Evaluation of a Novel Parent-Rated Scale for Selective Mutism

Gensthaler, Angelika; Dieter, Julia; Raisig, Susanne; Hartmann, Boris; Ligges, Marc; Kaess, Michael; Freitag, Christine M.; Schwenck, Christina

doi:10.1177/1073191118787328

Cited by 27 publications

(48 citation statements)

References 23 publications

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“…Our mean score findings in the TDs are quite similar to previous findings from the small group ( n = 18) of referred children diagnosed with anxiety disorders other than SM, where a total SMQ score >2.5 was reported ( Bergman et al, 2008 ). The relatively comparable parent-rated scores between children with anxiety disorders in the Bergman study ( Bergman et al, 2008 ) and the TDs in this study have also been reported on the more recently developed parent-rated FSSM ( Gensthaler et al, 2018 ). In the FSSM study, it was demonstrated that children with social phobia had scores about twice as high as those for the TDs and children with other anxiety disorders, and about half as high as the scores for children with SM, thus adding important information on speaking behavior as reported by parents in this diagnostic group ( Gensthaler et al, 2018 ).…”

Section: Discussionsupporting

confidence: 77%

“…Children with SAD may also show speech problems, such as longer speech latency, inappropriate tone or low voice volume, and reduced spontaneous speech ( Beidel et al, 2019 ). Whether speaking behavior differentiates the two conditions has not been evaluated until the recent publication of the Frankfurt Scale of Selective Mutism (FSSM; Gensthaler et al, 2018 ). The parent-rated FSSM is a validated, age-adjusted measure of SM for both research and clinical practice and includes a diagnostic scale (DS) and a severity scale for three age groups (3–18 years).…”

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confidence: 99%

“…The parent-rated FSSM is a validated, age-adjusted measure of SM for both research and clinical practice and includes a diagnostic scale (DS) and a severity scale for three age groups (3–18 years). In a study including children and adolescents with SM, SAD, or internalizing disorders, and a control group ( n = 334), the mean DS sum scores differed significantly between the diagnostic groups, and the receiver operating characteristic analysis gave optimal cutoffs for distinguishing SM from the other groups with the area under the curves of 0.94–1.00 ( Gensthaler et al, 2018 ).…”

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confidence: 99%

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The Selective Mutism Questionnaire: Data from typically developing children and children with selective mutism

Oerbeck

Øvergaard

Bergman³

et al. 2020

Clin Child Psychol Psychiatry

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The core symptom of the anxiety disorder selective mutism (SM) is absence of speech in specific situations, such as at school. The most commonly used standardized instruments to assess speaking behavior are the parent-rated Selective Mutism Questionnaire (SMQ) and the teacher-rated School Speech Questionnaire (SSQ), scored from 0 to 3, indicating that speaking behavior never, seldom, often, and always occur. They were developed to assess severity of mutism and potential effects of treatment. However, prospective data on speaking behavior in typically developing children (TDs) are missing in the literature. The main aim of this study was to present data from TDs over time with previously reported data from children treated for SM, as a comparison. Participants were 64 children aged 3–9 years, 32 TDs who were a matched control group to 32 children with SM. At baseline, the mean SMQ and SSQ scores were ⩾2.5 in TDs and 0.5 in children with SM. The TDs did not show significant changes over time, while significantly increased speech was found in children with SM after treatment. Thus, our findings support the use of the SMQ/SSQ to assess baseline SM severity and to evaluate potential treatment effects in future studies.

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Section: Discussionsupporting

confidence: 77%

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confidence: 99%

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confidence: 99%

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The Selective Mutism Questionnaire: Data from typically developing children and children with selective mutism

Oerbeck

Øvergaard

Bergman³

et al. 2020

Clin Child Psychol Psychiatry

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“…Because a social situation is usually influenced by all three factors an interaction between the three components can be assumed and children are usually confronted with more than one anxiety eliciting stimuli [25]. The three factors were confirmed by a factor analysis of a screening questionnaire [26] although another screening tool has found only one factor on which all items loaded [27]. Empirical data on talking patterns of children with SM are sparse yet, but there are some single research results that indicate proof for the existence of such factors that have an influence on the speaking behavior of children with SM.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of person, place, and activity that trigger failure to speak in children with selective mutism

