intervention for selective mutismintervention for selective mutism

selective mutism is based on case studies because selective mutism is a rare childhood conditions occurring in less than 1% of the population (Crundwell 49). In a large survey sent to child and adolescent psychiatrists, Carlson et al 17 showed that antidepressants were used most commonly to treat selective mutism. Selective Mutism (SM) is first & foremost an anxiety disorder in which a child who is otherwise chatty or talkative cant talk in other settings, like school or with friends. Specifically, speech would appear to be under control of setting-specific stimuli as opposed to the usual social stimuli (e.g., presence of a listener) and motivating operations that evoke speech. Shu-Lan Hung and others, Selective Mutism: Practice and Intervention Strategies for Children, Children & Schools, Volume 34, Issue 4, October 2012, Pages 222230, https://doi.org/10.1093/cs/cds006. Any comments that ask for telephone, address, e-mail, surveys and research studies will not be approved for posting. The central elements are a very close cooperation with the school, underlining both child- and parent-engagement, and the behavioral component of gradual exposure to the feared stimulus (e.g., speaking) is emphasized. Pediatric anxiety disorders can be effectively treated in the short term, and predictors of remission were found to be younger age, nonminority status, lower baseline anxiety severity, absence of other internalizing disorders, and absence of social phobia [34]. The SMQ includes 32 questions scored from 0 to 3, where 0 indicates that speaking behavior never occurs, and 1, 2 and 3 refer to seldom, often and always speaking, respectively. A majority of the parents (59%) had received some form of consultation/school meetings related to their childs school functioning. However, no sessions ended early because communication breakdowns rarely occurred during the intervention. Two children (one preschool- and one school-age child) who at the 5year follow-up did not speak in all school situations were diagnosed with SM in partial remission, after having been fluent speakers at the 1-year follow-up. Early intervention for children with selective mutism is associated with better outcomes in a shorter time period Speech and language therapists have a key role to play in supporting early identification as well as the management of selective mutism Bergman LR, Keller ML, Piacentini J, Bergman AJ. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Selective Mutism - From Diagnosis to Intervention | Anxiety and Again, there was a significant effect of age group (F1,30=12.01, p=0.002), but no significant time by age interaction (F4,115=0.82, p=0.52), see Fig. and transmitted securely. According to Diagnostic and Statistical Manual of Mental Disorders (DSM-5), SM is considered to be an anxiety disorder and may coexist with social anxiety disorder (SAD) and autism spectrum disorder (ASD). Sharkey L, Mc Nicholas F, Barry E, Begley M, Ahern S. J Behav Ther Exp Psychiatry. Please remember that the open and real-time nature of the comments posted to these venues makes it is impossible for ADAA to confirm the validity of any content posted, and though we reserve the right to review and edit or delete any such comment, we do not guarantee that we will monitor or review it. Despite this efficiency, the need to target each social situation individually is a substantial limitation for individuals with selective mutism who require intervention across numerous social situations. PDF Toolkit for Educators - Selective Mutism Early childhood educators play a unique role in helping to identify selective mutism, given that symptoms often do not occur in the . Muris P, Monait N, Weijsters L, Ollendick TH. sharing sensitive information, make sure youre on a federal McCoy K, Hermansen E. Video modeling for individuals with autism: A review of model types and effects. A case study of a school team who implemented such strategies with minimal support from a behavioral consultant is presented. [22] with the longest follow-up time (into adulthood), social phobia represented the most prevalent comorbid disorder. This is a prospective long term follow-up study conducted at mean 5years after the end of our school-based CBT especially adapted for children with SM. A good treatment for SM should involve strategies for generalization, which means helping the children speak to more people, in more places and in more situations. Go to book: Handbook of Evidence-Based Interventions for Children and Adolescents, Handbook of Evidence-Based Interventions for Children and Adolescents, Log in, redeem an access code, or make a purchase to access this content - click here for