Diversity of Selective Mutism: Clinical Care and Education for Person with Selective Mutism

Abstract

We surveyed public awareness of selective mutism in terms of diagnosis, treatment, and education in Japan. In DSM-5, selective mutism was reclassified as an anxiety disorder. Therefore, we expect the change to promote a better understanding of the problem and to focus greater attention on adults with selective mutism. We described the important aspects, such as management of children upon the first visit to a hospital, based on practical experience from K Pediatrics Clinic, which has provided treatment for many children with selective mutism. Specifically, we examined the symptoms related to nonverbal communication and nonspeaking behavior. Although the incidence of selective mutism is controversial, we introduced a large-scale survey recently conducted in Japan and outlined the management of children with selective mutism in schools. According to the survey, the incidence of selective mutism in grade-school children was 0.15–0.11% for boys and 0.20% for girls. In conclusion, we introduced the ICF approved by the World Health Organization and the WHODAS 2.0, which was derived from the ICF. We discussed the importance of the approach to a solution to the level of social participation, including studies to provide patient-led views of selective mutism, as well as physiological and individual level solutions in order to resolve the problem of selective mutism.