Overcoming mutism in adults with learning disabilities: A case study
Bell DM., Espie CA.
The literature review looks at the range of studies on people with selective mutism, withspecial emphasis on the field of learning disabilities. It finds three particular references (Labbe & Williamson 1984; Paniagua & Saeed 1988; Cline & Baldwin 1994b) that may be particularly pertinent to those people who appear to reduce their speech progressively over time in terms of both quantity of utterances and also who reduce the number of people to whom they will speak. This paper then considers the case of a woman of 36 years of age with Down's syndrome who had shown selective mutism for over 14 years, although this had become almost complete mutism for the last 8 years. The case was assessed and the woman was asked if she would be willing to participate in an attempt to reinforce communication and to gradually increase the number of words whispered or spoken in the presence of one person at first - the first author. Nonaversive behavioural methods were used and response initiation procedures were developed. Later, generalization of vocalizations to other people in other environments was encouraged. Sessions were carried out three times a week for about 2months with rapid success. The woman's quality of life at home and her social interactions at the resource centre were also reported to have improved.© 2003 BILD Publications, British Journal of Learning Disabilities.