When silence is not gold; how to best help children with selective mutism (2014 –2024)

Project Team Members (OUS):
Kristin Romvig Øvergaard

Kathe Lundahl Oslo School Psychology Services; Katharina Manassis, University of Toronto, Canada

The main project goal was to increase knowledge about assessment and treatment of children with Selective mutism (SM).

SM is a serious childhood anxiety condition that most often cause great suffering and impairment, especially related to social functioning and learning. It may persist into adulthood and considered difficult to treat. This project published one of the first randomized controlled treatment studies in the world. Using a home- and school based 3-months intervention, a significant time by group interaction was found, with significantly increased speech in the treatment group. Follow-up studies one- and five years after end of treatment demonstrated that treatment gains were maintained on both teacher- and parent rated questionnaires. Older age and severity at baseline and familial SM were significant negative predictors of outcome. 

The project also completed a literature review on the effect of medication in SM, a psychometric study on the internationally used SM questionnaires, and a chapter on the assessment and treatment of SM in an international online textbook on child and adolescent psychiatry. A textbook update is planned for 2024 along with a chapter on SM in a Norwegian textbook focusing on early intervention for children with different anxiety disorders.

Publications:

Kristensen, Hanne & Ørbeck, Beate (2021). Selektiv mutisme hos barn og unge. Tidsskr Nor Laegeforen 141(17) doi: 10.4045/tidsskr.21.0354. Print Nov 23.

Kristensen, Hanne & Ørbeck, Beate (2022). Kronikk. Selektiv mutisme. Norsk Helseinformatikk 16.05.22. https://nhi.no/rettigheter-og-helsetjeneste/helsetjenesten/Kronikk-selektiv-mutisme/

Lundahl, Kathe, Ørbeck, Beate, & Kristensen, Hanne (2021). Når taushet ikke er gull, en veileder ved selektiv mutisme.: Jaren: PP-tjenestens Materiellservice. 

The Selective Mutism Questionnaire: Data from typically developing children and children with selective mutism.
Oerbeck B, Overgaard KR, Bergman RL, Pripp AH, Kristensen H.Clin Child Psychol Psychiatry. 2020 Oct;25(4):754-765. doi: 10.1177/1359104520914695. 

Kristensen H, Oerbeck B, Manassis K, (2019). Selective mutism. Chapter 11. In Kristensen, H, Aalberg, M, Compton S (eds.) Pediatric Anxiety Disorders. London: Academic Press. https://doi.org/10.1016/C2016-0-04425-X

Selective mutism (engelsk og norsk utgave). Oerbeck B, Manassis K, Overgaard KR & Kristensen H (2019). I Rey JM (ed), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions. https://iacapap.org/iacapap-textbook-of-child-and-adolescent-mental-health/

Treatment of selective mutism: a 5-year follow-up study.
Oerbeck B, Overgaard KR, Stein MB, Pripp AH, Kristensen H.Eur Child Adolesc Psychiatry. 2018 Aug;27(8):997-1009. doi: 10.1007/s00787-018-1110-7. Epub 2018 Jan 22.PMID: 29357099 

The use of medication in selective mutism: a systematic review.
Manassis K, Oerbeck B, Overgaard KR.Eur Child Adolesc Psychiatry. 2016 Jun;25(6):571-8. doi: 10.1007/s00787-015-0794-1. Epub 2015 Nov 9.PMID: 26560144 Review.

Selective mutism: follow-up study 1 year after end of treatment.
Oerbeck B, Stein MB, Pripp AH, Kristensen H.Eur Child Adolesc Psychiatry. 2015 Jul;24(7):757-66. doi: 10.1007/s00787-014-0620-1. Epub 2014 Sep 30.PMID: 25267381 

A randomized controlled trial of a home and school-based intervention for selective mutism - defocused communication and behavioural techniques.
Oerbeck B, Stein MB, Wentzel-Larsen T, Langsrud Ø, Kristensen H.Child Adolesc Ment Health. 2014 Sep;19(3):192-198. doi: 10.1111/camh.12045. Epub 2013 Oct 26.PMID: 32878377

Selective mutism: a home-and kindergarten-based intervention for children 3-5 years: a pilot study.
Oerbeck B, Johansen J, Lundahl K, Kristensen H.Clin Child Psychol Psychiatry. 2012 Jul;17(3):370-83. doi: 10.1177/1359104511415174. Epub 2011 Aug 18. PMID: 21852320