Register for our Fall Groups!
Click here to learn about our Group Therapy Programs.
The Selective Mutism Program at Advanced Therapeutic Solutions aims at providing effective, evidence-based treatment for Selective Mutism (SM). Selective Mutism is a fear of speaking in public, despite the ability to speak. It is typically first noted when a child starts attending school and exhibits difficulty communicating with teachers/peers. Children with selective mutism speak freely and often at home and in comfortable settings, but may be unable to utter a sound in other settings or when unfamiliar people are around. The child may rely on nonverbal ways to communicate (point, gesture) or may limit communication to whispers and/or talking only to specific individuals. Treatment involves graduated exposures to feared stimuli that desensitizes the child so s/he can habituate to his/her fear.
Below is a list of clincal procedures used by ATS for treating Selective Mutism (SM). While outpatient therapy is effective, current research also supports effectiveness of intensive treatment. In many cases, intensive treatment accelerates treatment. For more information about SM and our intensive treatment program called Adventure Camp, please visit www.SelectiveMutismTreatment.net. Below is a description of the outpatient services we provide for SM.
CLINCIAL PROCEDURES FOR SELECTIVE MUTISM
EVALUATION AND OUTPATIENT TREATMENT
Description |
CPT Code |
Fee * dependent on level of clinician |
Diagnostic Evaluation: A 90-min diagnostic intake interview with the child’s parents to collect history, review of systems, differential diagnosis, review of prior records, review of sample videotape of child functioning, parents’ families psychiatric histories, especially in regards to SM and social anxiety. |
90791 |
$275-325 |
Child Observation & Parent Training Up to 60-min live behavioral observation(s) to assess and quantify the degree of mutism with and without the presence of a trained confederate “stranger,” (i.e., the therapist) allowing us to define baseline response rate to different question types, rate, latency and volume of speech with and without stranger present. Live training and modeling of basic exposure skills is provided to parents during this session. In this session and subsequent therapy sessions, Parents are taught, practice, and demonstrate the basics of the requisite prompting, monitoring, and reinforcement skills used by staff. Staff use modeling, shaping, corrective feedback, and contingent reinforcement with parents to train them in these skills. |
90837 |
$190-225 |
Parents Feedback Session and Parent Guidance: A one-hour feedback session with parents is held which includes presenting diagnoses, rule outs, and discussing their specific goals for their child and what they hope to gain from treatment at ATS. Decisions are made as to whether the child will start with therapy sessions only, allowing for the future addition of psychopharmacological treatment as an adjunct, or whether to start with combined treatment (or in rare cases to start with psychopharmacological treatment before CBT). Parents will be provided guidance on the behavioral techniques to implement at home and in the community with their child, to help maintain and generalize treatment gains. Parents are provided feedback about their child’s behavioral challenges and gains from the initial assessment sessions, and the specific techniques that will be used to successfully help their child overcome his/her specific barriers in the exposure process. Throughout treatment, parents may request additional feedback sessions to discuss next steps, including help with transfer of skills to school. |
90846 |
$190-225 |
Psychotherapy, Office Visit 45-min exposure sessions to condition the child to speak to parent in the presence of the therapist, then systematically over several sessions fading the parent out so the child is talking to the therapist in the absence of the parent. During these sessions, parents build on the basics taught during the Parent Training session, practicing and demonstrating to mastery the requisite prompting, monitoring, and reinforcement skills used by staff. Staff continue to use modeling, shaping, corrective feedback, and contingent reinforcement with child and parents. Our data show that we are able to establish verbal behavior within 6 sessions with the majority of our patients. |
90834 |
$125-190 |
Psychotherapy, School Visit / Community Visit
60-min exposure sessions provided in the school, home, or community setting to help transfer treatment gains into these domains. By nature of the disorder, SM symptoms occur selectively across environments. To increase transfer of treatment gains and help establish and maintain verbal behavior in other settings, in-vivo and in-situ exposure therapy is most effective. Similar to the office visit, your ATS Therapist works with school staff to train them how to appropriately prompt, monitor, and reinforce your child’s verbal behavior with guidance via modeling and demonstrating use of skills. Community visits are used to help parents use said skills in public, and/or provide exposure practice in new settings. These sessions are important to condition the child to speak in more than one setting, fostering generalization of verbal behavior in multiple settings. Our data show that patients who receive office, school, and community sessions show increased self-confidence, less inhibition, and overall significant improvement in verbal behavior. |
90837 |
$160-225 plus travel |