Long-term outcome revealed enduring cognitive and motor deficits in young adults with CH relative to control subjects. Verbal functions and Arithmetic were associated with L-thyroxine treatment variables, suggesting that more optimal treatment might be possible. Motor outcome was associated with CH severity, indicating a prenatal effect.

The objective of the present study was to examine the relationship between sluggish cognitive tempo (SCT), subtypes of attention-deficit/hyperactivity disorder (ADHD), and anxiety disorders (AnxDs). One hundred and forty-one children (90 males, 51 females) aged 7-13 years were assigned to four groups, i.e., referred children with comorbid AnxDs and ADHD (n = 25), ADHD (n = 39), AnxDs (n = 41), and nonreferred controls (n = 36). Furthermore we explored the association between SCT and several neurocognitive measures (reaction time, verbal memory, and spatial memory). Diagnoses were established using Kiddie-SADS P/L. SCT was assessed using a 17-item mother-reported questionnaire. SCT correlated significantly with inattentiveness, regardless of the subtype of ADHD. Furthermore, we found significant differences in the levels of SCT among the four groups, with the highest SCT scores observed in the comorbid group. SCT correlated with variability in spatial memory; in contrast, there was no correlation between SCT and reaction time.

In children referred to CAMHS, ND constitute the most frequently occurring group of disorders, with high rates of both homotypic and heterotypic comorbidity. This needs to be taken into consideration in health service planning and treatment delivery.

Background: Randomized controlled psychosocial treatment studies on selective mutism (SM) are lacking. Method: Overall, 24 children with SM, aged 3-9 years, were randomized to 3 months treatment (n = 12) or wait list (n = 12). Primary outcome measure was the School Speech Questionnaire. Results: A significant time by group interaction was found (p = .029) with significantly increased speech in the treatment group (p = .004) and no change in wait list controls (p = .936). A time by age interaction favoured younger children (p = .029). Clinical trail registration: Norwegian Research CouncilNCT01002196. Conclusions: The treatment significantly improved speech. Greater improvement in the younger age group highlights the importance of an early intervention. Key Practitioner Message• Early detection and treatment of children with selective mutism is crucial due to the elevated risk for chronicity of symptoms.• The preschool arena is an important setting for the recognition of anxious and withdrawn behaviour that often precedes selective mutism.• Evidence supports the use of a home-and school-based psychosocial intervention to increase speech.• Greater improvement in younger children (preschool) highlights the importance of early intervention.Keywords: Selective mutism; randomized controlled trial; behavioural intervention; social phobia; childhood anxiety IntroductionChildren with SM are characterized by a consistent lack of speech in specific social situations in which there is an expectation for speaking (e.g. school) despite speaking in other situations (e.g. home) (American Psychiatric Association, 2000). SM is found to be associated with comorbid anxiety diagnoses, in particular with social anxiety disorder, as well as neurodevelopmental disorders (Kristensen, 2000). Age of onset is typically before age 5 years (Black & Uhde, 1995). SM is relatively rare, with a prevalence of about 0.7-0.8% in childhood, somewhat more frequent in girls (Bergman, Piacentini, & McCracken, 2002). A 0.1% prevalence of SM was found in a representative sample of Norwegian 4 year olds using a preschool diagnostic interview (Wichstrom et al., 2012).SM is considered to be hard to treat and the literature on treatment for SM is dominated by case studies or case series. One review describes that the few existing studies (since 1980) with samples above five children have mainly used behavioural, cognitive-behavioural or multimodal interventions (Manassis, 2009). Another review states that behavioural interventions (including stimulus fading, desensitization, shaping, modelling and contingency management) are most frequently used (Cohan, Chavira, & Stein, 2006). Only two studies include a comparison group. The first study examined retrospectively the records for 25 children with SM treated either with behavioural therapy or a school-based remediation programme. The children treated with behavioural therapy showed a greater improvement compared to the group which received the school-based remediation intervention (Sluckin, Foreman, & Herbert,...

Cognitive behavioral therapy (CBT) is generally considered the recommended approach for selective mutism (SM). Prospective follow-up studies of treated SM and predictors of outcome are scarce. We have developed a CBT home and school-based intervention for children with SM previously found to increase speech in a pilot efficacy study and in a randomized controlled treatment study. In the present report we provide outcome data 1 year after having completed the 6-month course of CBT for 24 children with SM, aged 3–9 years (mean age 6.5 years, 16 girls). Primary outcome measures were the teacher rated School Speech Questionnaire (SSQ) and diagnostic status. At follow-up, no significant decline was found on the SSQ scores. Age and severity of SM had a significant effect upon outcome, as measured by the SSQ. Eight children still fulfilled diagnostic criteria for SM, four were in remission, and 12 children were without diagnosis. Younger children improved more, as 78 % of the children aged 3–5 years did not have SM, compared with 33 % of children aged 6–9 years. Treatment gain was upheld at follow-up. Greater improvement in the younger children highlights the importance of an early intervention.