Understanding the Outcome of Children who Selectively Do not Speak: A Retrospective Approach

Little is known about the longer-term outcomes of children diagnosed with selective mutism (SM) and/or social anxiety disorder (SAD); two anxiety disorders characterized by difficulties speaking in social situations despite being able to speak in other contexts.

This retrospective study aimed to descriptively evaluate the long-term SM and SAD diagnostic and symptom severity outcomes in a clinical youth sample.

Retrospective follow-up interviews were conducted with 31 parents of children/youth aged four to 14 years previously referred to a specialized anxiety clinic and diagnosed with SM and/or SAD (mean follow-up 4.2 years). Clinician and parent-report measures were used to determine follow-up diagnosis and symptom severity.

The majority (71%; n=22) of participants still met criteria for SM and/or SAD. Of these, 11 had SAD only; nine had a comorbid diagnosis of SM and SAD; and two had SM only. At follow-up 42% (n=13) were receiving school supports. Close to half (48%; n=15) of parents continued to express concerns about their child's anxiety. Almost all (90%, n=28) youth had attempted some form of treatment, with group cognitive behavioural therapy (CBT) reported as the most common form of treatment tried (48%, n=15). Almost thirty percent (29%, n=9) reported taking anxiety medications in the past with several (13%, n=4) still on medications at follow-up.

Study results suggest that symptoms of SM and SAD persist in the longer-term. Further investigation into the differences between diagnostic groups and their long-term treatment outcomes is clearly warranted.