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Selective mutism questionnaire scoring pdf

Selective mutism checklist pdf 2026

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The Selective Mutism Questionnaire (SMQ)© is a tool designed to assess a child's communication behaviors in various settings, including school, home, and social situations. It consists of statements that parents rate based on their child's recent behavior, focusing on how often the child speaks to peers, teachers, and family members. The questionnaire also includes items that evaluate the impact of selective mutism on the child's life and relationships. Additionally, it provides forms for homework assignments, exposure tasks, and progress tracking to support therapeutic interventions.

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Click ‘Get Form’ to open the selective mutism checklist PDF in the editor.
Begin by reviewing the 'AT SCHOOL' section. For each statement, select how frequently it applies to your child by choosing from 'Always', 'Often', 'Seldom', or 'Never'.
Move on to the 'HOME/FAMILY' section. Again, rate each statement based on your child's behavior in various family settings.
Next, complete the 'IN SOCIAL SITUATIONS' section. Assess how your child interacts with peers and adults outside of school.
Finally, address the 'Interference/Distress' questions. Rate how much not talking affects different areas of your child's life.
Once all sections are filled out, review your responses for accuracy before saving or sharing the completed form.

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What trauma causes mutism?

Childhood abuse is a cause of selective mutism because it is a traumatic experience and may lead to anxiety. An article by L. Guo et al from the June 2021 issue of Translational Psychiatry revealed childhood maltreatment may influence anxiety symptoms and coping styles.

What is the selective mutism assessment tool?

The Selective Mutism Questionnaire (SMQ)21 is the only available instrument developed to measure a childs frequency of non-speaking behavior across situations in which children are expected to speak.

How does selective mutism affect adulthood?

Anxiety and Social Phobia: Many adults with selective mutism experience intense anxiety and social phobia, making it challenging for them to communicate verbally in certain situations. Anxiety can make speaking in public or unfamiliar settings incredibly stressful.

Is selective mutism a form of PTSD?

When mutism occurs as a symptom of post-traumatic stress, it follows a very different pattern and the child suddenly stops talking in environments where they previously had no difficulty. Another misconception is that a child with selective mutism is controlling or manipulative, or has autism.

What is the best medication for selective mutism?

Typically, but not always, the first suggestedmedication for SM with or without social anxiety disorder will be an SSRI -- a selective serotonin reuptake inhibitor -- such as Fluoxetine (Prozac) or Sertraline (Zoloft).

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How do you break out of selective mutism?

Selective Mutism: Frozen in Silence Use gestures, images, email or texting. Let the person know whats coming so they can mentally prepare, especially when something changes or a transition is imminent. Choose activities that can be done with or without speech, like puzzles, watching movies, or reading.

What not to do with someone with selective mutism?

Do not pressurise or bribe your child to encourage them to speak. Let your child know you understand theyre scared to speak and have difficulty speaking at times. Tell them they can take small steps when they feel ready and reassure them that talking will get easier.

Selective mutism checklist pdf 2026

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What trauma causes mutism?

What is the selective mutism assessment tool?

How does selective mutism affect adulthood?

Is selective mutism a form of PTSD?

What is the best medication for selective mutism?

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How do you break out of selective mutism?

What not to do with someone with selective mutism?

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