Behavioral treatment of a selective mute Mexican‐American boy

Abstract

This case study describes a selective mute Mexican-American boy who, at initial referral, had never spoken to peers or teachers while in school. The treatment procedure employed shaping and reinforcement of speech in therapy sessions. These sessions involved the psychologist alone, the classroom teacher and psychologist, the boy's best friend and the psychologist, a small assertiveness skills group, and a small group for reading instruction. Results indicated that the subject first whispered one word and then gradually expanded his vocalizations from one-word answers to complete sentences over a 3-year period. By the end of the treatment, he answered questions in a normal tone of voice but rarely asked questions. Through the use of shaping, positive reinforcement, and stimulus fading, the treatment was successful in helping the boy to speak in several settings.Selective mutism (SM; formerly elective mutism) is a rare disorder characterized by refusal to speak when a person is capable of speech and speech is normally understood. , 1984). Fundudis, Kolvin, and Garside (1979) found that 2 out of 3,300 children were reported to have elective mutism at the age of 7 years; and Brown and Lloyd (1975) discovered that 42 of 6,072 kindergarten children were not speaking after 8 weeks of school.Although there are several reports of higher incidence of SM among children of minority cultures, statistical significance is seldom demonstrated (Hesselman, 1983). One exception (Bradley & Sloman, 1975) showed an elevated incidence among immigrant children in Canada. This positive trend was found again in a British sample, but the difference was not significant (Cline & Kysel, 1987.A review of behavioral interventions in the treatment of elective mutism was completed by Labbe and Williamson (1984). Most of the studies reviewed were based on contingency management using positive reinforcement and stimulus fading. Labbe and Williamson presented a scheme for assessment and treatment planning based on subtypes. Assessment of an elective mute client may involve differentiating between several categories of manifestation that call for different intervention strategies. Intervention strategies involve careful description of the environments in which the client will speak. For example, if the client speaks to only one person in most test environments, the

Increasing Verbal Behavior of a Student Who Is Selectively Mute

“…The teacher in each setting not only was giving few prompts but also was whispering the prompts by the conclusion of the fading period. This finding, indicating an increase in verbal responses and words used, lends support to prior research indicating the efficacy of positive reinforcement in increasing speech (Albert-Stewart, 1986;Auster et al, 2006;Cohan et al, 2006;Kratochwill, 1981;Krohn et al, 1992;Masten et al, 1996;Richburg & Cobia, 1994). As supported by virtually all authors, there was no indication that aversives should have been used or would have increased the treatment effect (e.g., Harris, 1996;Porjes, 1992;Tancer, 1992).…”

“…The use of the selection of a reinforcer from a menu supports the work of Amari, Slifer, Gerson, Schenck, and Kane (1999) and Porjes (1992). The addition of stimulus fading procedures to the reinforcement condition was used in the treatment of SM by Masten et al (1996), as well as Watson and Kramer (1992). The change of stimulus setting and gradually introducing interventions across settings was important in establishing verbal behavior and supports the work of Crundwell (2006) and Cunningham and McHolm (2001).…”

Practitioner Review: Psychosocial interventions for children with selective mutism: a critical evaluation of the literature from 1990–2005

“…Stimulus fading can also be used in problematic situations that occur outside of school (e.g., talking to grandparents, ordering in fast food restaurants). As shown in Table 1, interventions involving stimulus fading have been successful in increasing both the amount of speech and the number of people spoken to in a variety of settings (Masten et al, 1996;Watson & Kramer, 1992). Another type of behavioral intervention that appears promising for children with persistent SM is systematic desensitization (Rye & Ullman, 1999).…”

Behavioral Intervention to Treat Selective Mutism Across Multiple Social Situations and Community Settings

“…Selective mutism may result in social isolation and academic failure (Kolvin & Goodyer, 1982). Previous interventions for selective mutism have involved contingency management (e.g., Watson & Kramer, 1992), practice or priming (e.g., O'Reilly et al, 2008), shaping (e.g., Masten, Stacks, Caldwell-Colbert, & Jackson, 1996), and systematic desensitization (e.g., Rye & Ullman, 1999).…”