Refusal to Speak

Book excerpt: Selective mutism in children is characterized by persistent refusal to speak in one or more social situations (e.g., at school or among strangers), notwithstanding the demonstrated ability to use language at home. The range of treatment options has recently expanded to include promising behavioral, psychopharmacological, and multi-modal approaches in addition to psychodynamic and family systems therapy. Toward overcoming the traditional intractability of the disorder, the authors exhort clinicians - psychologists, psychiatrists, pediatricians, counselors, social workers - to familiarize themselves with all of the options in order to expand their repertoires and individualize treatment strategies. Comprehensive in scope, this book presents the major therapeutic approaches and offers alternatives to professionals working with selectively mute children.