Comparison of Treatment Strategies and the Selective Mutism Questionnaire (SMQ) Scores in Japanese and International Clinical Trials

In Japan, selective mutism (SM) symptoms are assessed using the Selective Mutism Questionnaire-Revised (SMQ-R). This study aimed to investigate SM treatment studies in Japan by analyzing changes in SMQ-R scores related to interventions and comparing the findings with the results of international studies that used the original Selective Mutism Questionnaire (SMQ). Based on a previous scoping review of clinical reports on SM in Japan, five articles that discussed the research on 28 participants were selected and compared with eight studies that were conducted on a total of 421 participants from international clinical research meta-analyses. Compared with international studies, research in Japan demonstrated higher individualization and longer intervention duration. Further, interventions in schools and public settings were not implemented, SM symptom improvements were smaller, and assessments of comorbidity and follow-up were lacking. To improve SM treatment in Japan, elements of behavioral therapy, which is predominantly used in international studies, need to be incorporated. Moreover, collaboration should be promoted across medical facilities, schools, and homes; and comprehensive assessment and follow-up must be ensured.