Integrated Behavior Therapy for Selective Mutism: A randomized controlled pilot study
Section snippets
Participants
Participants were recruited from a pediatric anxiety specialty clinic, mental health practitioner referrals, and postings on internet websites focused on selective mutism. Children were eligible for inclusion if they were ages 4–8 years, inclusive, at baseline and met.
DSM-IV criteria for a primary diagnosis of selective mutism (SM). Because a goal of this intervention was to integrate treatment within a functional context, children were required to be attending school or some other form of
Data analytic plan
Prior to analyses, data were screened to test statistical assumptions (e.g., normality). Standardized z-scores on all continuous data were examined, and a criterion of z ≥ ± 3.0 was used to identify outliers. One child had a z-score of z = 4.56 on the SNAP at baseline and was therefore not included in analyses of the SNAP. Simple between-group comparisons were conducted using χ2 tests for categorical measures and t-tests for continuous measures. Treatment effects were analyzed using 2 (Group:
Discussion
To our knowledge, this study represents the first randomized trial to provide empirical support for the feasibility, acceptability, and preliminary efficacy of a behavioral treatment adapted to the needs of children with SM. Parents and teachers reported high levels of satisfaction with the 24-week treatment, and all children assigned to Integrated Behavioral Therapy for SM (IBTSM) completed the intervention. Evaluation of treatment efficacy was promising; IBTSM resulted in increased functional
Acknowledgments
This study was supported by grant R34MH70938-01 from the National Institute of Mental health. The authors wish to thank Lisa O'Malley, MA, school assessment coordinator for her helpful input and support of the teachers involved in the study, and the therapists, interviewers, and research coordinators who were part of the study team. Special appreciation is extended to the children and families who participated in this research. Lastly, we would like to thank the teachers of the children who
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