Joint Attention in Parent–Child Dyads Involving Children with Selective Mutism: A Comparison Between Anxious and Typically Developing Children

Abstract

Although joint attention processes are known to play an important role in adaptive social behavior in typical development, we know little about these processes in clinical child populations. We compared early school age children with selective mutism (SM; n = 19) versus mixed anxiety (MA; n = 18) and community controls (CC; n = 26) on joint attention measures coded from direct observations with their parent during an unstructured free play task and two structured tasks. As predicted, the SM dyads established significantly fewer episodes of joint attention through parental initiation acts than the MA and CC dyads during the structured tasks. Findings suggest that children with SM may withdraw from their parents during stressful situations, thus missing out on opportunities for learning other coping skills. We discuss the implications of the present findings for understanding the maintenance and treatment of SM.

Children with autism spectrum disorders and selective mutism

“…Furthermore, a study on joint attention, a specific aspect of social communication, reported fewer episodes of joint attention in the SM group than in comparison group. 15 More girls than boys are affected by SM; 3 however, if that is the case in children with comorbid SM and ASD is not clear. A second aim was therefore to examine possible gender differences with regard to presence of ASD.…”

Anxiety in Children with Selective Mutism: A Meta-analysis

“…Perhaps these contradictory findings are caused by an observer bias in which the observers seek to attribute mutism to (social) anxiety [43,44]. Even though the overlap between SM and social phobia appears to be high, surprisingly low rates of comorbid social phobia have also been reported [49,50], although part of the children in these studies had been diagnosed with other comorbid anxiety disorders. As a matter of fact, comorbid diagnoses of anxiety disorder other than social phobia are commonly reported in children with SM, including specific phobia [46,50] and separation anxiety disorder [8,51].…”

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

“…Whether SM and SAD represent two distinct conditions is still not settled. Although most descriptive and controlled studies using diagnostic interviews have found high rates of comorbidity between SM and SAD (61–100%; Chavira et al, 2007; Manassis et al, 2007), there have been studies with low rates of SAD in SM (⩽18%; Carbone et al, 2010; Edison et al, 2011; Nowakowski et al, 2011). 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).…”