Efficacy of psychological interventions for selective mutism in children: A meta-analysis of randomized controlled trials

Child Care Health Dev. 2021 Nov;47(6):771-781. doi: 10.1111/cch.12895. Epub 2021 Jul 29.

Abstract

Background: Selective mutism is a rare childhood anxiety disorder characterized by a consistent failure to speak in certain social situations where speech is expected, despite fluent speech in other situations. The purpose of this meta-analysis was to investigate the efficacy of psychological interventions for selective mutism in randomized controlled trials (RCTs).

Methods: Five RCTs with a total of 233 participants were analysed using a random-effects model. A quality assessment of the included studies revealed that psychometrically sound measures and treatment manuals were used across all studies.

Results: The results of the analyses showed psychological interventions to be more effective than no treatment, with the overall weighted effect size of g = 0.87, indicating a large mean treatment effect. This effect did not significantly differ with whether only selective mutism specific or nonselective mutism specific measures were included in the analysis.

Conclusions: These findings provide support for the efficacy of psychological treatment for selective mutism. Future research could examine the effects of the successful treatments identified in this meta-analysis when compared with a psychological placebo or another bona fide treatment.

Keywords: child anxiety; efficacy; meta-analysis; selective mutism; treatment.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Anxiety Disorders / therapy
  • Child
  • Child Behavior Disorders*
  • Humans
  • Mutism* / therapy
  • Psychosocial Intervention
  • Randomized Controlled Trials as Topic