I could really use some adolescent-specific information on selective mutism. I am interested in therapy approaches, manuals, anecdotes, insights, whatever you've got.
Dear carl,
The selective mutism may start earlier and continue into teenage. Here are some ideas. You can always discuss with the authors to the papers here on RG:
Article Social phobia, anxiety, oppositional behavior, social skills...
Article SELECTIVE MUTISM: A PRIMER FOR PARENTS AND EDUCATORS
Article Adult Attachment Style in Mothers of Children with Selective Mutism
Article Selective mutism
Article Selective mutism and temperament: the silence and behavioral...
Incorporating technology into the treatment of a 17-year-old female with selective mutism.
By Bunnell, Brian E.; Beidel, Deborah C.
Clinical Case Studies, Vol 12(4), Aug 2013, 291-306.
Selective mutism (SM) is a relatively rare disorder and is most commonly found among young children. Children and adolescents presenting with SM and its associated features (e.g., social anxiety, social skills deficits) are often challenging to treat, and recent data suggest that SM is characterized by heightened levels of autonomic arousal, often coupled with behavioral avoidance. In this report, we present the case of Nina, a 17-year-old Caucasian female diagnosed with comorbid SM and social anxiety disorder. Standard intervention designed to treat social anxiety disorder (i.e., intensive exposure based on an extinction paradigm) met with a minimal response and no changes in speech behavior. Reconceptualization of the treatment approach led to a decision to focus directly on speech using a graduated exposure (desensitization) paradigm. To create an emotional response incompatible with anxiety, initial desensitization sessions used Apple iPad applications that allowed for engagement in amusing tasks and the pairing of vocalization with positive emotions. Traditional social skills training constituted the final treatment component. Advantages and limitations associated with the various treatment modalities used are discussed as well as recommendations for future clinical research. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Modular cognitive-behavioral treatment of an adolescent female with selective mutism and social phobia: A case study.
doi: http://dx.doi.org/10.1177/1534650112463956
By Christon, Lillian M.; Robinson, Elizabeth M.; Arnold, Cassidy C.; Lund, Hannah G.; Vrana, Scott R.; Southam-Gerow, Michael A.
Clinical Case Studies, Vol 11(6), Dec 2012, 474-491.
Selective mutism (SM), a debilitating disorder usually appearing in childhood, is diagnosed when an individual capable of speaking fails to speak in social situations in which there is an expectation for the individual to speak. There is very little empirical research on the assessment and treatment of SM in adolescents and adults. The case presented in this article applies a developmental adaptation of a modular cognitive-behavioral therapy approach to treat an adolescent female with SM and social phobia. The treatment consisted of 61 sessions, including sessions on psychoeducation, cognitive restructuring, relaxation, exposure, social skills, and parent training. The presenting symptoms, assessment strategy, and treatment elements are covered in detail. The client’s symptoms were assessed via fear hierarchy ratings, self-report and parent-report measures, and client and parent clinical interviews. (PsycINFO Database Record (c) 2013 APA, all rights reserved
Beware of older papers which do not reflect the current understanding of the condition. The Selective Mutism Resource Manual (Johnson/Wintgens) is the best treatment protocol for this condition. Version 2 is being published in the next couple of months and features extended information on treating adolescents.
Joanna: What age groups is The Selective Mutism Resource Manual designed for?
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