Skip to main content
SpringerLink
Log in

Behavioral and Socio-emotional Functioning in Children with Selective Mutism: A Comparison with Anxious and Typically Developing Children Across Multiple Informants

  • Published:
Journal of Abnormal Child Psychology Aims and scope Submit manuscript

Abstract

We examined differences among 158 children, 44 with selective mutism (SM; M = 8.2 years, SD = 3.4 years), 65 with mixed anxiety (MA; M = 8.9 years, SD = 3.2 years), and 49 community controls (M = 7.7 years, SD = 2.6 years) on primary caregiver, teacher, and child reports of behavioral and socio-emotional functioning. Children with SM were rated lower than controls on a range of social skills, but the SM and MA groups did not significantly differ on many of the social skills and anxiety measures. However, children with SM were rated higher than children with MA and controls on social anxiety. Findings suggest that SM may be conceptualized as an anxiety disorder, with primary deficits in social functioning and social anxiety. This interpretation supports a more specific classification of SM as an anxiety disorder for future diagnostic manuals than is currently described in the literature. The present findings also have implications for clinical practice, whereby social skills training merits inclusion in intervention for children with anxiety disorders as well as children with SM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders DSM-IV-TR. Washington: Author.

    Google Scholar 

  • Anstendig, K. D. (1999). Is selective mutism an anxiety disorder? Rethinking its DSM-IV classification. Journal of Anxiety Disorders, 13, 417–434.

    Article  PubMed  Google Scholar 

  • Bergman, R. L., Piacentini, J., & McCracken, J. T. (2002). Prevalence and description of selective mutism in a school-based sample. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 938–946.

    Article  PubMed  Google Scholar 

  • Bernstein, G. A., Bernat, D. H., Davis, A. A., & Layne, A. E. (2008). Symptom presentation and classroom functioning in a nonclinical sample of children with social phobia. Depression and Anxiety, 25, 752–760.

    Article  PubMed  Google Scholar 

  • Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., et al. (1997). The screen for child anxiety related emotional disorders (SCARED): Scale construction and psychometric characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 545–553.

    Article  PubMed  Google Scholar 

  • Black, B., & Uhde, T. W. (1992). Elective mutism as a variant of social phobia. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 1090–1094.

    Article  PubMed  Google Scholar 

  • Black, B., & Uhde, T. W. (1995). Psychiatric characteristics of children with selective mutism: A pilot study. Journal of the American Academy of Child & Adolescent Psychiatry, 34, 847–856.

    Article  Google Scholar 

  • Brown, J., & Llyod, H. (1975). A controlled study of not speaking in school. Journal of the Association of Workers for Maladjusted Children, 3, 49–63.

    Google Scholar 

  • Clarizio, H. (1994). Assessment of depression in children and adolescents by parents, teachers and peers. In W. Reynolds & H. Johnston (Eds.), Handbook of depression in children and adolescents (pp. 235–248). New York: Plenum Press.

    Google Scholar 

  • Cohan, S. L., Chavira, D. A., & Stein, M. B. (2006). Practitioner review: Psychosocial interventions for children with selective mutism: A critical evaluation of the literature from 1990–2005. Journal of Child Psychology and Psychiatry, 47, 1085–1097.

    Article  PubMed  Google Scholar 

  • Cohan, S. L., Price, J. M., & Stein, M. B. (2006). Suffering in silence: Why a developmental psychopathology perspective on selective mutism is needed. Journal of Developmental and Behavioral Pediatrics, 27, 341–355.

    Article  PubMed  Google Scholar 

  • Comer, J. S., & Kendall, P. C. (2004). A symptom-level examination of parent-child agreement in the diagnosis of anxious youths. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 878–886.

    Article  PubMed  Google Scholar 

  • Cunningham, C. E., McHolm, A. E., & Boyle, M. H. (2006). Social phobia, anxiety, oppositional behavior, social skills, and self-concept in children with specific selective mutism, generalized selective mutism, and community controls. European Child & Adolescent Psychiatry, 15, 245–255.

