Anxiety Disorder

Selective
Mutism
Presented by: Muhammad Babar
 Diagnostic criteria
 Consistent failure to speak in certain
situations.

 Some children are shy and do not like

talking to people at a specific time. This
might start when your child goes to school.

 Children with Selective Mutism will speak

in their homes in the presence of
immediate family.

According to DSM V
 Diagnostic criteria

 Children with Selective Mutism cannot

initiate communication with their peers and
are unknown.

 They often refuse to speak at school, leading

to academic impairment.

According to DSM V
 Diagnostic criteria

 Expression of a desire to speak that is held

back by anxiousness, fear, or
embarrassment.

 Fidgeting, eye contact avoidance, lack of

movement, or lack of expression when in
feared situations.

According to DSM V
 Selective Mutism Video

Let’s understand Selective Mutism by watching

this video.

https://youtu.be/K2VFx_iOnxQ
 Case Study
“The successful treatment of long-term Selective Mutism”
Mark S.Rye, DouglasUllman

 13 years old boy

 Seventh grade who had selective mutism in school since kindergarten.
 He had a long history of not speaking in school even though he talked at home.
 Treatment consisted of Systematic Desensitization & Exposure Therapy
 Treatment consisted of 63 sessions, each of which lasted between 20–60
minutes.
 Case Study

• Treatment was temporarily discontinued while the student was on

summer vacation.
• Systematic desensitization was utilized in order to address the student's
underlying anxieties related to speaking in school.
• Exposure Therapy was utilied to create anxiety provoking situations
which was initially accomplished through guided imagery.
Result: At 1 year Follow Up his speech was improved alot.
 Etiology

 Environmental
 Temperamental
 Genetic and physiological factors
 Associated features

Selective Mutism may include:

o Excessive shyness
o Fear of social embarrassment
o Low self-esteem
o Speech and language disorders
o Panic disorders
o Other anxiety disorders.
According to DSM V
 Diagnosis onset of Selective Mutism

 According to DSM V, the onset of

Selective Mutism is usually at age 5
years.

 It's often first noticed when the child

starts to interact with people outside
their family.

According to DSM V
Treatment for Selective Mutism

 Stimulus fading:
Your child may be with someone they talk to easily at first. Then, a new
person may slowly join in. This will help your child get comfortable with new
situations.
 Treatment for Selective Mutism

 Shaping:
The SLP will praise or give rewards to your child for trying to communicate.
Your child may first only point or use other gestures. Then, they may mouth a
word, which means saying it silently or whispering. The goal is for your child
to speak in all situations.
 Treatment for Selective Mutism

 Exposure therapy:
During exposure therapy, a psychologist creates a safe space wherein an
individual is exposed to the object of their fear (with selective mutism, this
may be speaking in front of or directly to a stranger).
 References

• Diagnostic Statistical Manual (DSM V)

• https://www.wscaweb.org/wp-content/uploads/2018/02/
37fbdf7198c43a65a05ed61660ee0a3f.pdf

• https://www.asha.org/public/speech/disorders/selective-
mutism/

• https://youtu.be/K2VFx_iOnxQ

• https://www.sciencedirect.com/science/article/abs/pii/
S0005791699000300