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Updated: Jun 19, 2026

A Treatment Package without Escape Extinction to Address Food Selectivity
Published on: August 21, 2015
Treating youths with selective mutism with an alternating design of exposure-based practice and contingency
Jennifer Vecchio1, Christopher A Kearney
1Department of Psychology, University of Nevada, Las Vegas, NV 89154-5030, USA. chris.kearney@unlv.edu
Abstract:
Selective mutism is a severe childhood disorder involving failure to speak in public situations in which speaking is expected. The present study examined 9 youths with selective mutism treated with child-focused, exposure-based practices and parent-focused contingency management via an alternating treatments design. Broadband measures of functioning were employed, but particular focus was made on behavioral assessment of words spoken audibly and daily in public situations. Treatment ranged from 8 to 32 sessions and resulted in positive end-state functioning for 8 of 9 participants. Broader analyses indicated greater effectiveness for exposure-based practice than contingency management. The results support recent case reports of behavioral treatment for this population but in more rigorous fashion. Clinical and research challenges are discussed, including caveats about length and intensity of treatment for this population and need to develop standardized daily measures.
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