options, Evidence-Based Interventions for Selective Mutism for Children and Adolescents, Treatment Integrity: Evidence-Based Interventions in Applied Settings, Evidence-Based Interventions for Comprehensive School Crises, Evidence-Based Interventions to Support Youth Following Natural Disasters: Evidence-Based Principles and Practices, Evidence-Based Interventions for School Violence, Evidence-Based Interventions for Suicidal Behavior in Children and Adolescents, Evidence-Based Interventions for Childhood Grief in Children and Adolescents, Students With Educational Issues and Learning Disorders, Evidence-Based Interventions for Reading Disabilities in Children and Adolescents, Evidence-Based Interventions for Math Disabilities in Children and Adolescents, Evidence-Based Interventions for Written-Language Disorders in Children and Adolescents, Evidence-Based Interventions for Homework Compliance in Children and Adolescents, Evidence-Based Interventions for Working With Culturally Diverse Children and Families, Children and Adolescents With Childhood Psychopathologies, Evidence-Based Interventions for Anger and Aggression in Children and Adolescents, Evidence-Based Interventions for Bullying Among Children and Adolescents, Evidence-Based Interventions for Attention Deficit Hyperactivity Disorder in Children and Adolescents, Evidence-Based Interventions for Oppositional Defiant Disorder in Children and Adolescents, Evidence-Based Interventions for Conduct Disorder in Children and Adolescents, Evidence-Based Interventions for Children and Adolescents With Emotional and Behavioral Disorders, Evidence-Based Interventions for Obsessive-Compulsive Disorder in Children and Adolescents, Evidence-Based Interventions for Social Anxiety Disorder in Children and Adolescents, Evidence-Based Interventions for Separation Anxiety Disorder in Children and Adolescents, Evidence-Based Interventions for Specific Phobias in Children and Adolescents, Evidence-Based Interventions for School Refusal Behavior in Children and Adolescents, Internalizing Disorders: Depressive Related, Evidence-Based Interventions for Major Depressive Disorder in Children and Adolescents, Evidence-Based Interventions for Persistent Depressive Disorder in Children and Adolescents, Evidence-Based Interventions for Pediatric Bipolar Disorder, Evidence-Based Interventions for Posttraumatic Stress Disorder in Children and Adolescents, Evidence-Based Interventions for Stress in Children and Adolescents, Evidence-Based Interventions for Children and Adolescents of Divorced Parents, Evidence-Based Interventions for Social Skill Deficits in Children and Adolescents, Evidence-Based Interventions for Self-Concept in Children and Adolescents, Evidence-Based Interventions for Promoting Subjective Well-Being in Children and Adolescents, Physical Conditions and Health-Related Disorders, Evidence-Based Interventions for Eating Disorders in Children and Adolescents, Evidence-Based Interventions for Childhood Obesity, Evidence-Based Interventions for Tourettes and Other Chronic Tic Disorders in Children and Adolescents, Evidence-Based Interventions for Elimination Disorders in Children and Adolescents: Enuresis and Encopresis, Evidence-Based Interventions for Asthma in Children and Adolescents, Neuropsychological Development and Considerations for Prevention, Evidence-Based Interventions for Autism Spectrum Disorders in Children and Adolescents, Evidence-Based Interventions for Traumatic Brain Injuries and Concussions in Children and Adolescents, Management of Neurodevelopmental Disorders, Assessment of Behavioral, Social, and Emotional Functioning. government site. To effectively overcome Selective Mutism and all anxieties, an individual needs to be involved in a treatment program, such as those rooted in evidenced-based Social Communication Anxiety Treatment (S-CAT), like Individualized Intensives and CommuniCamp Intensive Group Treatment & Parent Training Program. The SM module relates to the speaking behavior of the child in different social situations. in Kindergarten to grade two was 0.71%. As shown in Fig. It can continue into adolescence and adulthood if not managed. Careers, Unable to load your collection due to an error. Cohan SL, Chavira DA, Shipon-Blum E, Hitchcock C, Roesch SC, Stein MB. and transmitted securely. sharing sensitive information, make sure youre on a federal Diagnosis in children. IBTSM appears to be a promising new intervention that is efficacious in increasing functional speaking behaviors, feasible, and acceptable to parents and teachers. Inventory of life quality in children and adolescents. Suffering in silence: why a developmental psychopathology perspective on selective mutism is needed. SSQ results further indicated a more