The treatment of reluctant speech using contingency management procedures

Williamson, Donald A.; Sewell, William R.; Sanders, Steven W.; Haney, Jack N.; White, Duncan A.

doi:10.1016/0005-7916(77)90037-4

Cited by 23 publications

(5 citation statements)

References 9 publications

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“…In previous SM research, broader definitions of SM included children who were reluctant to speak or who spoke with low frequency (e.g., Hill & Scull, 1985;Sanok & Striefel, 1979). Williamson et al (1977b) argued that a distinction should be made between reluctant and mute speaking patterns. Cline and Baldwin (1994) This document is copyrighted by the American Psychological Association or one of its allied publishers.…”

Section: Mute and Variant Talking Behaviorsmentioning

confidence: 99%

“…Laybourne (1979) made a distinction between primary and secondary forms of SM. Hill and Scull (1985), Labbe and Williamson (1984), and Williamson and colleagues (1977b) discussed children who were reluctant to speak but who did speak. Blake and Moss (1967), Sanok and Ascione (1979), and Sanok and Striefel (1979) described children who spoke with low frequency as well as children who were selectively mute.…”

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confidence: 99%

“…How often a person talks, how often a person can be heard by others, and how often a person talks spontaneously are talking behaviors that have received relatively little attention in SM research. Theoretically, issues have been raised about whether to include these variant talking behaviors under the rubric of SM (Cline & Baldwin, 1984; Labbe & Williamson, 1984; Williamson et al, 1977a; Williamson et al, 1977b). We attempt in this research to determine if variant talking behaviors accompany the SM syndrome at any point during its developmental course.…”

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confidence: 99%

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Selective mutism: Phenomenological characteristics.

Ford¹,

Sladeczek²,

Carlson³

et al. 1998

School Psychology Quarterly

108

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The purpose of this study was to gain phenomenological information about Selective Mutism (SM) in the following areas: (a) mute and variant talking patterns that occur prior to the identification of SM and/or which occur as conditions within the SM syndrome, (b) events that precipitate SM, (c) biological vulnerabilities for SM in terms of anxiety and temperament variables, (d) characteristics associated with SM, (e) other problems experienced with SM, and (f) school and social competencies. A comprehensive survey included 153 participants who had experience with SM, 135 of whom were under 18 years of age and 18 of whom were 18 years of age or older. Evidence supported three theoretical assumptions. First, results supported the existence of variant talking behaviors (talking with less frequency, volume, and spontaneity than usual), in addition to mutism, prior to the identification of SM and as part of the SM syndrome. Setting (home, school, community) affected the rate of occurrence for mute and variant talking behaviors, with these behaviors occurring primarily in the school and community settings. Second, evidence supported a link between SM and social anxiety or phobia. Participants who no longer had SM continued to experience problems conversing and discomfort in social situations. Internalized problems were significantly greater than Externalized problems on the Child Behavior Checklist (CBCL) and Youth Self-Report (YSR). Item analysis of these two scales also revealed anxiety symptoms for children with SM. Third, we found support of the notion that persons with SM may have characteristics similar to behaviorally inhibited or slow-to-warm children, suggesting a potential link between temperament and SM. As infants or toddlers, participants typically did not respond well to new stimuli. They also had difficulty handling transition or change. Implications for future research are presented.

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Section: Mute and Variant Talking Behaviorsmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Selective mutism: Phenomenological characteristics.

Ford¹,

Sladeczek²,

Carlson³

et al. 1998

School Psychology Quarterly

108

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“…Both Kratochwill 283 (1981) and Labbe and Williamson (1984) conducted comprehensive reviews of the literature, and indicated that a variety of treatment methods have been tried; also see Cline and Baldwin (1994) and Hadley (1994) for recent reviews. Behavioral treatments have included the use of stimulus fading (e.g., Conrad et al 1974, Wulbert et al 1973), contingency management (e.g., Williamson et al 1977), avoidance conditioning (e.g., Van der Kooy and Webster 1975), in vivo desensitization (e.g., Rasbury 1974), shaping procedures (e.g., Blake and Moss 1967), and modeling and self-modeling techniques (e.g., Pigott and Gonzales 1987). Though successful, these behavior therapy procedures have been questioned because of: (1) a lack of data on the maintenance or generalization of speech behavior, (2) the lack of information on spontaneous speech, and (3) their high cost and the intense use of professional time.…”

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confidence: 99%

Prevalence and Treatment of Selective Mutism in Clinical Practice: A Survey of Child and Adolescent Psychiatrists

