Innovation of diagnostics and treatment of selective mutism: towards personalized care

Selective mutism is an anxiety disorder that is characterized the consistent absence of speaking in situations where it is expected (e.g. in school), while the child can speak freely in other environments (e.g. at home). Selective mutism usually occurs in young children. As there is no evidence based treatment nor a validated diagnostical instrument, this study aims to investigate the effectiveness of an innovative treatment protocol for selective mutism and to validate the Dutch translation of the Selective Mutism Questionnaire.

Selective mutism is an anxiety disorder that occurs mostly in young children. Selective mutism is characterizes by consisted failure to speak in various specific social situations, in which the child is expected to speak (e.g. at school), whereas the child can speak in other situations (e.g. at home). Selective mutism is usually identified between the ages of 3-5 years and cannot be attributed to a language or speaking disorder. There is no evidence based treatment protocol nor psychometrically sound diagnostical tool for selective mutism available, the aim of this study is to investigate the effectiveness of an innovative treatment protocol and to validate the authorized Dutch translation of the Selective Mutism Questionnaire.

The outcomes are assessed at baseline during intake, 12 weeks after baseline (either after the first 12 weeks of treatment or after the waiting list period of 12 weeks) and at the end of treatment.

Symptoms of selective mutism are assessed with the Selective Mutism Questionnaire and the Selective Mutism chapter of the ADIS-C clinical interview.

Anxiety and mood symptoms are assessed with the ADIS-C clinical interview.

Additional psychopathology in the child is assessed with the Child Behavior Checklist, the Teacher Report form and depending on age, the Youth Self Report.

The self-image is assessed depending on age with the Self-Perception Profile for Children/Adolescents.

The quality of life is assessed with the Child Health Questionnaire.

The previous care consumption is assessed during intake.

The intervention that is being investigated is behavioral therapy following the treatment protocol ‘Speaking in school, a matter of doing’ Wippo & Güldner, 2003). The intervention is investigated by the use of a randomized controlled trial. Participants will be randomized to either direct treatment or a waiting list control group.