Schwenck

Gensthaler

Vogel

et al. 2021

Eur Child Adolesc Psychiatry

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Selective Mutism (SM) is an anxiety disorder with predictable and circumscribed situations in which children remain silent while they speak unaffectedly in others. However, core features of anxiety inducing stimuli have rarely been studied so far. Parents of children with elevated SM symptomatology participated in an online-based study and answered open ended questions about specific characteristics of a person, place, and activity that elicit failure to speak in their child. The final sample consisted of n = 91 parents with children aged between 3 and 17 years (M = 8.02 years, SD = 3.94). Answers were analyzed by qualitative content analysis. Characteristics of a person were assigned to five categories with lack of distance as the most frequently reported feature. With respect to a place, the majority of parents mentioned unknown places as a silence trigger. The most frequently mentioned feature of an activity that was designated to be associated to silence was new activity. There were only few associations between the designation of these features, age, and gender. For the first time, anxiety inducing triggers related to person, place, and activity were comprehensively assessed in children with SM. This allows a differentiated and deeper understanding of an understudied disorder. The majority of characteristics can be associated with proposed etiological factors such as increased behavioral inhibition, conditioning processes, social anxiety, and a strong need for control. Implications for effective treatments are discussed.

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“…Children showing SM in its extreme form (i.e., <1%; Bergman et al, 2002;Karakaya et al, 2008) are usually referred to a clinical facility for treatment because the persistent non-speaking behavior obviously hinders them in performing adequately in school and establishing friendships with other children (Manassis, 2009). It is good to bear in mind, however, that SM is a dimensional phenomenon as there are also young children who are not totally silent in certain social situations, but clearly use less spoken language as they would do in other settings (Gensthaler et al, 2020). This means that SM, just like other psychiatric conditions, is better conceptualized as a continuum rather than as a categorical diagnostic entity, and this justifies that its scientific inquiry should not only be conducted in clinical samples but also in non-clinical populations.…”

Section: Introductionmentioning

confidence: 99%

Symptoms of Selective Mutism in Non-clinical 3- to 6-Year-Old Children: Relations With Social Anxiety, Autistic Features, and Behavioral Inhibition

et al. 2021

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Selective mutism (SM) is a psychiatric condition that is characterized by a failure to speak in specific social situations (e. g., at school) despite speaking normally in other situations (e.g., at home). There is abundant evidence that anxiety, and social anxiety in particular, is a prominent feature of SM, which is the main reason why this condition is currently classified as an anxiety disorder. Meanwhile, there is increasing support for the notion that autism-related problems are also involved in SM. The present study examined the relations between SM and social anxiety, autistic features, and behavioral inhibition to the unfamiliar (i.e., the tendency to react with restraint and withdrawal when confronted with unfamiliar stimuli and situations). Parents of 172 3- to 6-year-old preschool children completed an online survey for measuring the relevant constructs. Results showed that there were positive and statistically significant correlations between SM and social anxiety, autistic features, and behavioral inhibition. Regression analyses revealed that (1) both social anxiety and autistic features accounted for a significant and unique proportion of the variance in SM scores, and (2) that both of these variables no longer made a significant contribution once behavioral inhibition was added to the model. It can be concluded that while the involvement of social anxiety is unambiguous in SM, autism-related problems are also implicated. Furthermore, behavioral inhibition seems to play a key role in the non-speaking behavior of non-clinical young children.

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Evaluation of a Novel Parent-Rated Scale for Selective Mutism

Cited by 27 publications

References 23 publications

The Selective Mutism Questionnaire: Data from typically developing children and children with selective mutism

The Selective Mutism Questionnaire: Data from typically developing children and children with selective mutism

Characteristics of person, place, and activity that trigger failure to speak in children with selective mutism

Symptoms of Selective Mutism in Non-clinical 3- to 6-Year-Old Children: Relations With Social Anxiety, Autistic Features, and Behavioral Inhibition

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