Incorporating Technology Into the Treatment of a 17-Year-Old Female With Selective Mutism

    Authors

    B. E. Bunnell;D. C. Beidel

    Comments

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    Abbreviated Journal Title

    Clin. Case Stud.

    Keywords

    selective mutism; treatment; social skills; SOCIAL PHOBIA; ELECTIVE MUTISM; BEHAVIORAL TREATMENT; ANXIETY DISORDER; CHILDREN; PREVALENCE; Psychology, Clinical; Psychiatry

    Abstract

    Selective mutism (SM) is a relatively rare disorder and is most commonly found among young children. Children and adolescents presenting with SM and its associated features (e.g., social anxiety, social skills deficits) are often challenging to treat, and recent data suggest that SM is characterized by heightened levels of autonomic arousal, often coupled with behavioral avoidance. In this report, we present the case of Nina, a 17-year-old Caucasian female diagnosed with comorbid SM and social anxiety disorder. Standard intervention designed to treat social anxiety disorder (i.e., intensive exposure based on an extinction paradigm) met with a minimal response and no changes in speech behavior. Reconceptualization of the treatment approach led to a decision to focus directly on speech using a graduated exposure (desensitization) paradigm. To create an emotional response incompatible with anxiety, initial desensitization sessions used Apple iPad applications that allowed for engagement in amusing tasks and the pairing of vocalization with positive emotions. Traditional social skills training constituted the final treatment component. Advantages and limitations associated with the various treatment modalities used are discussed as well as recommendations for future clinical research.

    Journal Title

    Clinical Case Studies

    Volume

    12

    Issue/Number

    4

    Publication Date

    1-1-2013

    Document Type

    Article

    Language

    English

    First Page

    291

    Last Page

    306

    WOS Identifier

    WOS:000346587500003

    ISSN

    1534-6501

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