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. 2025 Jun;56(3):683-695.
doi: 10.1007/s10578-023-01589-8. Epub 2023 Aug 31.

An Updated Characterization of Childhood Selective Mutism: Exploring Clinical Features, Treatment Utilization, and School Services

Kira Boneff-Peng  1   2 , Patricia C Lasutschinkow  3 , Zachary A Colton  3 , Carol R Freedman-Doan  3
Affiliations

An Updated Characterization of Childhood Selective Mutism: Exploring Clinical Features, Treatment Utilization, and School Services

Kira Boneff-Peng et al. Child Psychiatry Hum Dev. 2025 Jun.

Abstract

Selective mutism (SM) is a severe but understudied childhood anxiety disorder. Most epidemiological research on SM was conducted decades ago and is limited by small sample sizes. This study analyzes parent-reported clinical data from 230 children with diagnosed and suspected SM to provide current information about the presentation of this disorder. Overall, anxiety and social anxiety symptoms were elevated. Gender ratio, comorbidities and family history of psychopathology were generally aligned with previous research. However, age of onset and diagnosis were both earlier than previously reported, with an average delay of 2 years between onset and diagnosis. The majority of children received therapy and school accommodations for their SM, yet there was large variability in types of interventions. This is the largest survey of children with SM conducted primarily within the US and it constitutes the first systematic inquiry into interventions and accommodations received within clinical and school settings.

Keywords: Child anxiety; Selective mutism; Social anxiety.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that they have no relevant financial or non-financial interests to disclose. Informed Consent: Informed consent was obtained from all individual participants included in the study. Research Involving in Human and Animal Participants: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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