Clinical Perspective on Passive Audio Vocal Measurement in the Evaluation of Selective Mutism.

Helen Y Xu,Jacob Stroud,Arno Klein,Michael P Milham,Juliet Schwarz,Rachel Busman,Bonhwang Koo,Jake Jungwoo Son,Renee K Jozanovic,Jon Clucas

doi:10.3389/fpsyt.2018.00443

Abstract

Selective Mutism (SM) is an anxiety disorder often diagnosed in early childhood and characterized by persistent failure to speak in certain social situations but not others. Diagnosing SM and monitoring treatment response can be quite complex, due in part to changing definitions of and scarcity of research about the disorder. Subjective self-reports and parent/teacher interviews can complicate SM diagnosis and therapy, given that similar speech problems of etiologically heterogeneous origin can be attributed to SM. The present perspective discusses the potential for passive audio capture to help overcome psychiatry's current lack of objective and quantifiable assessments in the context of SM. We present supportive evidence from two pilot studies indicating the feasibility of using a digital wearable device to quantify child vocalization features affected by SM. We also highlight comparative analyses of passive audio capture and its potential to enhance diagnostic characterizations for SM, as well as possible limitations of such technologies.

Highlights

Selective Mutism (SM) is an anxiety disorder characterized by persistent failure to speak in certain social situations but not others
As the field increasingly questioned the volitional nature of the disorder, the Diagnostic Statistical Manual (DSM)-IV made two major changes: [1] the key diagnostic criterion was changed from a “refusal to speak” to a “failure,” and [2] the name was changed to selective mutism
Selective Mutism is an understudied anxiety disorder that would benefit from objective measures to characterize the heterogeneity of symptoms and treatment outcomes

Summary

Introduction

Selective Mutism (SM) is an anxiety disorder characterized by persistent failure to speak in certain social situations but not others. SM-related symptoms can present long-term difficulties for children in developing social communication skills, in performing at school and in engaging with peers or others [3]. As the field increasingly questioned the volitional nature of the disorder, the DSM-IV made two major changes: [1] the key diagnostic criterion was changed from a “refusal to speak” to a “failure,” and [2] the name was changed to selective mutism. These changes deemphasized unwillingness and oppositionality and moved away from strictly psychosocial conceptualizations of SM.

Results

Discussion

Conclusion