The outcome of children with selective mutism following cognitive behavioral intervention: a follow-up study.
Selective mutism (SM) is a relatively rare childhood disorder and is underdiagnosed and undertreated. The purpose of the retrospective naturalistic study was to examine the long-term outcome of children with SM who were treated with specifically designed modular cognitive behavioral therapy (MCBT). Parents of 36 children who met diagnostic criteria of SM that received MCBT treatment were invited for a follow-up evaluation. Parents were interviewed using structured scales and completed questionnaires regarding the child, including the Selective Mutism Questionnaire (SMQ). Twenty-four subjects were identified and evaluated. Their mean age ± SD of onset of SM symptoms, beginning of treatment, and age at follow-up were 3.4 ± 1.4, 6.4 ± 3.1, and 9.3 ± 3.4 years, respectively. There was robust improvement from beginning of treatment to follow-up evaluation in SM, social anxiety disorder, and specific phobia symptoms. The recovery rate from SM was 84.2 %.


CONCLUSIONS
SM-focused MCBT is feasible in children and possibly effective in inducing long-term reduction of SM and comorbid anxiety symptoms.


BACKGROUND
• There are limited empirical data on selective mutism (SM) treatment outcome and specifically on cognitive-behavioral therapy, with the majority of studies being uncontrolled case reports of 1 to 2 cases each. • There is also limited data on the long-term outcome of children with SM following treatment. What is New: • Modular cognitive behavioral treatment is a feasible and possibly effective treatment for SM. Intervention at a younger age is more effective comparing to an older age. • Treatment for SM also decreases the rate of psychiatric comorbidities, including separation anxiety disorder and specific phobia.
The Anxiety Clinic at the Child Psychiatry Unit, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, 52621, Israel.
Claudia
C
Lang
The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Ziv
Z
Nir
The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Ayelet
A
Gothelf
The Anxiety Clinic at the Child Psychiatry Unit, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, 52621, Israel.|The Interdisciplinary Center, Herzliya, Israel.
Shoshi
S
Domachevsky
The Psychology Department, Boston University, Boston, MA, USA.
Lee
L
Ginton
The Anxiety Clinic at the Child Psychiatry Unit, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, 52621, Israel.|The Interdisciplinary Center, Herzliya, Israel.
Jonathan
J
Kushnir
The Anxiety Clinic at the Child Psychiatry Unit, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, 52621, Israel. gothelf@post.tau.ac.il.|The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. gothelf@post.tau.ac.il.
Doron
D
Gothelf
D000293:Adolescent; D001007:Anxiety / Q000150:complications / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009155:Mutism / Q000523:psychology / Q000628:therapy*; D010290:Parents; D010698:Phobic Disorders / Q000150:complications / Q000628:therapy*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
Anxiety; CBT; Comorbidity; Outcome; Prognosis; Selective mutism questionnaire