Carlson¹,

Kratochwill²,

Johnston³

1994

Journal of Child and Adolescent Psychopharmacology

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This study investigates the use of medications by child and adolescent psychiatrists for treating selective mutism. In 1993, a one-page survey was mailed to 962 child and adolescent psychiatrists selected at random from approximately 2500 active members of the American Academy of Child and Adolescent Psychiatry. Of the 962 questionnaires sent, 411 were returned (return rate 43%) and 308 were completed (sample participation rate 32%). A prevalence estimate of selective mutism within a clinical sample was calculated to be 1 case of selective mutism per 936 new patients (0.11 %). Less than two-thirds (199/308) of the responding psychiatrists reported having treated a child with selective mutism in their practice. Of those who had treated a child with selective mutism, 36% (n = 71) reported having prescribed medication for this disorder. Antidepressants were the most frequently endorsed medication for being potentially beneficial in treating a hypothetical case example and, in addition, for being actually used by child psychiatrists in clinical practice for children diagnosed with selective mutism. Antianxiety agents were reported, at much lower rates, to be potentially useful in a hypothetical case and actually used in clinical practice for treating children with this disorder. These findings suggest that child psychiatrists may view selective mutism as being related to, having symptoms similar to, or often presenting comorbidly with depressive or anxiety disorders. However, a therapeutic program that includes pharmacotherapy was endorsed as the most effective treatment modality for selective mutism by only 14% of the reporting psychiatrists. Psychiatrists' impressions and observations cannot, even collectively, be used to make clinical inferences about the usefulness of treatments. This study did not examine treatment efficacy, since the outcomes of these open clinical trials were not judged by independent observers but were reported as observed and recollected by the clinicians involved. Moreover, these data on the treatment practices of sampled members of the American Academy of Child and Adolescent Psychiatry may not reflect the practices of other psychiatrists or pediatricians. The results indicate that child and adolescent psychiatrists are prescribing a variety of medications for selective mutism without the benefit of adequate efficacy studies. There is a significant need for further research and dissemination of information in this area.There is a paucity of research that has examined the actual or potential benefits of psychotropic medications as a treatment modality for selective mutism. Only three studies on the pharmacotherapy of

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“…As part of shaping the desired behavior, the therapist employed contingency management, which is the systematic reinforcement of desired behaviors and the withholding of reinforcement or implementing punishment for undesired behaviors. Contingency management has a long history of success in treating both “reluctant speech” and stuttering, which present similarly to SM (Ryan, 2004; Williamson, Sewell, Sanders, Haney, & White, 1977). For Max, his therapist would provide rewards (e.g., playing with a toy he liked) following a verbalization which indicated his desire for the toy; thus, his speech was consistently tied to a clear, desired positive outcome.…”

Section: Course Of Treatment and Assessment Of Progressmentioning

confidence: 99%

Selective Mutism in Early Childhood

Conn

Coyne

2014

Clinical Case Studies

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Selective mutism (SM) is a relatively uncommon disorder in childhood, occurring in only 0.3 to 1.8 children per thousand. In early childhood, diagnosing SM can be particularly challenging, and the condition often goes unrecognized until the school years. Given the potential comorbidity of anxiety and communication deficits, treatment can be challenging and attendance in early childhood educational programs allows intervention in a contextually sensitive way that may also help address comorbidities and promote generalization. Thus, this case study of an African American preschool boy highlights the unique obstacles and opportunities of assessment and treatment in a preschool setting. Furthermore, we describe a three-step behavioral approach to addressing SM in collaboration with educators over a 3-month period. Substantive research indicates that early intervention with SM is associated with decreased likelihood of developing an anxiety-related disorder later in childhood; therefore, tailored assessment and intervention in early childhood within a community-based setting may be extremely useful. Keywords selective mutism, early childhood, early intervention, behavioral management 1 Theoretical and Research Basis for Treatment Selective mutism (SM) is a disorder marked by the consistent failure to speak in certain social settings (e.g., school), while there is presence of speech in others (e.g., home). SM is considered relatively rare with prevalence estimated at between 0.3 and 1.8 children per thousand among preschools and elementary schools (

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The treatment of reluctant speech using contingency management procedures

Cited by 23 publications

References 9 publications

Selective mutism: Phenomenological characteristics.

Selective mutism: Phenomenological characteristics.

Prevalence and Treatment of Selective Mutism in Clinical Practice: A Survey of Child and Adolescent Psychiatrists

Selective Mutism in Early Childhood

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