pronounced increase in speech in younger children. All but one child spoke freely in all preschool settings after a mean of 17weeks treatment (sd 5, range 824weeks). The final inclusion was confirmation of the SM diagnosis after a parental diagnostic interview and a child assessment to rule out severe intellectual problems. Treatment for children with selective mutism. Dr. Busman is the former president of the Selective Mutism Association, the nations largest network of professionals, families, and individuals with selective mutism. We evaluated a behavioral intervention for a 9-year-old girl with selective mutism. Social communication anxiety treatment (S-CAT) for children and families with selective mutism: a pilot study. ADAA does not provide psychiatric, psychological, or medical advice, diagnosis, or treatment. 2 Please note this Educators' toolkit was written by the Selective Mutism Association; all authors live in the United States and the information contained within is directly applicable to the Children aged 39years, consecutively referred from outpatient Child and Adolescent Mental Health Clinics (CAMHS) or school psychology services in Southern Norway who fulfilled DSM diagnostic criteria for SM. However, it is also likely that a natural development is at play, especially for the elimination disorders and separation anxiety, known for being age dependent [2]. Cohan SL, Price JM, Stein MB. Breakdowns were defined as failures in communication in which (a) the communication partner repeated a question, (b) the communication partner asked Leslie to repeat herself, or (c) Leslie did not respond within 5s of being asked a question. Refrain from transmitting any message, information, data, or text that is unlawful, threatening, abusive, harassing, defamatory, vulgar, obscene, that may be invasive of another 's privacy, hateful, or bashing communications - especially those aimed at gender, race, color, sexual orientation, national origin, religious views or disability. The level of significance was defined as p<0.05. As in the SMQ, 0 indicates that speaking behavior never occurs, and 1, 2, and 3 refer to seldom, often and always speaking, respectively. The content, view and opinions published in Blogs written by our personnel or contributors or from links or posts on the Website from other sources - belong solely to their respective authors and do not necessarily reflect the views of ADAA, its members, management or employees. Bethesda, MD 20894, Web Policies Do not use an Oxford Academic personal account. Federal government websites often end in .gov or .mil. Practitioner review: psychosocial interventions for children with selective mutism: a critical evaluation of the literature from 19902005. A mean ILC problem score can then be calculated (range 07), where a score of 1.28 (sd 1.60) has been reported in Norwegian school children aged 816years (, {"type":"clinical-trial","attrs":{"text":"NCT01002196","term_id":"NCT01002196"}}, Selective mutism, Child anxiety, CBT, Quality of life, Self-report. Therefore, the increase in responses from Restaurant 1 to Restaurant 2 is explained by the increase in opportunity. A mean score range (range 15) and a problem score (PR) (where ratings of 1 or 2 indicates no problem, and ratings of 3, 4 or 5 indicates that a problem with speaking is present), was computed. In the following years, different CBT approaches have been reported to lead to symptom improvement in case series using both individual- and group formats [19, 20]. Descriptive statistics using mean/standard deviation (sd) or number/percentage of patients are presented for the diagnoses, SM questionnaires (SSQ, SMQ), the ILC and speaking behavior. Although most of them talked outside of home, 50% still experienced it as somewhat challenging. Selective mutism - Wikipedia Selective mutism and social anxiety disorder: all in the family? http://creativecommons.org/licenses/by/4.0/, http://iacapap.org/wp-content/uploads/F.5-MUTISM-NORWEGIAN-2016.pdf. One could question our use of the normative school sample aged 816years, for boys and girls together (LQ028 mean=22.59), as participants in the present study were 814years of age. The percentage of problems on the ILC subscales for children in the present study (SM, n=28) versus a sample of Norwegian schoolchildren [44] (Ctr, n=1987). The session was ended after 10min or two communication breakdowns. Clinical gains were largely maintained at follow-up, as rated by a both a child psychiatrist, teachers, and parents. Journal of Child Psychology and Psychiatry. Full remission: children who no longer fulfilled diagnostic criteria for SM, as they spoke freely at school. Epub 2019 Jul 18. It is important to note that Restaurant 2's menu and routine required