Multi-Faceted Assessment of Children with Selective Mutism: Challenges and Practical Suggestions

Abstract

The multi-faceted nature of Selective Mutism (SM), and its comorbidity with other disorders, necessitates a comprehensive assessment process. However, evaluating children with SM presents significant challenges, including difficulties in building rapport, establishing an accurate diagnosis, and conducting formal psychological and neuropsychological assessments. This paper explores the key obstacles in assessing children with SM and provides practical recommendations for overcoming these challenges. Effective strategies for reducing anxiety during assessments include extended rapport-building phases, playful and engaging interactions, and the strategic use of parental involvement. Additionally, given the variability in SM symptoms across different settings, a multi-informant and multi-method assessment approach—including clinical observation, structured interviews, and standardized parent- and teacher-report measures—is recommended. This paper also discusses adaptations for formal testing, particularly in cognitive, language, and neurodevelopmental assessments, where SM-related speech avoidance can interfere with standardized evaluations. Nonverbal assessment tools, modifications to testing environments, and alternative response formats are proposed as potential solutions. Furthermore, we highlight the importance of differentiating SM from overlapping conditions, such as autism spectrum disorder and language impairments, to ensure accurate diagnosis and intervention planning. By implementing tailored assessment strategies, clinicians and researchers can improve diagnostic accuracy and better understand the unique needs of children with SM. This, in turn, can inform individualized treatment plans, enhance educational placement decisions, and support the overall well-being of children with SM.

Keywords

• selective mutism
• psychological assessment
• neuropsychological assessment