs, particularly fluoxetine, are effective for severe cases.
- Treatment persistence of SM or anxiety symptoms is common.
Conclusions:
- Multidisciplinary approaches involving schools and families are crucial.
- Further research is needed on targeted treatments and optimal family/school involvement.
- Improved treatment strategies are required to enhance outcomes for children with SM.
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