School-Based Assessment and Intervention in Selective Mutism: A Narrative Review and Practical Framework

Öz

Selective mutism is an anxiety disorder characterized by a child’s consistent failure to speak in specific social situations, most commonly at school, despite preserved speech in safe contexts such as home. It often becomes more apparent around school entry and may negatively affect academic participation, peer relationships, and family functioning. This review aims to present a clinically applicable and structured practical framework for the assessment and intervention of selective mutism in the school context. The article was prepared as a current narrative review and does not claim to be a systematic review. Within this scope, the definition, clinical significance, differential diagnosis, assessment tools, intervention components, and the role of family-school-clinic collaboration in the treatment process are discussed in light of the current literature. Available literature suggests that the most frequently reported and comparatively better-supported intervention components include hierarchical exposure, stimulus fading, shaping, and reinforcement strategies targeting speaking behaviour. Cognitive behavioural protocols aim to systematically reduce avoidance through low-pressure communication principles, home-school coordination, and small, measurable communication goals. For assessment and follow-up, parent and teacher reports should be interpreted together with behavioural indicators of speaking. In conclusion, effective care requires a structured programme that reduces avoidance through school, family, and clinical collaboration rather than forcing the child to speak. This review provides a practical framework for school teams and clinicians, including an implementable protocol, follow-up indicators, and common pitfalls.

Anahtar Kelimeler

• selective mutism
• school‑based intervention
• exposure
• anxiety disorder

Seçici Konuşmazlıkta Okul Temelli Değerlendirme ve Müdahale: Anlatı Derlemesi ve Pratik Bir Çerçeve

Öz

Seçici konuşmazlık, çocuğun belirli sosyal bağlamlarda, çoğunlukla okulda, tutarlı biçimde konuşamaması; buna karşın ev gibi güvenli bağlamlarda konuşmanın korunması ile karakterize bir kaygı bozukluğudur. Okula başlama döneminde daha görünür hâle gelir; akademik katılımı, akran ilişkilerini ve aile işlevselliğini olumsuz etkileyebilir. Bu derlemenin amacı, seçici konuşmazlıkta değerlendirme ve müdahaleyi okul bağlamında klinikte uygulanabilir, yapılandırılmış bir pratik çerçeve olarak sunmaktır. Çalışma, sistematik derleme iddiası taşımayan güncel bir anlatı derlemesi olarak hazırlanmıştır. Bu kapsamda seçici konuşmazlığın tanımı, klinik önemi, ayırıcı tanısı, değerlendirme araçları, müdahale bileşenleri ve aile-okul-klinik iş birliğinin tedavi sürecindeki rolü güncel literatür doğrultusunda ele alınmıştır. Mevcut literatür, müdahalelerde en sık bildirilen ve görece daha güçlü destek bulan bileşenlerin hiyerarşik maruziyet, kademeli geçiş, şekillendirme ve konuşma davranışını hedefleyen pekiştirme stratejileri olduğunu düşündürmektedir. Bilişsel davranışçı protokoller; düşük baskılı iletişim ilkeleri, ev-okul koordinasyonu ve küçük, ölçülebilir iletişim hedefleri üzerinden kaçınmayı sistematik biçimde azaltmayı amaçlar. Değerlendirme ve izlemde ebeveyn ve öğretmen bildirimleri, konuşma davranışına ilişkin davranışsal göstergelerle birlikte yorumlanmalıdır. Sonuç olarak, etkili yaklaşım çocuğu konuşturmaya zorlama yerine; okul, aile ve klinik iş birliği içinde kaçınmayı azaltan yapılandırılmış bir programdır. Bu derleme, okul ekibi ve klinisyenler için uygulanabilir bir protokol, izlem göstergeleri ve sık yapılan hataları içeren pratik bir çerçeve sunmaktadır.

Anahtar Kelimeler

• selektif mutizm
• okul temelli müdahale
• maruziyet
• kaygı bozukluğu

Kaynakça

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