Incorporating Technology Into the Treatment of a 17-Year-Old Female With Selective Mutism

Abstract

Selective mutism (SM) is a relatively rare disorder and is most commonly found among young children. Children and adolescents presenting with SM and its associated features (e.g., social anxiety, social skills deficits) are often challenging to treat, and recent data suggest that SM is characterized by heightened levels of autonomic arousal, often coupled with behavioral avoidance. In this report, we present the case of Nina, a 17-year-old Caucasian female diagnosed with comorbid SM and social anxiety disorder. Standard intervention designed to treat social anxiety disorder (i.e., intensive exposure based on an extinction paradigm) met with a minimal response and no changes in speech behavior. Reconceptualization of the treatment approach led to a decision to focus directly on speech using a graduated exposure (desensitization) paradigm. To create an emotional response incompatible with anxiety, initial desensitization sessions used Apple iPad applications that allowed for engagement in amusing tasks and the pairing of vocalization with positive emotions. Traditional social skills training constituted the final treatment component. Advantages and limitations associated with the various treatment modalities used are discussed as well as recommendations for future clinical research.

The SPAIC-11 and SPAICP-11: Two brief child- and parent-rated measures of social anxiety

“…The parent version of the SPAI-C (SPAIC-PV; Beidel, Turner, & Morris, 2004) has been used in a number of investigations (e.g., Bunnell & Beidel. 2013; Higa, Fernandez, Nakamura, Chorpita, & Daleiden, 2006; Rork & Morris, 2009; Young, Bunnell, & Beidel, 2012) and consists of 26 items that have been adapted from the SPAI-C to reflect a parent’s report of his/her child’s anxiety (e.g., the SPAI-C item “I feel anxious when speaking to peers” is reworded as “my child feels anxious when speaking to peers” on the SPAIC-PV).…”

SPELTA: An expert system to generate therapy plans for speech and language disorders

“…More recently, Palmer et al (2012) argued that the advances in artificial intelligence and audiovisual signal processing make it possible to automate certain SLT tasks and thus deliver more intensive and efficient therapy out of the clinics, while making better use of the therapists' time. The state-of-the-art in this area includes web-based developments (Ooi, Raja, Sung, Fung, & Koh, 2012), mobile applications (Bunnell & Beidel, 2013) and various types of robots (Choe, Jung, Baird, & Grupen, 2013;Kose, Akalin, & Uluer, 2014), featuring components of voice-based and gesture-based interaction (Hogrefe, Ziegler, Wiesmayer, Weidinger, & Goldenberg, 2013;Sekine & Rose, 2013), avatars in the role of 'virtual therapists' (Abad et al, 2013;Teodoro, Martin, Keshner, Shi, & Rudnicky, 2013), etc. Expert systems have been used in this area, for example, to adapt parameters of the user interfaces, in order to make them more amenable and engaging (Kostoulas et al, 2012).…”

A Proposal of an Ecosystem Based on Intelligent Ict Tools to Support the Diagnosis and Intervention of Patients With Communication Disorders

“…An approach to web-based CBT for the treatment of children with selective mutism (SM) was presented by Ooi et al [19]; the proposal was tested with 5 children during 14 weeks, and the results showed significant progress in the speech frequency in social situations (school and home) in 4 of them. Likewise, Bunnell and Beidel [20] described a case where the traditional therapy (intensive exposure based on an extinction paradigm) was not helpful, whereas the use of mobile applications for engagement in amusing tasks and the pairing of vocalization with positive emotions obtained much better results.…”