User:NicholasDeniro/New sandbox 2

Shaping

The subject is slowly encouraged to speak. The subject is reinforced first for interacting nonverbally, then for saying certain sounds (such as the sound that each letter of the alphabet makes) rather than words, then for whispering, and finally saying a word or more. In addition, combining shaping with Intensive Group Behavioral Therapy (IGBT) has been shown to reduce symptoms of selective mutism, and in some cases has even been shown to eliminate symptoms. Shaping seems to be reinforced by the group dynamic of this therapeutic method, and the positive effects are amplified as a result. Another approach to shaping is used with mobile apps, in which programs designed to assist in this therapy are given to children in order to improve their speaking ability. The ability of these apps to give more targeted approaches to shaping that can be beneficial to children who are otherwise unreceptive.

Drug Treatment

Some practitioners believe there would be evidence indicating anxiolytics to be helpful in treating children and adults with selective mutism, to decrease anxiety levels and thereby speed the process of therapy. Use of medication may end after nine to twelve months, once the person has learned skills to cope with anxiety and has become more comfortable in social situations. Medication is more often used for older children, teenagers, and adults whose anxiety has led to depression and other problems.

Medication, when used, should never be considered the entire treatment for a person with selective mutism. However, the reason why medication needs to be considered as a treatment at all is because selective mutism is still prevalent, despite psychosocial efforts. But while on medication, the person should still be in therapy to help them learn how to handle anxiety and prepare them for life without medication, as medication is typically a short-term solution.

Since selective mutism is categorized as an anxiety disorder, using similar medication to treat either makes sense. Antidepressants have been used in addition to self-modeling and mystery motivation to aid in the learning process.[further explanation needed] General consensus has been that SSRIs have been useful in treating selective mutism. In a systematic review, ten studies were looked at which involved SSRI medications, and all reported medication was well tolerated. In one of them, Black and Uhde (1994) conducted a double-blind, placebo-controlled study investigating the effects of fluoxetine. By parent report, fluoxetine-treated children showed significantly greater improvement than placebo-treated children. In another, Dummit III et al. (1996) administered flouxetine to 21 children for nine weeks and found that 76% of the children had reduced or no symptoms by the end of the experiment. This indicated that fluoxetine is an SSRI that is indeed helpful in treating selective mutism, indeed it is one of the most effective SSRIs available. The usage of fluoxetine in these studies is seen as most effective in combination with other forms of cognitive therapy.