Finding Voice: Treating Selective Mutism and Social Anxiety

Often baffling to parents, teachers, and some therapists, the social anxiety disorder known as selective mutism prevents children from moving toward normal social communication, critical in the school-age years. Finding Voice is not a manual for treatment of selective mutism in a rote manner. Some psychological and communication disorders might be treated with a manualised procedure, but this is not one of those disorders. The behavioural variations and rate of progress varies widely among children with selective mutism. These variations limit a manualised response. Rather than serving a menu to the reader, this book teaches how to create different menus, based on the tastes of the children and their parents.

Long-time therapist Robert Schum shares his years of experience helping children, their families, and their teachers. The author discusses the symptoms and treatment of selective mutism, and includes a variety of case histories with insightful intervention examples based on best-practice procedures for primary grades to adolescence. He notes that there is a family pattern of social anxiety among children who have selective mutism. This book covers assessment, treatment, and school intervention.

"Selective Mutism is an often misunderstood and confusing mental health problem. The book fills a major void in the literature on the treatment of selective mutism. Dr. Schum provides a concise and well formulated resource, written in plain, easy to understand language, explaining the integral differences between selective mutism and social anxiety. His work is not only clinically useful, but extremely informative for families and school personnel alike, who are struggling to find ways of understanding and helping the selectively mute child. His case examples help to mitigate the myths that often surround these children. This book provides the reader with concrete guidelines that are easily followed to facilitate steps involved in enabling speech, and always taking in the developmental perspective of the child or adolescent, which is often overlooked in other works. This book should be a mandatory read for anyone working with selectively mute children. It is very well written, practical, and very informative."
- Sandra L. Mendlowitz, PhD.,C. Psych. Child & Youth Outpatient Mental Health. Psychiatry, SickKids Hospital Assistant Professor, Child Psychiatry, Faculty of Medicine, University of Toronto, Ontario, Canada

"Dr. Schum's book offers a fresh perspective and treatment tips for adolescents and older children, a population not frequently addressed in books on Selective Mutism. I look forward to using many of his activities with my adolescent patients!"
- Aimee Kotrba, Ph.D. Licensed Psychologist, Owner of Thriving Minds Behavioral Health

"An expert in the assessment and treatment of children with communication and language disorders, Dr. Robert Schum draws upon several decades of clinical practice to further our understanding of children with selective mutism. Although selective mutism is relatively rare, this book should be read by everyone who works with children – teachers, speech-language pathologists, medical and mental health professionals, as well as by parents of children with selective mutism. Even if they do not see children with selective mutism, the material on social anxiety is worth the read. There is so much valuable information to assist in differential diagnosis and treatment, as well as refuting some of the common misconceptions surrounding selective mutism. The information presented in chapters on Living with Anxiety, Toys and Games, Adolescents, Don’ts, and Housekeeping are especially innovative. Similarly, the appendices are extremely useful with specific details regarding assessment, 504 accommodation, and lists of potential interventions. Rather than a manual where one size fits all, this approach is tailored to the individual child, to the particular situations, people, and expectations that elicit anxiety severe enough to produce selective mutism. Dr. Schum presents numerous specific strategies and techniques to intervene and improve communication, utilizing the concepts of audience, familiarity, and performance. The intervention is a hierarchical approach structured so that the child can master anxiety at every level. It is very encouraging – “all communication is good communication”, and the chapters and figures illustrate the step-by-step approach for effective progress. Also critical is the need for everyone to be on the same page- parents, teachers, mental health professionals, an undertaking that is challenging but necessary to understand the particular needs of this child and how to enhance their progress. The book presents selective mutism with a great deal of optimism. Dr. Schum’s case studies show that, while it is challenging for families and professionals, these children do well over time. Given the lack of research in this area thus far, we are fortunate to have the clinical experience of Dr. Schum and those who see children with selective mutism. This would be a next step for those interested in this field to develop research studies to test the efficacy of interventions."
- Mary Jo Kupst, Ph.D., Emerita Professor of Pediatrics, Medical College of Wisconsin