Assessment of selective mutism and school refusal behavior

Abstract

Selective mutism and school refusal behavior are complex, emergent, and often ambiguous problems that can present frustrating challenges for clinicians and researchers. Selective mutism is a condition in which a child fails to speak in public situations where speaking is expected. Children with selective mutism often speak well in familiar situations such as home but not in public situations. Failure to speak must last at least 1 month. Selective mutism does not generally apply to youths who lack comfort or knowledge with the primary language spoken in public situations (American Psychiatric Association, 2000). The conceptualization of selective mutism remains unclear, but researchers often link the condition to social anxiety, mild oppositional behavior, and/or communication problems (Cohan et al., 2008; Kristensen, 2000; Sharp, Sherman, & Gross, 2007; Vecchio & Kearney, 2005; Yeganeh, Beidel, & Turner, 2006). Selective mutism can lead to peer rejection, incomplete verbal academic tasks or standardized tests, and/or inadequate language or social skills (Cohan, Price, & Stein, 2006; Cunningham, McHolm, & Boyle, 2006; Remschmidt, Poller, Herpert-Dahlmann, Hennighausen, & Gutenbrunner, 2001; Steinhausen, Wachter, Laimbock, & Metzke, 2006).