The school nurse plays a pivotal role in the assessment and treatment of selective mutism (SM), a rare disorder found in elementary school children. Due to anxiety, children with SM do not speak in uncomfortable situations, primarily the school setting. Diagnosis of SM is often missed in the formative years because the child does speak at home. Early diagnosis and treatment provide the key to addressing this rare disorder. The school nurse plays a critical role as a member of the Instructional Support Team (IST). The school nurse, as team liaison, provides communication between parents, school staff, and medical personnel. School nurses make a difference by advocating for the child with SM and possessing the necessary knowledge to effectively intervene. This article discusses a team approach to the assessment and treatment of SM and the role of the school nurse in the school setting.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders(4th ed., text revision). Washington, DC: Author.
2.
BergmanR. L.PiacentiniJ.McCrackenJ. T. (2002). Prevalence and description of selective mutism in a school-based sample. Journal of the American Academy of Child Adolescent Psychiatry, 41, 938–946.
3.
BlackB.UhdeT. (1994). Treatment of elective mutism with fluoxetine: A double-blind, placebo-controlled study. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 1000–1006.
4.
BlackB. B.UhdeT. W. (1995). Psychiatric characteristics of children with selective mutism: A pilot study. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 847–855.
5.
BorgerG. W.BartleyD. L.ArmstrongN.KaatzD.BensonD. (2007). The importance of a team approach in working effectively with selective mutism: A case study. Teaching Exceptional Children Plus, 4, 2–11. Retrieved March 10, 2011, fromhttp://escholarship.bc.edu/education/tecplus/vol4/iss2/art1.
6.
BuzzellaB. A.Ehrenreich-MayJ.PincusD. B. (2011). Comorbidity and family factors associated with selective mutism. Child Development Research (2011), 1–9. doi:10.1155/2011/909508.
7.
CarlsonJ. S.MitchellA. D.SegoolN. (2008). The current state of empirical support for the pharmacological treatment of selective mutism. School Psychology Quarterly, 23, 354–369.
8.
CohanS. L.ChaviraD. A.Shipon-BlumE.HitchcockC.RoeschS. C.SteinM. B. (2008). Refining the classification of children with selective mutism: A latent profile analysis. Journal of Clinical Child and Adolescent Psychiatry, 37, 770–784.
9.
CohanS. L.ChaviraD. A.SteinM. B. (2006). Practitioner review: Psychosocial interventions for children with selective mutism: A critical evaluation of the literature from 1990-2005. Journal of Child Psychology and Psychiatry, 47, 1085–1097.
10.
CrundwellR.MarcA. (2006). Identifying and teaching children with selective mutism. Teaching Exceptional Children, 38, 48–54.
11.
DowS. P.SoniesB. C.ScheibD.MossS. E.LeonardH. L. (1998). Practical guidelines for the assessment and treatment of selective mutism. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 836–846.
12.
DummitE. S.KleinR. G.TancerN. K.AscheB.MartinJ. (1996). Fluoxetine treatment of children with selective mutism: An open trial. Journal of the American Academy of Child Adolescent Psychiatry, 35, 615–621.
13.
GiddanJ. J.RossG. J.SechlerL. L.BeckerB. R. (1997). Selective mutism in elementary school: Multidisciplinary interventions. Language, Speech, and Hearing Services in Schools, 28, 127–133.
14.
Hagermoser SanettiL. M.LuiselliJ. K. (2009). Evidence-based practices for selective mutism: Implementation by a school team. School Psychology Forum: Research in Practice, 3, 27–42.
15.
HamrinV.SeahillL. (2005). Selective serotonin reuptake inhibitors for children and adolescents with major depression: Current controversies and recommendations. Issues in Mental Health Nursing, 26, 433–450. doi:10.1080/01612840590922452.
JosephP. R. (1999). Selective mutism: The child who doesn’t speak at school. Pediatrics, 104, 308–310.
18.
KearneyC. A.VecchioJ. (2006). Functional analysis and treatment of selective mutism in children. The Journal of Speech-Language Pathology and Applied Behavior Analysis, 1, 141–148.
19.
KristensenH. (2000). Selective mutism and comorbidity with developmental disorder/delay, anxiety disorder, and elimination disorder. Journal of the American Academy of Child Adolescent Psychiatry, 39, 249–256.
20.
KrysanskiV. (2003). A brief review of selective mutism literature. The Journal of Psychology, 137, 29–40.
21.
KumpulainenK. (2002). Phenomenology and treatment of selective mutism. CNS Drugs, 16, 175–180.
22.
KumpulainenK.RasanenE.RaaskaH.SomppiV. (1998). Selective mutism among second-graders in elementary school. European Child and Adolescent Psychiatry, 7, 24–29.
23.
ManassisK.FungD.TannockR.SlomanL.FiksenbaumL.McInnesA. (2003). Characterizing selective mutism: Is it more than social anxiety?Depression and Anxiety, 18, 153–161.
24.
MotavelliN. (1995). Fluoxetine for selective mutism. American Academy of Child and Adolescent Psychiatry, 34, 701–703.
25.
OmdalH. (2008). Including children with selective mutism in mainstream schools and kindergartens: Problems and possibilities. International Journal of Inclusive Education, 12(3):301–315.
26.
SchrumR. L. (2002). Selective mutism: An integrated treatment approach. The ASHA Leader, 7, 4–6.
27.
SchwartzR. H.FreedyA. S.SheridanM. J. (2006). Selective mutism: Are primary care physicians missing the silence?Clinical Pediatrics, 45, 43–48.
SharkeyL.McNicholasF. (2008). More than 100 years of silence, elective mutism: A review of the literature. European Child & Adolescent Psychiatry, 17, 255–263.
