Feasibility and Acceptability Study of Early Intervention Music Therapy for Young Children with Selective Mutism

IntroductionSelective Mutism (SM) is an anxiety disorder affecting some children starting school. Usual presentation is lack of speech at school, contrasting with confident speech at home. Estimated prevalence is 0.7%, rising to 2.2% for children who are second language learners. Long-term impacts include complex mental health conditions for children not receiving timely intervention. There are calls for effective treatments as part of a multi-modal care pathway. Case study research describes music therapy leading to generalised speech, but an evidenced-based approach is currently lacking. This study evaluates acceptability and feasibility of a manualised music therapy intervention for children with SM. MethodsFour children with SM in early years school settings were offered manualised music therapy over a 14-week period. In-depth qualitative interviews were conducted with the music therapist, a school staff member and a parent of each child (n=12). Interviews were analysed using a framework grounded in well-theorised constructs of acceptability and feasibility. ResultsAcceptability was high for all participant groups, with clear comprehension and confidence in an intervention viewed as appropriate for the early years population. Need for cultural competence in delivery was highlighted. Analysis of feasibility demonstrated rapid recruitment, practicality and fit with the school environment, and a strong sense of perceived effectiveness including anxiety reduction, improved emotional well-being, increased self-expression and generalised speech. DiscussionThis study has added to the methodological literature on evaluating acceptability and feasibility in music therapy interventions and has indicated the appropriateness of moving to experimental testing of the SM intervention evaluated here.