The current state of empirical support for the pharmacological treatment of selective mutism.

Carlson, John S.; Mitchell, Angela D.; Segool, Natasha K.

doi:10.1037/1045-3830.23.3.354

Cited by 28 publications

(15 citation statements)

References 73 publications

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“…The value of VSM has been under‐recognized in reviews of selective mutism interventions because speed of change and economy of treatment have not been among the criteria. These outcomes are in contrast to much lower rates of success and duration of treatment (2‐12 months, with some notable exceptions) with contingency management or pharmacology, the only other interventions with promise (Carlson, Mitchell, & Segool, 2008). For example, Kehle et al (1990; Table 1) describe a child who had not spoken in school for 3 years.…”

Section: Rapid Learningmentioning

confidence: 90%

Self modeling: Expanding the theories of learning

Dowrick

2011

Psychology in the Schools

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Self modeling (SM) offers a unique expansion of learning theory. For several decades, a steady trickle of empirical studies has reported consistent evidence for the efficacy of SM as a procedure for positive behavior change across physical, social, educational, and diagnostic variations. SM became accepted as an extreme case of model similarity; improved self-efficacy became a frequent "explanation" of how it worked. Recently, however, the mounting evidence for ultra-rapid behavior change (particularly in feedforward versions of video SM) and incomplete satisfaction with explanatory models of observational learning in general suggested a rethinking of underlying theory. The most rapid learning by humans can be achieved by mental simulations of future events, based on reconfigured preexisting component skills. These reconsiderations of learning from the future, emphasizing learning from oneself, have coincided with developments in neurocognitive theories of mirror neurons and mental time travel. A reexamination of principles not tied to any medium show SM not to be a special case but to be the most fundamental form of observational learning. In the meantime, commercial technology has advanced in ways that are putting more of this self-determining behavior change into younger and younger hands and minds. C 2011 Wiley Periodicals, Inc.Better to be drawn by images of the future than driven by ghosts of the past.

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Section: Rapid Learningmentioning

confidence: 90%

Self modeling: Expanding the theories of learning

Dowrick

2011

Psychology in the Schools

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“…Studies that feature randomized single-case experimental design , that use robust statistical techniques to augment visual analysis (to improve evidence standards), and that include more settings for generalization (e.g., the community) are needed to demonstrate that psychosocial interventions are a viable alternative to pharmacological interventions when treating SM (Carlson et al, 2008). Further examination is also needed to solidify the link between anxiety and SM, specifically, how anxiety may be involved with the etiology of this disorder.…”

Section: Contributions Of This Study and Future Researchmentioning

confidence: 97%

“…However, it is important to note that although SM is rare and may not affect many students in the school setting; Carlson, Mitchell, and Segool (2008) noted that ''for comparison sake, the rate of selective mutism is slightly higher than the prevalence of autism (0.50%)' ' (p. 354).…”

mentioning

confidence: 97%

“…Because a child's mute behavior becomes more entrenched without intervention, and because of the possible negative impact of SM on a child's educational and social functioning, it is important to intervene early and prevent the child's symptoms from becoming intractable (Schwartz, Freedy, & Sheridan, 2006) and negatively affecting the educational outcomes of the child. Given that the setting in which many children with SM fail to speak is the school-where familiar individuals (e.g., the parents) are not often presentschool-based consultants are in an optimal position to engage in assessment and intervention services with these children, which may effect change in their learning and behavioral functioning (Carlson et al, 2008;Kearney, 2010).…”

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confidence: 98%

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Treatment of Selective Mutism: Applications in the Clinic and School Through Conjoint Consultation

Mitchell¹,

Kratochwill

2013

Journal of Educational and Psychological Consultation

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“…6 Moreover, as in Sara's case, pharmacotherapy is usually combined with psychosocial interventions, making it difficult to attribute improvement to one or the other treatment method. Nevertheless, the frequent association between selective mutism and social anxiety (a disorder that has been shown to be responsive to SSRIs in several large randomized controlled trials 7 ) and the findings of 2 systematic reviews on selective mutism 2,3 suggest that these medications merit consideration in this population, particularly when symptoms are severe and fail to remit in response to psychosocial interventions. The risks and benefits of medication must be carefully evaluated in each case against the risks and benefits of not pursuing medication (e.g., the risk of academic and social deterioration).…”

mentioning

confidence: 99%

SSRIs in a case of selective mutism

Manassis

Avery

2013

J Psychiatry Neurosci

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SSRIs in a case of selective mutismSara, an 8-year-old girl of Asian descent, was referred for psychiatric assessment in grade 3. She was the elder of 2 children in a stable, intact, middleclass family. Sara was temperamentally shy and spoke English with a slight accent, but her development history was otherwise unremarkable. Sara's parents immigrated to Canada shortly before her birth, but they spoke English with their children at home and reported Sara's speech to be normal there. Starting in kindergarten, Sara did not speak to teachers, but she whispered to her sister and 1 familiar peer in the school yard. Many behavioural strategies were attempted to elicit speech in class, but none succeeded. In grade 1, Sara's pediatrician recommended fluoxetine, but her parents were unwilling to consider psycho tropic medication for her at that time. In the ensuing 2 years, Sara's functioning deteriorated. According to Sara's grade 2 progress report card, her teacher was "unable to evaluate" Sara for many subjects and subsequently raised the possibility of her having a developmental delay. Sara's familiar peer moved away, increasing her social isolation.After a thorough assessment, consultation with Sara's school and several family discussions about the risks and benefits of medication, Sara's parents reluctantly agreed to a trial of fluoxetine. Sara experienced no adverse effects from this medication. After 3 weeks of taking 10 mg of fluoxetine per day, Sara appeared more relaxed and began talking to her sister's friends. Concurrently, her grade 3 teacher patiently spent a few minutes each day reading and talking to Sara one-on-one.After about 8 weeks on medication, Sara began answering her teacher's questions, and soon afterwards she began speaking in class. Relieved, her parents decided to discontinue medication, and proudly announced "All she needed was the right teacher." They declined further psychi atric follow-up.Sara's case represents a typical example of selective mutism, a condition where children fail to speak in certain social situations despite generally being able to speak at home. Minor abnormalities of speech or speaking English as a second language are common in these children and may contribute to their self-consciousness or social anxiety. Given the frequent link between selective mutism and social anxiety, selective serotonin reuptake inhibitors (SSRIs) are sometimes considered, especially in patients in whom psychosocial intervention has failed. As in Sara's case, parents are usually reluctant to medicate young children, which often results in treatment delays and deterioration in functioning. Further increasing parents' and clinicians' concerns about medical treatment, pharmacotherapy for selective mutism is off-label, evidence for SSRIs is limited and the long-term effects of SSRIs in this population are unknown. Evidence supporting the use of SSRIs to treat patients with selective mutism consists mostly of case reports and open trials, and includes fewer than 100 cases in total.2,3 A positive ran...

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The current state of empirical support for the pharmacological treatment of selective mutism.

Cited by 28 publications

References 73 publications

Self modeling: Expanding the theories of learning

Self modeling: Expanding the theories of learning

Treatment of Selective Mutism: Applications in the Clinic and School Through Conjoint Consultation

SSRIs in a case of selective mutism

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