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Pediatric selective mutism therapy: a randomized controlled trial
Maria Esposito1, Francesca Gimigliano2, Maria R Barillari3
1Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy.
Insights
Psychomotor treatment significantly reduced anxiety and improved social interactions in children with selective mutism (SM). This therapy offers a safe and effective approach for pediatric SM rehabilitation.
Area of Science:
- Pediatric Psychiatry
- Child Psychology
- Developmental Neuroscience
Background:
- Selective mutism (SM) is a rare childhood anxiety disorder with significant functional impairment.
- Current treatment options for SM are limited, highlighting the need for effective interventions.
Purpose of the Study:
- To evaluate the efficacy of a six-month standard psychomotor treatment for children with SM.
- To assess associated lifestyle changes and their impact on SM symptoms.
Main Methods:
- A randomized controlled trial involving 138 children with SM was conducted.
- Participants received either psychomotor treatment or behavioral/educational counseling for six months.
- Child Behavior Checklist (CBCL) and Selective Mutism Questionnaire (SMQ) were used for assessments.
Main Results:
- Psychomotor treatment led to significant reductions in CBCL scores for social relations, anxiety/depression, and overall problems.
- SMQ assessments showed a significant decrease in SM symptoms across school, family, and social settings.
- Improvements were observed in withdrawn behavior and internalizing problems.
Conclusions:
- Psychomotor treatment demonstrates a positive effect as part of a rehabilitative program for children with selective mutism.
- This study identifies psychomotricity as a safe and effective therapy for pediatric SM.
- Further research is warranted to confirm these preliminary findings.
Background:
Selective mutism (SM) is a rare disease in children coded by DSM-5 as an anxiety disorder. Despite the disabling nature of the disease, there is still no specific treatment.
Aim:
The aims of this study were to verify the efficacy of six-month standard psychomotor treatment and the positive changes in lifestyle, in a population of children affected by SM.
Design:
Randomized controlled trial registered in the European Clinical Trials Registry (EuDract 2015-001161-36).
Setting:
University third level Centre (Child and Adolescent Neuropsychiatry Clinic).
Population:
Study population was composed by 67 children in group A (psychomotricity treatment) (35 M, mean age 7.84±1.15) and 71 children in group B (behavioral and educational counseling) (37 M, mean age 7.75±1.36).
Methods:
Psychomotor treatment was administered by trained child therapists in residential settings three times per week. Each child was treated for the whole period by the same therapist and all the therapists shared the same protocol. The standard psychomotor session length is of 45 minutes. At T0 and after 6 months (T1) of treatments, patients underwent a behavioral and SM severity assessment. To verify the effects of the psychomotor management, the Child Behavior Checklist questionnaire (CBCL) and Selective Mutism Questionnaire (SMQ) were administered to the parents.
Results:
After 6 months of psychomotor treatment SM children showed a significant reduction among CBCL scores such as in social relations, anxious/depressed, social problems and total problems (P<0.001), Withdrawn (P=0.007) and Internalizing problems (P=0.020). Regarding SM severity according to SMQ assessment, children of group A showed a reduction of SM symptoms in all situations (school, P=0.003; family, P=0.018; and social, P=0.030 situations) and in SMQ total score (P<0.001).
Conclusions:
Our preliminary results suggest the positive effect of the psychomotor treatment in rehabilitative program for children affected by selective mutism, even if further studies are needed.
Clinical Rehabilitation Impact:
The present study identifies in psychomotricity a safe and efficacy therapy for pediatric selective mutism.
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