Selective Mutism
Conditions
Keywords
Selective mutism, Children, Treatment
Brief summary
The purpose of this pilot study is to explore the outcome of a manual based treatment for children with Selective Mutism
Detailed description
Objectives: The main aim of this pilot study is to increase our knowledge on interventions for Selective Mutism (SM), a childhood condition characterized by a persistent lack of speech in specific situations despite the ability to comprehend and use language. A survey on the treatment offered this group in Norway 1997-2000 showed great variations in therapeutic approach and the overall outcome was poor. Correspondent with the notion of SM as a variant of social anxiety, several case studies have described successful treatments using behaviour techniques (BT's) such as stimulus fading and shaping. In addition, the author's clinical experience is that defocusing in communication (e.g. regulation of gaze contact; sitting beside instead of in front of the child, avoiding direct questioning, talking about interesting but impersonal topics) represents another important toil in getting the mute child to start talking. However, to date there are no randomized controlled SM treatment studies, and in fact we know little of what works best to help these children. Our research group has developed an assessment- and treatment manual for children with SM. In this exploring pilot study referred children with SM aged 3-5 years (n=7) will be given an intervention according to the treatment manual. The intervention is conducted at home and in the kindergarten or at school and includes stimulus fading techniques with weekly sessions. Therapists will be members of the research group or local therapist under supervision.
Interventions
BEHAVIORALInterventions at home, in the kindergarten/school
Weekly interventions including behavior techniques (stimulus fading)
Sponsors
Ullevaal University Hospital
Regionsenter for barn og unges psykiske helse
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
3 Years to 9 Years
Healthy volunteers
No
Inclusion criteria
* Children with a clinical diagnosis of Selective Mutism (SM)
Exclusion criteria
* Children with Mental Retardation (IQ\<50) * Children with Pervasive Developmental Disorder (PDD) * Children with SM in active treatment * Children with SM on medication * Children whose parents are non-Norwegian speaking
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| School Speech Questionnaire (SSQ) | 6 months | SSQ is a teacher-report measure assessing the frequency of the child's speaking behaviour at school. It is a 9-item questionnaire. Each item has four possible responses, ranging 0 (never), 1 (seldom), 2 (often) and 3 (always). The standard sum score is added up from the six questions (as defined by its author Lindsey Bergman) and then divided by 6 to make up a corresponding factor score ranging from 0-3.(worst value=0 and best value=3) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Children Who Obtained the Different Treatment Modules (Level of Speaking;Level 1 Through to 6) | 6 months | 6 Predefined treatment goals reflecting speaking levels from 1 through to 6. 1: Speaks to the therapist(T) in a separate room in the kindergarten with parent (P) present. 2: Speaks to T in a separate room without P. 3: Speaks to a teacher in a separate room with T present. 4: Speaks to other teachers in a separate room with T present. 5: Speaks to teachers in some kindergarten settings without T present. 6: Speaks to teachers in all settings in kindergarten without T present. Each child receives one score at end of treatment according to their acquired level (worst value=1, best value =6) |
Countries
Norway
Participant flow
Recruitment details
November, 2007 to July, 2008.Location: medical clinic
Participants by arm
| Arm | Count |
|---|---|
| Behavioral All participants received identical behavioral treatment with no control group. | 7 |
| Total | 7 |
Baseline characteristics
| Characteristic | Behavioral |
|---|---|
| Age, Categorical <=18 years | 7 Participants |
| Age, Categorical >=65 years | 0 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants |
| Age Continuous | 4.30 years STANDARD_DEVIATION 0.75 |
| Region of Enrollment Norway | 7 participants |
| School speech questionnaire (SSQ) | 0.59 units on a scale STANDARD_DEVIATION 0.51 |
| Sex: Female, Male Female | 5 Participants |
| Sex: Female, Male Male | 2 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 0 / 7 |
| serious Total, serious adverse events | 0 / 7 |
Outcome results
Primary
School Speech Questionnaire (SSQ)
SSQ is a teacher-report measure assessing the frequency of the child's speaking behaviour at school. It is a 9-item questionnaire. Each item has four possible responses, ranging 0 (never), 1 (seldom), 2 (often) and 3 (always). The standard sum score is added up from the six questions (as defined by its author Lindsey Bergman) and then divided by 6 to make up a corresponding factor score ranging from 0-3.(worst value=0 and best value=3)
Time frame: 6 months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Behavioral | School Speech Questionnaire (SSQ) | 2.68 Units on a scale | Standard Deviation 0.35 |
p-value: <0.00195% CI: [1.69, 2.49]paired t-test
Secondary
Number of Children Who Obtained the Different Treatment Modules (Level of Speaking;Level 1 Through to 6)
6 Predefined treatment goals reflecting speaking levels from 1 through to 6. 1: Speaks to the therapist(T) in a separate room in the kindergarten with parent (P) present. 2: Speaks to T in a separate room without P. 3: Speaks to a teacher in a separate room with T present. 4: Speaks to other teachers in a separate room with T present. 5: Speaks to teachers in some kindergarten settings without T present. 6: Speaks to teachers in all settings in kindergarten without T present. Each child receives one score at end of treatment according to their acquired level (worst value=1, best value =6)
Time frame: 6 months
Population: All participants analyzed
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Behavioral | Number of Children Who Obtained the Different Treatment Modules (Level of Speaking;Level 1 Through to 6) | Level 6 | 6 participants |
| Behavioral | Number of Children Who Obtained the Different Treatment Modules (Level of Speaking;Level 1 Through to 6) | Level 5 | 1 participants |
| Behavioral | Number of Children Who Obtained the Different Treatment Modules (Level of Speaking;Level 1 Through to 6) | Level 4 | 0 participants |
| Behavioral | Number of Children Who Obtained the Different Treatment Modules (Level of Speaking;Level 1 Through to 6) | Level 3 | 0 participants |
| Behavioral | Number of Children Who Obtained the Different Treatment Modules (Level of Speaking;Level 1 Through to 6) | Level 2 | 0 participants |
| Behavioral | Number of Children Who Obtained the Different Treatment Modules (Level of Speaking;Level 1 Through to 6) | Level 1 | 0 participants |