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Intensive group behavioral treatment (IGBT) for children with selective mutism: A preliminary randomized clinical
Danielle Cornacchio1, Jami M Furr1, Amanda L Sanchez1
1Center for Children and Families, Mental Health Interventions and Technology (MINT) Program, Department of Psychology, Florida International University.
Insights
Intensive group behavioral treatment (IGBT) shows promise for childhood selective mutism (SM), with significant improvements in social anxiety and functioning. Many children no longer met diagnostic criteria after treatment, indicating its effectiveness.
Area of Science:
- Child Psychology
- Behavioral Therapy
- Clinical Trials
Background:
- Childhood selective mutism (SM) lacks sufficient evidence-based treatment options.
- Controlled trials evaluating targeted interventions for SM are scarce.
Purpose of the Study:
- To evaluate the efficacy and acceptability of an intensive group behavioral treatment (IGBT) for children with selective mutism.
- This is the first controlled trial to assess IGBT for SM.
Main Methods:
- Twenty-nine children (5-9 years) with SM were randomized to either immediate 5-day IGBT or a 4-week waitlist with psychoeducational resources.
- Assessments were conducted at Week 4 and 8 weeks into the subsequent school year.
Main Results:
- The immediate IGBT group showed high satisfaction and low perceived barriers.
- At Week 4, 50% of the IGBT group and 0% of the waitlist group were clinical responders.
- Significant improvements were observed in social anxiety, social verbal behavior, and global functioning post-treatment and at follow-up.
Conclusions:
- Intensive group behavioral treatment (IGBT) is the first empirically supported treatment for selective mutism (SM).
- Further research is needed to explore treatment mechanisms and optimize formats for affected children.
Objective:
Very few controlled trials have evaluated targeted treatment methods for childhood selective mutism (SM); the availability of evidence-based services remains limited. This study is the first controlled trial to evaluate an intensive group behavioral treatment (IGBT) for children with SM.
Method:
Twenty-nine children with SM (5-9 years; 76% female; 35% ethnic minority) were randomized to immediate SM 5-day IGBT or to a 4-week waitlist with psychoeducational resources (WLP), and were assessed at Week 4 and again 8 weeks into the following school year.
Results:
IGBT was associated with high satisfaction and low perceived barriers to treatment participation. At Week 4, 50% of the immediate IGBT condition and 0% of the WLP condition were classified as "clinical responders." Further, Time × Condition interactions were significant for social anxiety severity, verbal behavior in social situations, and global functioning (but not for SM severity, verbal behavior in home settings, or overall anxiety). School-year follow-up assessments revealed significant improvements across all outcomes. Eight weeks into the following school year, 46% of IGBT-treated children were free of an SM diagnosis. In addition, teachers in the post-IGBT school year rated less school impairment and more classroom verbal behavior relative to teachers in the pre-IGBT school year.
Conclusions:
Findings provide the first empirical support for the efficacy and acceptability of IGBT for SM. Further study is needed to examine mechanisms of IGBT response, and other effective SM treatment methods, in order to clarify which treatment formats work best for which affected children. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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