Selective Mutism - From Diagnosis to Intervention

Selective Mutism - From Diagnosis to Intervention

Rachel Busman, PsyD

Rachel-busman

Rachel Busman, PsyD, is the senior director of the Anxiety Disorders Center and director of the Selective Mutism Service at the Child Mind Institute. She leads a team of clinicians providing evaluation and innovative treatment to children with selective mutism. Dr. Busman is President of the Selective Mutism Association, the nation’s largest network of professionals, families, and individuals with selective mutism. 

Dr. Busman has extensive experience providing cognitive behavioral therapy (CBT) to children, teenagers and young adults struggling with anxiety disorders and school difficulties. She also has specific interest and expertise in the evaluation and treatment of obsessive-compulsive disorder, separation anxiety disorder, social anxiety disorder and specific phobias. 

Dr. Busman has worked with children in both inpatient and outpatient settings at a major academic medical center, where she directed a multidisciplinary team. She has taught and supervised psychiatry residents and child psychiatry fellows, and lectured extensively on a variety of topics, including the evidence-based assessment and treatment of anxiety disorders in children and teens. 

Dr. Busman works intensively with children who have selective mutism, and is dedicated to establishing trust and instilling a sense of hope in her patients as she helps them on their path to recovery.

Selective Mutism - From Diagnosis to Intervention

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October was Selective Mutism Awareness month. Even though the month is over, it’s still fresh enough on the mind to keep the conversation going, as Selective Mutism (SM) is an anxiety disorder that deserves attention. Everyone knows what anxiety is, but far fewer have heard of, or know what Selective Mutism is. 

I am asked all the time “What’s SM?” I love being asked this question, because it allows me to convey important information about the disorder and open the lines of communication with the person asking. Selective Mutism (SM) is first & foremost an anxiety disorder in which a child who is otherwise chatty or talkative can’t talk in other settings, like school or with friends. Children with SM might not be able to talk at all in school, or they may be speaking in a whisper or to a limited extent. Some children with SM are able to talk to peers but others can’t do this, even when they want to.

People also ask me, “Isn’t that just shy?” That’s a really common question but no. Being shy isn’t the same as having SM. People who are shy usually warm up in situations over time, whereas children with SM aren’t able to speak and participate even after a while and sometimes even with extended family members.  Another common myth is that something must have happened to the child to make them stop talking. However, while children do experience traumas and sometimes develop Post Traumatic Stress Disorders, SM and trauma related disorders are different.

Since children with SM often speak a lot at home, the disorder becomes most apparent when a child enters school or a day care setting. Parents are often shocked to hear that their otherwise talkative and bubbly child hasn’t spoken a word all year or has only said a few words in some isolated situations. Another common situation is when the well-meaning clerk asks, “how old are you” and is met with a blank stare or a hidden face. 

Children with SM have an anxiety disorder, and treatment, especially behavioral or cognitive -behavioral treatment can be very effective. Parents are often involved highly in treatment, as they are usually the only people with whom the child speaks. A good treatment for SM should involve strategies for generalization, which means helping the children speak to more people, in more places and in more situations. 

For more information about SM, visit the Selective Mutism Association. There are also some very good social media groups that connect parents of children with SM. 

View Rachel's accompanying webinar here. 

Rachel Busman, PsyD

Rachel-busman

Rachel Busman, PsyD, is the senior director of the Anxiety Disorders Center and director of the Selective Mutism Service at the Child Mind Institute. She leads a team of clinicians providing evaluation and innovative treatment to children with selective mutism. Dr. Busman is President of the Selective Mutism Association, the nation’s largest network of professionals, families, and individuals with selective mutism. 

Dr. Busman has extensive experience providing cognitive behavioral therapy (CBT) to children, teenagers and young adults struggling with anxiety disorders and school difficulties. She also has specific interest and expertise in the evaluation and treatment of obsessive-compulsive disorder, separation anxiety disorder, social anxiety disorder and specific phobias. 

Dr. Busman has worked with children in both inpatient and outpatient settings at a major academic medical center, where she directed a multidisciplinary team. She has taught and supervised psychiatry residents and child psychiatry fellows, and lectured extensively on a variety of topics, including the evidence-based assessment and treatment of anxiety disorders in children and teens. 

Dr. Busman works intensively with children who have selective mutism, and is dedicated to establishing trust and instilling a sense of hope in her patients as she helps them on their path to recovery.

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