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Integrated Behavior Therapy for Exclusively Anxious Selective Mutism: A Nonconcurrent Multiple-Baseline Design across
Allison K Siroky1, John S Carlson2, Aimee Kotrba3
1Nationwide Children's Hospital Big Lots Behavioral Health Services, Columbus, OH 43215, USA.
Pediatric Reports
|October 24, 2023
Summary
This study found that a 16-session Integrated Behavior Therapy for Selective Mutism (IBTSM) showed excellent adherence and caregiver acceptance. While not all children met full remission, many demonstrated significant improvements in social anxiety and speaking behaviors, with 60% no longer meeting SM criteria.
Area of Science:
- Child psychology
- Anxiety disorders
- Behavioral therapy
Background:
- Selective mutism (SM) is a rare childhood anxiety disorder impacting academic and social functioning.
- Cognitive-behavioral treatments are effective for SM, but manualized approaches by novice clinicians require further study.
Purpose of the Study:
- To examine the adherence, effectiveness, and acceptability of a condensed, 16-session Integrated Behavior Therapy for Selective Mutism (IBTSM).
- To evaluate the first manualized treatment for SM in a clinical setting.
Main Methods:
- A nonconcurrent multiple-baseline single-case design was employed with five children diagnosed with the exclusively anxious subtype of SM.
- IBTSM was implemented, and weekly caregiver ratings of social anxiety and speaking behaviors were collected.
Main Results:
- IBTSM demonstrated excellent adherence (98%) and was rated as acceptable by all caregivers.
- While visual analyses did not show a replicated intervention effect, Tau-U and RCI indicated significant individual improvements in social anxiety and speaking behaviors.
- Sixty percent (three out of five) of children no longer met diagnostic criteria for SM post-treatment.
Conclusions:
- The condensed IBTSM is a feasible and acceptable treatment for selective mutism in children.
- The treatment shows promise for improving social anxiety and speaking behaviors, leading to diagnostic remission in a majority of participants.
- Further research on manualized treatments for SM by novice clinicians is warranted.
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