Assessment and Treatment of Selective Mutism in a Child With Autism Spectrum Disorder

Abstract

Over 60% of children diagnosed with selective mutism are also diagnosed with Autism Spectrum Disorder. Previous research established that behavioral interventions are effective at increasing speech in children with both diagnoses. However, few studies conducted assessments to determine environmental variables that inhibit speech, and such assessments are necessary for the development of effective and efficient treatments. This case study describes an assessment that evaluated the function(s) of selective mutism. The results confirmed that the participant did not talk to avoid social interaction and that mutism occurred primarily in the presence of multiple, unfamiliar people. Our first treatment focused on increasing tolerance for social interaction, demonstrated by an increase in speech production in the presence of unfamiliar people. Our second treatment focused on increasing qualitative aspects of the participant’s speech (i.e., both responses and initiations). Finally, we taught the participant’s parents to implement the treatment in naturalistic settings, and the participant demonstrated generalization of treatment effects across people and settings. Implications for clinical practice and future research are discussed.