When to intervene in selective mutism: The multimodal treatment of a case of persistent selective mutism

An identification and treatment model differentiating Transient from Persistent Selective Mutism is proposed. The model incorporates treatment recommendations for Persistent Selective Mutism and suggests that interventions are not usually warranted for Transient Selective Mutism. The case study of a 6-year-old female manifesting Persistent Selective Mutism is presented. A multimodal treatment approach combining behavioral techniques with play therapy and family involvement was applied to improve her verbal interactions. Pre- and posttreatment evaluations were conducted. During pretreatment evaluations the child was manifesting Persistent Selective Mutism, immaturity, and withdrawal behaviors. At posttreatment evaluations she was talking in a manner consistent with her peers without problematic behaviors displayed. Results of a 6-month follow-up completed after the child had entered first grade showed that she was continuing to speak in a manner consistent with her peers without behavioral concerns.