Comparing interventions for selective mutism: a pilot study

Can J Psychiatry. 2008 Oct;53(10):700-3. doi: 10.1177/070674370805301010.


Objective: To examine the outcome within 6 to 8 months of medical and nonmedical intervention for children with severe selective mutism (SM).

Method: Children with SM (n = 17) and their mothers, seen in a previous study, attended follow-up appointments with a clinician. Obtained by maternal report were: treatment received, current diagnosis (based on semi-structured interview), speech in various environments, and global improvement. An independent clinician also rated global functioning.

Results: The diagnosis of SM persisted in 16 children, but significant symptomatic improvement was evident in the sample. All children had received school consultations. Children who had been treated with selective serotonin reuptake inhibitors (SSRI) (n = 10) showed greater global improvement, improvement in functioning, and improvement in speech outside the family than children who were unmedicated (n = 7). No differences were evident for children receiving and not receiving additional nonmedical intervention.

Conclusions: The findings suggest the potential benefit of SSRI treatment in severe SM, but randomized comparative treatment studies are indicated.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Combined Modality Therapy
  • Female
  • Fluoxetine / therapeutic use*
  • Follow-Up Studies
  • Humans
  • Male
  • Mutism / diagnosis
  • Mutism / drug therapy*
  • Mutism / psychology
  • Personality Assessment
  • Phobic Disorders / diagnosis
  • Phobic Disorders / psychology
  • Phobic Disorders / therapy
  • Pilot Projects
  • Psychotherapy
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*
  • Sertraline / therapeutic use*
  • Sex Factors
  • Social Environment
  • Speech Therapy


  • Serotonin Uptake Inhibitors
  • Fluoxetine
  • Sertraline