Intensive group behavioral treatment (IGBT) for children with selective mutism: A preliminary randomized clinical trial.

Cornacchio, Danielle; Furr, Jami M.; Sanchez, Amanda L.; Hong, Natalie; Feinberg, Leah; Tenenbaum, Rachel B.; Busto, Cristina del; Bry, Laura J.; Poznanski, Bridget; Miguel, Elizabeth; Ollendick, Thomas H.; Kurtz, Steven M.; Comer, Jonathan S.

doi:10.1037/ccp0000422

Cited by 49 publications

(60 citation statements)

References 63 publications

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“…Furthermore, although the children with SM showed a significantly increased speech after treatment, they still lagged behind the TDs. Comparable end points (⩽2) on the SMQ/SSQ after treatment has also been reported in other studies of SM ( Bergman et al, 2013 ; Catchpole et al, 2019 ; Cornacchio et al, 2019 ; Klein et al, 2017 ). At present, we do not know whether a more intensified treatment would increase speech in children with SM, or whether a somewhat reduced level of speech is to be expected in a group of children where behaviorally inhibited temperament is prominent ( Gensthaler et al, 2016 ; Muris et al, 2016 ).…”

Section: Discussionsupporting

confidence: 79%

“…Baseline scores below 1 on the SSQ and the SMQ School subscale have largely been supported in data from recent SM treatment studies which include a reasonably large samples of children, in both United States and Europe ( Bergman et al, 2013 ; Catchpole et al, 2019 ; Cornacchio et al, 2019 ; Klein et al, 2017 ; Lang et al, 2016 ; Oerbeck et al, 2014 ) (see Table 1 ). These studies also demonstrate small, but significant changes after treatment (of different lengths) with post-treatment scores ranging from 1 to 3 (generally ⩽2).…”

mentioning

confidence: 75%

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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: 79%

mentioning

confidence: 75%

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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“…A preliminary randomized clinical trial into behavioral treatment of selective mutism showed an effect size of Cohen's d = 0.58 on speaking in social situations [ 15 ]. To determine effects on our primary outcome (i.e.…”

Section: Methodsmentioning

confidence: 99%

“…A recent non-randomized trial showed that behavioral techniques with additional parent child interaction therapy improve SM symptoms [ 13 ]. Three previous randomized controlled trials (RCT) investigated showed that behavioral therapy was effective for selective mutism [ 8 , 14 , 15 ]. These studies provided therapy in different settings i.e.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of a behavioral treatment protocol for selective mutism in children: Design of a randomized controlled trial

Pereira

Ensink

Güldner³

et al. 2020

Contemporary Clinical Trials Communications

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Selective mutism (SM) is a relatively rare anxiety disorder, characterized by a child's consistent failure to speak in various specific social situations (e.g., at school), while being able to speak in other situations (e.g., at home). Prevalence rates vary from 0.2% to 1.9%. SM is usually identified between the ages of 3–5 years. It is often underdiagnosed and consequently children receive no or inadequate treatment, with negative consequences for school and social functioning. If left untreated, SM can result in complex, chronic anxiety and/or mood disorders in adolescence and impaired working careers in adulthood. Currently, no evidence-based treatment for SM is available in the Netherlands, therefore this study aims to [1] test the effectiveness of a treatment protocol for SM that is carried out at school, and to [2] identify baseline predictors for treatment success. This article presents the design of a randomized controlled trial into the effectiveness of a behavioral therapeutic protocol for selective mutism in children (age 3–18). The expected study population is n = 76. Results of the treatment group (n = 38) will be compared with those of a waiting list control group (WCG) (n = 38). Pre and post treatment assessments will be conducted at comparable moments in both groups, with baseline assessment at intake, the second assessment at 12 weeks and post-assessment at the end of treatment. If proven effective, we aim to structurally implement this protocol as evidence-based treatment for SM.

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Screening for Anxiety in Children and Adolescents

Viswanathan

Wallace

Middleton

et al. 2022

JAMA

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ImportanceAnxiety in children and adolescents is associated with impaired functioning, educational underachievement, and future mental health conditions.ObjectiveTo review the evidence on screening for anxiety in children and adolescents to inform the US Preventive Services Task Force.Data SourcesPubMed, Cochrane Library, PsycINFO, CINAHL, and trial registries through July 19, 2021; references, experts, and surveillance through June 1, 2022.Study SelectionEnglish-language, randomized clinical trials (RCTs) of screening; diagnostic test accuracy studies; RCTs of cognitive behavioral therapy (CBT) or US Food and Drug Administration–approved pharmacotherapy; RCTs, observational studies, and systematic reviews reporting harms.Data Extraction and SynthesisTwo reviewers assessed titles/abstracts, full-text articles, and study quality and extracted data; when at least 3 similar studies were available, meta-analyses were conducted.Main Outcomes and MeasuresTest accuracy, symptoms, response, remission, loss of diagnosis, all-cause mortality, functioning, suicide-related symptoms or events, adverse events.ResultsThirty-nine studies (N = 6065) were included. No study reported on the direct benefits or harms of screening on health outcomes. Ten studies (n = 3260) reported the sensitivity of screening instruments, ranging from 0.34 to 1.00, with specificity ranging from 0.47 to 0.99. Twenty-nine RCTs (n = 2805) reported on treatment: 22 on CBT, 6 on pharmacotherapy, and 1 on CBT, sertraline, and CBT plus sertraline. CBT was associated with gains on several pooled measures of symptom improvement (magnitude of change varied by outcome measure), response (pooled relative risk [RR], 1.89 [95% CI, 1.17 to 3.05]; n = 606; 6 studies), remission (RR, 2.68 [95% CI, 1.48 to 4.88]; n = 321; 4 studies), and loss of diagnosis (RR range, 3.02-3.09) when compared with usual care or wait-list controls. The evidence on functioning for CBT was mixed. Pharmacotherapy, when compared with placebo, was associated with gains on 2 pooled measures of symptom improvement—mean difference (Pediatric Anxiety Rating Scale mean difference, −4.0 [95% CI, −5.5 to −2.5]; n = 726; 5 studies; and Clinical Global Impression–Severity scale mean difference, −0.84 [95% CI, −1.13 to −0.55]; n = 550; 4 studies) and response (RR, 2.11 [95% CI, 1.58 to 2.98]; n = 370; 5 studies)—but was mixed on measures of functioning. Eleven RCTs (n = 1293) reported harms of anxiety treatments. Suicide-related harms were rare, and the differences were not statistically significantly different.Conclusions and RelevanceIndirect evidence suggested that some screening instruments were reasonably accurate. CBT and pharmacotherapy were associated with benefits; no statistically significant association with harms was reported.

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Intensive group behavioral treatment (IGBT) for children with selective mutism: A preliminary randomized clinical trial.

Cited by 49 publications

References 63 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

Effectiveness of a behavioral treatment protocol for selective mutism in children: Design of a randomized controlled trial

Screening for Anxiety in Children and Adolescents

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