“…He concluded that "elective mutism is not, as has been suggested, a clinical entity, but rather an abnormal psychogenic reaction which may be viewed as learned behaviour, dependent upon a variety of precipitating factors in differing personality types". Some of the more recent American studies describe behavioural approaches to treatment (Straughan et al, 1965;Reid et al, 1967;Nolan and Pence, 1970;Wulbert et al, 1973;Bednar, 1974;Appleman et al, 1975;Adkins, 1975;Nash et al, 1979) but because of the rarity of the condition, literature remains relatively sparse.…”