User:NicholasDeniro/Selective mutism

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

Research has been dedicated to indicating that anxiolytics to be helpful in treating children and adults with selective mutism and to decrease anxiety levels, thereby speeding up 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.

Selective mutism is categorized as an anxiety disorder, which means that using similar medication can be used to treat either. 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.