Social Communication Anxiety Treatment (S-CAT) for children and families with selective mutism: A pilot study

Abstract

This research assessed the feasibility of Social Communication Anxiety Treatment (S-CAT) developed by Elisa Shipon-Blum, a brief multimodal approach, to increase social communication in 40 children aged 5-12 years with selective mutism (SM). SM is a disorder in which children consistently fail to speak in specific situations although they have the ability to do so. Key features of this approach are the SM-Social Communication Comfort Scale (SCCS), transfer of control (ToC), a nonchalant therapeutic style, and cognitive-behavioral strategies over a brief time frame. Following 9 weeks of treatment, children showed significant gains in speaking frequency on all 17 items from the Selective Mutism Questionnaire (SMQ), a standardized measure of SM severity. Children also showed decreased levels of anxiety and withdrawal as reported by parents on the Child Behavior Checklist (CBCL). SM initial symptom severity and family therapy compliance, but not duration of SM, contributed to treatment outcomes.

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

“…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).…”

Treatment of selective mutism: a 5-year follow-up study

“…The elements of our treatment are quite similar to previous controlled [26] and uncontrolled [27, 28] treatment studies for children with SM. 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.…”

“…In general, girls have comprised the majority in recent clinical samples treated for SM [28, 33]. However, a more even gender ratio is also found [27, 33] but whether gender has a predictive value upon treatment outcome, has, as far as we know not been studied.…”

“…In 2017, a pilot study examined the outcome of another multimodal approach (the Social Communication Anxiety Treatment; S-CAT) in 33 of 40 children with SM [ 28 ]. They were treated at mean age 6 years for mean 9 weeks by one therapist at a private specialty practice for SM.…”

Behandlungsmethoden des selektiven Mutismus

“…Es wird immer wieder zur Diskussion gestellt, ob der selektive Mutismus heilbar oder nur überwindbar sei. Neuere Studien weisen auf die Therapierbarkeit des selektiven Mutismus [8,9]. In einer Metaanalyse von Studien zum Langzeitverlauf [5] zeigen 74 % der Behandelten eine komplette Remission oder aber massive Verbesserung der Symptomatik.…”