the cashier to ask more questions than in Restaurant 1. Register, Oxford University Press is a department of the University of Oxford. Abstract Objective: To evaluate the feasibility, acceptability, and preliminary efficacy of a novel behavioral intervention for reducing symptoms of selective mutism and increasing functional speech. In 25 children, those given individual programs with a behavioral component were more likely to have improved compared with those given standard school-based remedial programs, 210years after referral, and familial psychopathology was a negative prognostic factor [23]. Any comments or opinions expressed are those of their respective contributors only. Because of a substantial overlap between SM and SAD, it is widely believed that the disorders may have similar genetic etiologies. Among these seven children, only two did not also have SM, or SM in partial remission. Whether the three children that changed status negatively in the present study (one relapse of SM and two diagnosed with SM in partial remission, after having been fluent speakers at the 1-year follow-up) show intermittent mutistic behavior or a more persisting mutism, cannot be ascertained in the present study. Most parents reported that they had used what they learned during the treatment period (defocused communication and graded exposure tasks) when they found it appropriate during the follow-up period. As noted in our previous follow-up studies [32, 33], the main improvement in speaking was found after 3months of treatment (T2). For the group as a whole (Table2), we found that the mean teacher reported SSQ scores changed from a level at baseline between Never and Seldom (0.55) to a level close to Often (1.86) at follow-up. National Library of Medicine However, our results are good compared to the important CAMELS study on children with anxiety disorders reporting a mean relapse in about half of acute responders when assessed at mean 6years after randomization. Thus, rigorously speaking they did not fulfill the DSM criteria of Consistent lack of speech. government site. Manassis K, Tannock R. Comparing interventions for selective mutism: a pilot study. Leslie was taken to the restaurant by an experimenter and her mother, given money, and asked to order anything she wanted. Child psychiatry. PMC The treatment was discontinued if the child started to speak freely before reaching the maximum length of treatment (6months). The behavioral components have been emphasized, as the symptom of muteness and the young age of onset of SM make the cognitive restructuring less feasible. We find it particularly promising that we could observe a significant effect, when our CAMHS therapists were not experts in SM or CBT. Due to the gradual shift in the understanding of SM from an act of will to an anxiety-based avoidance of speaking in specific situations, SM was classified as an anxiety disorder in the fifth edition of Diagnostic and statistical manual of mental disorders (DSM-5) [2]. An official website of the United States government. National Library of Medicine Key words: selective mutism, role play, video self-modeling, communication intervention, community settings _____ Selective mutism is a childhood disorder in which speech occurs in some environments but not in others (American Psychiatric Association, 2000). To purchase short-term access, please sign in to your personal account above. 1995. However, we note that the good outcome found in the retrospective study of 33 of 40 children with SM was achieved after mean 12months of therapy by one therapist [27], and the lack of active treatment reported by the parents in the present study could support the early findings of general undertreatment of pediatric anxiety disorders [48]. Sample size was limited. Federal government websites often end in .gov or .mil. If you would like more information on Selective Mutism and the work of the Selective Mutism Association, please visit selectivemutism.org. Selective Mutism in Elementary School: Multidisciplinary Interventions Online ahead of print. Leslie chose to work on ordering in a restaurant first, meeting adults second, and playing with peers last. Video self-modeling (VSM) is the use of video to depict the child as a model engaged in appropriate and exemplary behavior as a treatment to improve target behaviors. By giving a description of how we defined SM we could allow for study replication. SM can have a debilitating impact on the psychosocial and academic functioning in childhood. Children with SM have an anxiety disorder, and treatment, especially behavioral or cognitive -behavioral treatment can be very effective. Seligman LD, Ollendick TH. Behavioral treatment of a selectively mute Mexican-American boy.