title: The sounds of silence: language, cognition, and anxiety in selective mutism.
abstract: OBJECTIVE
  To determine whether oral language, working memory, and social anxiety differentiate children with selective mutism (SM), children with anxiety disorders (ANX), and normal controls (NCs) and explore predictors of mutism severity.
  
  
  METHODS
  Children ages 6 to 10 years with SM (n = 44) were compared with children with ANX (n = 28) and NCs (n = 19) of similar age on standardized measures of language, nonverbal working memory, and social anxiety. Variables correlating with mutism severity were entered in stepwise regressions to determine predictors of mute behavior in SM.
  
  
  RESULTS
  Children with SM scored significantly lower on standardized language measures than children with ANX and NCs and showed greater visual memory deficits and social anxiety relative to these two groups. Age and receptive grammar ability predicted less severe mutism, whereas social anxiety predicted more severe mutism. These factors accounted for 38% of the variance in mutism severity.
  
  
  CONCLUSIONS
  Social anxiety and language deficits are evident in SM, may predict mutism severity, and should be evaluated in clinical assessment. Replication is indicated, as are further studies of cognition and of intervention in SM, using large, diverse samples.
authors: Drs. Manassis and Tannock are with The Hospital for Sick Children and the University of Toronto; Drs. Garland and Clark are with the University of British Columbia, Vancouver; Dr. Minde is with McGill University, Montreal; and Dr. McInnes is with the University of Windsor, Windsor, Ontario, Canada.. Electronic address: katharina.manassis@sickkids.ca.
authors: Katharina
authors: K
authors: Manassis
authors: Drs. Manassis and Tannock are with The Hospital for Sick Children and the University of Toronto; Drs. Garland and Clark are with the University of British Columbia, Vancouver; Dr. Minde is with McGill University, Montreal; and Dr. McInnes is with the University of Windsor, Windsor, Ontario, Canada.
authors: Rosemary
authors: R
authors: Tannock
authors: Drs. Manassis and Tannock are with The Hospital for Sick Children and the University of Toronto; Drs. Garland and Clark are with the University of British Columbia, Vancouver; Dr. Minde is with McGill University, Montreal; and Dr. McInnes is with the University of Windsor, Windsor, Ontario, Canada.
authors: E Jane
authors: EJ
authors: Garland
authors: Drs. Manassis and Tannock are with The Hospital for Sick Children and the University of Toronto; Drs. Garland and Clark are with the University of British Columbia, Vancouver; Dr. Minde is with McGill University, Montreal; and Dr. McInnes is with the University of Windsor, Windsor, Ontario, Canada.
authors: Klaus
authors: K
authors: Minde
authors: Drs. Manassis and Tannock are with The Hospital for Sick Children and the University of Toronto; Drs. Garland and Clark are with the University of British Columbia, Vancouver; Dr. Minde is with McGill University, Montreal; and Dr. McInnes is with the University of Windsor, Windsor, Ontario, Canada.
authors: Alison
authors: A
authors: McINNES
authors: Drs. Manassis and Tannock are with The Hospital for Sick Children and the University of Toronto; Drs. Garland and Clark are with the University of British Columbia, Vancouver; Dr. Minde is with McGill University, Montreal; and Dr. McInnes is with the University of Windsor, Windsor, Ontario, Canada.
authors: Sandra
authors: S
authors: Clark
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007806:Language Disorders / Q000175:diagnosis / Q000453:epidemiology*; D007807:Language Tests; D008297:Male; D009155:Mutism / Q000453:epidemiology* / Q000523:psychology*; D009483:Neuropsychological Tests; D012720:Severity of Illness Index