Elective mutism: fixation and the double bind

Family Relationships in Selective Mutism—A Comparison Group Study of Children and Adolescents

Selective mutism (SM) mostly develops early in childhood and this has led to interest into whether there could be differences in relationships in families with SM compared to a control group without SM. Currently, there are merely few empirical studies examining family relationships in SM. A sample of 28 children and adolescents with SM was compared to 33 controls without SM. The groups were investigated using self-report questionnaires (Selective Mutism Questionnaire, Child-Parent Relationship Test—Child Version) for the assessment of SM and family relationships. Children with SM did not report a significantly different relationship to their mothers compared with the control group without SM. However, the scores in respect to the relationship to their fathers were significantly lower in cohesion, identification and autonomy compared with children without SM. Relationships in families with SM should be considered more in therapy.

Innovative Analyses and Interventions in the Treatment of Selective Mutism

The authors present a successful, 25-session, multidimensional intervention for the treatment of selectivemutismin a 6-year-old male with a 1-year observational follow-up. They also include an evaluative review of the extant literature of the treatment of selective mutism from 1950 to the present. Their assessment approach utilized behavioral, cognitive, systems, and psychodynamic components. Treatment efficacy was assessed through videotaped observation of behavioral time-samples of the client during therapeutic interaction, self-report, parental report, and real-time behavioral observations at school. Results indicated a significant increase in verbal behaviors during therapy sessions, paired t(17) = 2.31, p= .033. In addition, the client was observed to be verbally interacting with peers and teachers at school at 1-year follow-up. These results suggest that the authors’ multidimensional approach to the treatment of selectivemutismmay offer a successful, brief intervention for those families in which parents decline use of pharmacotherapy in a child.

Kiddie-Infant Descriptive Instrument for Emotional States (KIDIES): use in children with developmental disorders

The Kiddie-Infant Descriptive Instrument for Emotional States (KIDIES) was used to overcome the limitations of microanalytic facial observations and subjective assessments in the diagnosis of childhood developmental disorders. The KIDIES quantifies eight behavioral and eight affective dimensions by evaluating facial, vocal, gestural, and postural displays. In a sample of 42 subjects, KIDIES ratings distinguished between children with pervasive developmental disorder and a comparison group with mixed developmental diagnoses, and demonstrated sensitivity to emotional changes as a result of environmental shift. The results suggest that the KIDIES has potential as a reliable instrument for evaluating emotional and behavioral patterns in young developmentally disordered children.