    Article  Google Scholar 

  • Cunningham, C. E., McHolm, A., Boyle, M. H., & Patel, S. (2004). Behavioral and emotional adjustment, family functioning, academic performance, and social relationships in children with selective mutism. Journal of Child Psychology and Psychiatry, 45, 1363–1372.

    Article  PubMed  Google Scholar 

  • Dummit, E. S., Klein, R. G., Tancer, N. K., & Asche, B. (1997). Systematic assessment of 50 children with selective mutism. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 653–660.

    Article  PubMed  Google Scholar 

  • Elizur, Y., & Perednik, R. (2003). Prevalence and description of selective mutism in immigrant and native families: A controlled study. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 1451–1459.

    Article  PubMed  Google Scholar 

  • Enders, C. K. (2006). A primer on the use of modern missing-data methods in Psychosomatic medicine research. Psychosomatic Medicine, 68, 427–736.

    Article  PubMed  Google Scholar 

  • Ford, M. A., Sladeczek, I. E., Carlson, J., & Kratochwill, T. R. (1998). Selective mutism: Phenomenological characteristics. School Psychology Quarterly, 12, 192–227.

    Article  Google Scholar 

  • Garcia, A. M., Freeman, J. B., Francis, G., Miller, L. M., & Leonard, H. L. (2004). Selective mutism. New York: Oxford University Press.

    Google Scholar 

  • Giddan, J. J., Ross, G. J., Sechler, L. L., & Becker, B. R. (1997). Selective mutism in elementary school: Multidisciplinary interventions. Language, Speech, and Hearing Services in Schools, 28, 127–133.

    Google Scholar 

  • Gresham, F. M., & Elliot, S. N. (1990). Social skills rating system. Circle Pines: American Guidance Service.

    Google Scholar 

  • Hirshfeld-Becker, D. R., Biederman, J., Henin, A., Faraone, S. V., Davis, S., Harrington, K., et al. (2007). Behavioral inhibition in preschool children at risk is a specific predictor of middle childhood social anxiety: A five-year follow-up. Journal of Developmental and Behavioral Pediatrics, 28, 225–233.

    Article  PubMed  Google Scholar 

  • Kolvin, I., & Fundudis, T. (1981). Elective mute children: Psychological development and background factors. Journal of Child Psychology and Psychiatry, 22, 219–232.

    Article  PubMed  Google Scholar 

  • Kopp, S., & Gillberg, C. (1997). Selective mutism: A population-based study: A research note. Journal of Child Psychology and Psychiatry, 38, 257–262.

    Article  PubMed  Google Scholar 

  • Kristensen, H. (2000). Selective mutism and comorbidity with developmental disorder/delay, anxiety disorder, and elimination disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 249–256.

    Article  PubMed  Google Scholar 

  • Kristensen, H., & Torgersen, S. (2002). A case-control study of EAS child and parental temperaments in selectively mute children with and without a co-morbid communication disorder. Nordic Journal of Psychiatry, 56, 347–353.

    Article  PubMed  Google Scholar 

  • Kumpulainen, K. (2002). Phenomenology and treatment of selective mutism. CNS Drugs, 16, 175–180.

    Article  PubMed  Google Scholar 

  • Kumpulainen, K., Räsänen, E., Raaska, H., & Somppi, V. (1998). Selective mutism among second-graders in elementary school. European Child & Adolescent Psychiatry, 7, 24–29.

    Article  Google Scholar 

  • Mclnnes, A., & Manassis, K. (2005). When silence is not golden: An integrated approach to selective mutism. Seminars in Speech and Language, 26, 201–210.

    Article  Google Scholar 

  • Nowakowski, M. E., Cunningham, C. C., McHolm, A. E., Evans, M. A., Edison, S., St. Pierre, J., et al. (2009). Language and academic abilities in children with selective mutism. Infant and Child Development, 18, 271–290.

