Parent-Child Interactive Therapy Effective for Selective Mutism

Little girl covering mouth in front of fence

Parent-child interaction therapy (PCIT) was an effective treatment for selective mutism in children, according to study data published in the Journal of Anxiety Disorders.

Participants were recruited from the outpatient mental health department at a children’s hospital in Vancouver, British Columbia, Canada. Children aged 4 to 10 years with selective mutism were eligible for inclusion. Children with comorbid autism spectrum disorder, intellectual disability, mania, or psychosis were excluded. Enrolled participants participated in 16 consecutive weekly sessions of PCIT at the outpatient clinic; most sessions included the parent, child, and therapist. Outcome measures included a series of tests capturing speaking behaviors and language competence. Assessments were conducted at baseline, pretreatment and posttreatment, and at 3- and 12-months’ follow-up.

A total of 31 children participated in the study, 15 of whom were boys. Mean (standard deviation) participant age was 6.47 (1.68) years. A third (32.3%) of participating children had a first language other than English. Nearly half (41.9%) of participants self-identified as Asian, 35.5% as European/White, 9.7% as multiracial, 3.2% as South Asian, and 9.7% “unspecified.” Significant improvements in speaking behavior were observed between the pre- and posttreatment points (P <.001; Cohen’s d =1.80). These improvements were maintained at the 3- and 12-month follow-up visits (both P <.001). Improvements were observed in all parent-reported domains, including school, community, and home/family. Teacher reports of child anxiety also significantly improved at posttreatment compared with pretreatment. Parents generally reported high satisfaction with PCIT, with a mean (standard deviation) satisfaction rating of 3.86 (0.25) out of a possible 4.00. Neither patient age nor baseline language competence predicted PCIT response.

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These data highlight the efficacy and acceptability of PCIT-informed treatment for selective mutism. Data generalizability may be limited by small sample size and nonrandomized study design. Even so, providers may find these results useful in designing treatment for youths and families affected by selective mutism.


Catchpole R, Young A, Baer S, Salih T. Examining a novel, parent child interaction therapy-informed, behavioral treatment of selective mutism. J Anxiety Disord. 2019;66:102112.