The behavioral treatment of elective mutism: Two case studies

Williamson, Donald A.; Sanders, Steve H.; Sewell, William R.; Haney, Jack N.; White, Duncan A.

doi:10.1016/0005-7916(77)90036-2

Cited by 13 publications

(8 citation statements)

References 9 publications

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“…Therefore, when this condition existed for a study, all data points across treatment phases were used to calculate the treatment mean. For example, in the Williamson, Sanders, Sewell, Haney, and White study (1977), a combination of behavioral interventions were used such as shaping/modeling, escape, positive reinforcement, and stimulus fading. The same outcome variable, the percent of prompted verbal responses, was measured across phases.If treatment was generalized to different settings (e.g., begins in clinic, then generalized to school or home) or different people (e.g., begins with parent, then generalized to teacher or peer), an effect size was calculated for each setting or person for which the same outcome variable was measured (e.g., Cunningham, Cataldo, Mallion & Keyes, 1984; Sanok & Striefel, 1979).…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of selective mutism: A best-evidence synthesis.

Stone¹,

Kratochwill²,

Sladezcek³

et al. 2002

School Psychology Quarterly

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A major goal of treatment of children with selective mutism has been to help them speak in situations to people with whom they did not previously speak. A systematic analysis examining the effectiveness of treatment models, assessed by treatment outcomes (e.g., speaking) and methodological quality of the studies, has not been conducted on the existing selective mutism literature. Further, most treatment outcome studies have utilized case studies or single-case designs, which, until recently, were more difficult to examine systematically (e.g., meta-analysis). Thus, this study represents the first systematic analysis of the major treatment approaches used for selective mutism with the goal of drawing conclusions about selecting evidence-based procedures for practice. Based on nonparametric statistical tests of effect sizes, the major findings include the following: (a) treatment of selective mutism is more effective than no treatment, (b) behaviorally oriented treatment approaches are more effective than no treatment, and (c) no differential effectiveness was found between two common models of behavior therapy (i.e., applied behavior analysis and combined behavioral approaches). In addition, researchers have given minimal attention to the impact of selective mutism on educational performance. In this study, which reviewed existing research, information regarding academic achievement was evaluated qualitatively. Recommendations are made for improving the methodologi-168

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Treatment of selective mutism: A best-evidence synthesis.

Stone¹,

Kratochwill²,

Sladezcek³

et al. 2002

School Psychology Quarterly

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show abstract

“…This finding is consistent with Hill and Scull (1985), who concluded that eliminating nonverbal responding is necessary for increasing verbal behavior. Williamson, Sanders, Sewell, Haney, and White (1977) used two procedures, escape and reinforcement sampling, to elicit speech in an elective mute. The escape procedure with positive reinforcement did not, in this case, produce generalizable speech.…”

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confidence: 99%

Multimethod behavioral treatment of long-term selective mutism

Watson

Kramer

1992

Psychol. Schs.

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This single-subject, experimental research design examined the efficacy of treating severe, long-term selective mutism in a 9-year-old male using shaping, multiple reinforcers, natural consequences, stimulus fading, and mild aversives. Different treatment regimens were implemented in the home and school environments. A multiple baseline design across settings with changing criterion was used to evaluate the home intervention, and an A-B-A design was used for the school intervention. The home intervention resulted in an increase in the number of verbalizations in each setting and prompted generalization to additional settings. The school intervention increased the number of people spoken to, but the results were not maintained at follow-up nor did they generalize outside of the training situation. Possible explanations for the discrepancy in maintenance and generalization data between the two programs are presented.

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“…Stimuli from the "safe" environment are gradually faded out as stimuli from the more threatening situations are gradually faded in (Labbe & Williamson, 1984; Richards & Hansen, 1978). Assuming that the child is not speaking in the school environment, therapists employing stimulus fading will often begin treatment either in the home environment with the mother present (Conrad et al, 1974; Richards & Hansen, 1978), at a clinic (Reid et al, 1967; Williamson et al, 1977; Wulbert et al, 1973), or in a "safe" location within the school (Lipton, 1980; Rosenbaum & Kellman, 1973). Aspects of the classroom environment (e.g., teacher, classmates, environmental cues) are then gradually introduced with the expectation that the child will produce the desired verbal behavior for each new stimulus before moving to a more difficult stimulus.…”

Section: Treatment Techniquesmentioning

confidence: 99%

“…In an attempt to shorten the duration and cost of treatment, some have attempted to combine two or more approaches to enhance the impact of the intervention. As suggested by Williamson et al (1977), multiple strategies may be necessary because "it is difficult to find the single procedure which will produce the initial verbal response in the nonverbal environment" (Williamson et al, 1977, p. 143).…”

mentioning

confidence: 99%

Combining self-modeling and stimulus fading in the treatment of an electively mute child.

Holmbeck¹,

Lavigne²

1992

Psychotherapy: Theory, Research, Practice, Training

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The purpose of this article is to report on the combined application of two treatment approaches that have proven effective in past case studies, namely, stimulus fading and self-modeling. More specifically, each successful stage of the stimulus fading procedure was videotaped and shown to the electively mute child prior to each subsequent stage of fading treatment. A 6-year, 4month-old Filipino female who had not spoken in IV2 years of school, began speaking in clinic and school settings after seven clinical sessions involving the fading and modeling procedure and four school consultation visits.The essential feature of elective mutism is the "persistent refusal to talk in one or more major social situations (including at school)" (DSM-HI-R, American Psychiatric Association, 1987, p. 89) in a child who has the ability to speak and comprehend spoken language. Although not included in the diagnostic criteria of the DSM-I1I-R, other personality and familial characteristics have also been identified: excessive shyness, anxiety, social isolation and withdrawal, maternal overprotection, a symbiotic relationship with a parent (usually the mother), language difficulties, early hospitalization or trauma, marital disharmony, fear of strangers, depression, and a manipulative,

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The behavioral treatment of elective mutism: Two case studies

Cited by 13 publications

References 9 publications

Treatment of selective mutism: A best-evidence synthesis.

Treatment of selective mutism: A best-evidence synthesis.

Multimethod behavioral treatment of long-term selective mutism

Combining self-modeling and stimulus fading in the treatment of an electively mute child.

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