    Article  Google Scholar 

  • Remschmidt, H., Poller, M., Herpertz-Dahlmann, B., Hennighausen, K., & Gutenbrunner, C. (2001). A follow-up study of 45 patients with elective mutism. European Archives of Psychiatry and Clinical Neuroscience, 251, 284–296.

    Article  PubMed  Google Scholar 

  • Schniering, C. A., Hudson, J. L., & Rapee, R. M. (2000). Issues in the diagnosis and assessment of anxiety disorders in children and adolescents. Clinical Psychology Review, 20, 453–478.

    Article  PubMed  Google Scholar 

  • Shaffer, D., Fisher, P., Lucas, C. P., Dulcan, M. K., & Schwab-Stone, M. E. (2000). NIMH diagnostic interview schedule for children version IV (NIMH DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 28–38.

    Article  PubMed  Google Scholar 

  • Sharp, W. G., Sherman, C., & Gross, A. M. (2007). Selective mutism and anxiety: A review of the current conceptualization of the disorder. Journal of Anxiety Disorders, 21, 568–579.

    Article  PubMed  Google Scholar 

  • Standart, S., & Le Couteur, A. (2003). The quiet child: A literature review of selective mutism. Child and Adolescent Mental Health, 8, 154–160.

    Article  Google Scholar 

  • Steinhausen, H., & Juzi, C. (1996). Elective mutism: An analysis of 100 cases. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 606–614.

    Article  PubMed  Google Scholar 

  • Vecchio, J. L., & Kearney, C. A. (2005). Selective mutism in children: Comparison to youths with and without anxiety disorders. Journal of Psychopathology and Behavioral Assessment, 27, 31–37.

    Article  Google Scholar 

  • Voncken, M. J., Alden, L. E., Bögels, S. M., & Roelofs, J. (2008). Social rejection in social anxiety disorder: The role of performance deficits, evoked negative emotions and dissimilarity. British Journal of Clinical Psychology, 47, 439–450.

    Article  PubMed  Google Scholar 

  • Yeganeh, R., Beidel, D. C., & Turner, S. M. (2006). Selective mutism: More than social anxiety? Depression and Anxiety, 23, 117–123.

    Article  Google Scholar 

  • Yeganeh, R., Beidel, D. C., Turner, S. M., Pina, A. A., & Silverman, W. K. (2003). Clinical distinctions between selective mutism and social phobia: An investigation of childhood psychopathology. Journal of the American Academy of Child and Adolescent Psychiatry, 42, 1069–1075.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This research was supported by a grant from the Ontario Mental Health Foundation (OMHF) and the Jack Laidlaw Chair in Patient-Centred Health Care. The authors would like to thank Lindsay Bennett, Sue McKee, Renee Nossal, Matilda Nowakowski, and Jamie Sawyer for their assistance with data collection. We would also like to thank the many children, their primary caregivers and teachers for their participation in the study.

Author information

Authors and Affiliations

  1. McMaster Integrative Neuroscience, Discovery, & Study (MiNDS), McMaster University, Hamilton, ON, Canada

    Diana Carbone & Louis A. Schmidt

  2. Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, ON, L8S 4K1, Canada

    Louis A. Schmidt

  3. Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada

    Charles C. Cunningham, Angela E. McHolm, Shannon Edison & Michael H. Boyle

  4. Child and Parent Resource Institute (CPRI), London, ON, Canada

    Jeff St. Pierre

Authors
  1. Diana Carbone
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Louis A. Schmidt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Charles C. Cunningham
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Angela E. McHolm
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shannon Edison
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jeff St. Pierre
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michael H. Boyle
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Louis A. Schmidt.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Carbone, D., Schmidt, L.A., Cunningham, C.C. et al. Behavioral and Socio-emotional Functioning in Children with Selective Mutism: A Comparison with Anxious and Typically Developing Children Across Multiple Informants. J Abnorm Child Psychol 38, 1057–1067 (2010). https://doi.org/10.1007/s10802-010-9425-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10802-010-9425-y

Keywords

Search

Navigation